Antibody dependent disease enhancement (ADE) after COVID-19 vaccination and beta glucans as a safer strategy in management. Issue 15 (6th April 2023) - Ikewaki, Nobunao
Graphical abstract: Highlights: Antibody dependent disease enhancement (ADE) after vaccination has been reported in animal and clinical studies earlier. Abnormal macrophages induced by the vaccines has been suggested as the key underlying mechanism. We recommend a safer strategy of employing biological response modifier beta glucans as vaccine adjuvants for COVID-19, The beta-glucans are capable of eliciting a beneficial immune response without triggering abnormal macrophage effector functions. Abstract: A potential risk associated with vaccines for COVID-19 is antibody-dependent disease enhancement (ADE) in which vaccine induced antibody mediated immune responses may lead to enhanced SARS CoV- 2 acquisition or increased disease severity. Though ADE has not been clinically demonstrated with any of the COVID-19 vaccines so far, when neutralizing antibodies are suboptimal, the severity of COVID-19 has been reported to be greater. ADE is presumed to occur via abnormal macrophages induced by the vaccine based immune response by antibody-mediated virus uptake into Fc gamma receptor IIa (FcγRIIa) or by the formation of Fc-mediated excessive antibody effector functions. Beta-glucans which are naturally occurring polysaccharides known for unique immunomodulation by capability to interact with macrophages, eliciting a specific beneficial immune-response and enhancing all arms of the immune system, importantly without over-activation are suggested as safer nutritional supplement-based vaccine adjuvants for COVID-19.