Antibody therapies and methods for treating coronavirus infection
Described herein are methods of treating COVID19 from a coronavirus infection, methods of treating a subject having a coronavirus infection, methods of improving a survival rate of a subject having a coronavirus infection, methods of determining prognosis of a subject having a coronavirus infection, methods of preventing or treating organ-dysfunction or multi-organ dysfunction or failure associated with a coronavirus infection, methods of combinational therapy for a subject having a coronavirus infection, methods of reducing microthrombi formation or low flow organ-ischemia associated with a coronavirus infection by administering a DEspR inhibitor.
1. A method of treating a coronavirus infection in a subject,
the method comprising administering a therapeutically effective amount of a Dual Endothelin/VEGF signal peptide Receptor (DEspR) inhibitor to the subject;
wherein the DEspR inhibitor is an anti-DEspR antibody reagent or antigen-binding fragment thereof, capable of specifically binding DEspR.
2. The method of claim 1 , wherein the subject is determined to have an elevated level of DEspR+CD11b+ cells as compared to a non-infected subject.
3. The method of claim 2 , wherein the DEspR+CD11b+ cells are DEspR+CD11b+ neutrophils, DEspR+CD11b+ monocytes, DEspR+CD11b+ lymphocytes, DEspR+CD11b+ cytoplasts, or DEspR+ DNA strands, or a combination of any of the foregoing.
4. The method of claim 1 , wherein the administering is effective to treat COVID19 disease manifestations and complications beyond the coronavirus infectivity status in the subject.
5. The method of claim 1 , wherein the coronavirus is SARS CoV2 causing COVID-19.
6. The method of claim 1 , wherein the subject is further determined to have i) an elevated DEspR+ neutrophil to lymphocyte ratio (d+NLR); ii) an elevated ratio of DEspR+ neutrophils to COVID19-associated (a) hyperinflammation cytokines or cytokine storm biomarkers, (b) oxidative stress biomarkers, (c) endothelial dysfunction biomarkers, or (d) a combination of any of (a), (b), and (c); or iii) a combination of i) or ii).
7. The method of claim 6 , wherein the hyperinflammation cytokines or cytokine storm biomarkers comprise IL-6, IL-8, IL-1β, or IL-18, or a combination thereof.
8. The method of claim 6 , wherein the oxidative stress biomarkers comprise myeloperoxidase (MPO).
9. The method of claim 6 , wherein the endothelial dysfunction biomarkers comprise endothelin-1 (ET1).
10. The method of claim 1 , wherein the anti-DEspR antibody reagent or fragment thereof comprises 6 complementary determining regions selected from:
a) SEQ ID NOs: 1-3 and 9-11,
b) SEQ ID NOs: 1-3 and 17-19,
c) SEQ ID NOs: 5-7 and 13-15,
d) SEQ ID NOs: 21-23 and 25-27, and
e) SEQ ID NOs: 29-31 and 33-35.
11. The method of claim 1 , wherein the subject has or is diagnosed as having acute respiratory distress syndrome (ARDS).
12. A method of treating a subject having a coronavirus infection in a subject in need thereof, the method comprising administering a Dual Endothelin/VEGF signal peptide Receptor (DEspR) inhibitor to a subject determined to have:
i) an elevated level or rising level of DEspR+CD11b+ cells, or
ii) an elevated level of non-resolving neutrophil-monocyte inflammatory amplification that blocks initiation of next step anti-viral adaptive immunity, anti-viral cellular immunity, resolution, or a combination thereof, measured as:
(1) DEspR+CD11b+ cells,
(2) a level of hyperinflammation-response marked by elevated ratio DEspR+CD11b+ neutrophils to plasma cytokine storm biomarkers,
(3) a level of hyperinflammation-response marked by elevated ratio DEspR+CD11b+ neutrophils to plasma oxidative stress biomarkers,
(4) a level of hyperinflammation-response marked by elevated ratio DEspR+CD11b+ neutrophils to endothelial dysfunction biomarkers, or
(5) a combination of any of (1), (2), (3), or (4);
in a sample obtained from the subject,
wherein an elevated level is elevated as compared to the level in a control subject not having a coronavirus infection; and
wherein the DEspR inhibitor is an anti-DEspR antibody reagent or antigen-binding fragment thereof.
