Monoclonal antibody for COVID-19: Unveiling the recipe of a new cocktail

The coronavirus disease 2019(COVID-19)pandemic has had a tremendous adverse impact on the global health system,public sector,and social aspects.It is unarguably the worst pandemic of the century.However,COVID-19 management is a mystery in front of us,and an authentic treatment is urgently needed.Various repurposed drugs,like ivermectin,remdesivir,tocilizumab,baricitinib,etc.,have been used to treat COVID-19,but none are promising.Antibody therapy and their combinations are emerging modalities for treating moderate COVID-19,and they have shown the potential to reduce hospitalisations.One antibody monotherapy,bamlanivimab,and two cocktails,casirivimab/imdevimab and bamlanivimab/esterivimab,have received authorization for emergency use by the United States Food and Drug Administration for the treatment of mild COVID-19 in high risk individuals.The European Emergency has made similar recommendations for use of the drug in COVID-19 patients without oxygen therapy.This brief review will focus on monoclonal antibodies and their combination cocktail therapy in managing COVID-19 infection.

Pseudomonas fluorescens-like bacteria from the stomach:A microbiological and molecular study

AIM:To characterize oxidase-and urease-producing bacterial isolates,grown aerobically,that originated from antral biopsies of patients suffering from acid peptic diseases.METHODS:A total of 258 antral biopsy specimens were subjected to isolation of bacteria followed by tests for oxidase and urease production,acid tolerance and aerobic growth.The selected isolates were further characterized by molecular techniques viz.amplifications for 16S rRNA using universal eubacterial and HSP60 gene specific primers.The amplicons were subjected to restriction analysis and partial sequencing.A phylogenetic tree was generated using unweighted pair group method with arithmetic mean(UPGMA) from evolutionary distance computed with bootstrap test of phylogeny.Assessment of acidity tolerance of bacteria isolated from antrum was performed using hydrochloric acid from 10-7 mol/L to 10-1 mol/L.RESULTS:Of the 258 antral biopsy specimens collected from patients,179(69.4%) were positive for urease production by rapid urease test and 31%(80/258) yielded typical Helicobacter pylori(H.pylori) after 5-7 d of incubation under a microaerophilic environment.A total of 240(93%) antral biopsies yielded homogeneous semi-translucent and small colonies after overnight incubation.The partial 16S rRNA sequences revealed that the isolates had 99% similarity with Pseudomonas species.A phylogenetic tree on the basis of 16S rRNA sequences denoted that JQ927226 and JQ927227 were likely to be related to Pseudomonas fluorescens(P.fluorescens).On the basis ofHSP60 sequences applied to the UPGMA phylogenetic tree,it was observed that isolated strains in an aerobic environment were likely to be P.fluorescens,and HSP60 sequences had more discriminatory potential rather than 16S rRNA sequences.Interestingly,this bacterium was acid tolerant for hours at low pH.Further,a total of 250(96.9%) genomic DNA samples of 258 biopsy specimens and DNA from 240 bacterial isolates were positive for the 613 bp amplicons by targeting P.fluorescens-specific conserved putative outer membrane protein gene sequences.CONCLUSION:This study indicates that bacterial isolates from antral biopsies grown aerobically were P.fluorescens,and thus acid-tolerant bacteria other than H.pylori can also colonize the stomach and may be implicated in pathogenesis/protection.

Use of hydroxychloroquine and azithromycin combination to treat the COVID-19 infection

Coronavirus disease 2019(COVID-19)infection is unequivocally the worst crisis in recent decades,which is caused by a severe acute respiratory virus 2.Currently,there is no effective therapy for the COVID-19 infection.Different countries have different guidelines for treating COVID-19 in the absence of an approved therapy for COVID-19.Therefore,there is an imminent need to identify effective treatments,and several clinical trials have been conducted worldwide.Both hydroxychloroquine[HCQS],chloroquine,and azithromycin(AZ)have been widely used for management based on in vitro studies favoring antiviral effects against the COVID-19 virus.However,there is evidence both in favor and against the use of hydroxychloroquine and azithromycin(HCQS+AZ)combination therapy to manage the COVID-19 infection.The combination of hydroxychloroquine and azithromycin was significantly associated with increased adverse events.However,the inference of these findings was from observational studies.Therefore,large randomized trials are imperative to show the future path for the use of HCQS+AZ combination therapy.However,owing to the ban on HCQS use in COVID-19,this may no longer be essential.This review is on the pharmacology,trials,regimens,and side effects of hydroxychloroquine and azithromycin combination therapy.