13. The method of claim 12 , wherein the DEspR+CD11b+ cells are DEspR+CD11b+ neutrophils, DEspR+CD11b+ monocytes, DEspR+CD11b+ lymphocytes, DEspR+CD11b+ cytoplasts, or a combination thereof.
14. The method of claim 12 , wherein the level of DEspR+CD11b+ cells is detected by measuring a level of DEspR+CD11b+ aggregates or DEspR+ DNA strands in a blood sample.
15. The method of claim 12 , wherein an elevated or rising level of DEspR+CD11b+ cells in the subject indicates the subject will require intensive care.
16. The method of claim 12 , wherein the subject has or is diagnosed as having acute respiratory distress syndrome (ARDS).
17. A method of treating organ-dysfunction or multi-organ dysfunction or multi-organ failure associated with a coronavirus infection in a subject in need thereof, the method comprising administering a therapeutically effective amount of a Dual Endothelin/VEGF signal peptide Receptor (DEspR) inhibitor to the subject;
wherein the DEspR inhibitor is an anti-DEspR antibody reagent or antigen-binding fragment thereof.
18. The method of claim 17 , subject is a subject determined to have elevated or rising levels of DEspR+CD11b+ cells, elevated hyperinflammation DEspR+ neutrophil-IL6/MPO/ET1 ratios, or a combination thereof, as compared to a control subject.
19. The method of claim 17 , wherein the DEspR+CD11b+ cells are DEspR+CD11b+ neutrophils, DEspR+CD11b+ monocytes, DEspR+CD11b+ lymphocytes, DEspR+CD11b+ cytoplasts, or a combination thereof.
20. The method of claim 17 , wherein the organ-dysfunction or multi-organ dysfunction or multi-organ failure associated with the coronavirus infection arises from microcirculatory dysfunction, microvascular inclusion, low flow ischemia, thromboses, systemic microthromboses, microcirculatory vascular aggregation, or a combination thereof.
21. The method of claim 17 , wherein the organ-dysfunction or multi-organ dysfunction or multi-organ failure associated with the coronavirus infection is derived from COVID19-induced cytokine storm, low flow organ ischemia from DEspR+CD11b+ aggregates leading to characteristic COVID19-hypoxemia, renal dysfunction, cardiac ischemia, neurological dysfunction from low flow ischemia or delayed cerebral ischemia or neuroinflammation, liver dysfunction/failure, hematological coagulopathy or microthromboses, or a combination thereof.
22. The method of claim 21 , wherein the neurological dysfunction is characterized by loss of consciousness, seizures, confusion, or a combination thereof.
23. The method of claim 17 , wherein the organ-dysfunction or multi-organ dysfunction or multi-organ failure associated with the coronavirus infection is selected from the group consisting of systemic inflammatory response syndrome (SIRS); acute lung injury (ALI); acute respiratory distress syndrome (ARDS); multi-organ failure or multi-organ dysfunction syndrome (MODS); acute kidney injury (AKI); liver failure, ischemic stroke; delayed cerebral ischemia, and/or encephalopathy.
24. The method of claim 17 , wherein the organ-dysfunction or multi-organ dysfunction or multi-organ failure associated with the coronavirus infection is ARDS.
25. The method of claim 17 , wherein the subject has or is diagnosed as having acute respiratory distress syndrome (ARDS).
26. A method of combinational therapy for a subject having a coronavirus infection, the method comprising administering to the subject a therapeutic agent or a therapy in combination with a Dual Endothelin/VEGF signal peptide Receptor (DEspR) inhibitor, wherein the therapeutic agent or the therapy alleviates a sign or a symptom associated with the coronavirus infection in the subject; and
wherein the DEspR inhibitor is an anti-DEspR antibody reagent or antigen-binding fragment thereof.
27. The method of claim 26 , wherein the therapy is an application of a respiratory ventilation or an alternative delivery system for supplemental oxygen.
28. The method of claim 26 , wherein the subject has or is diagnosed as having acute respiratory distress syndrome (ARDS).