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Direct enhancement of viral neutralising antibody potency by the complement system: a largely forgotten phenomenon

Abstract:
Neutralisation assays are commonly used to assess vaccine-induced and naturally acquired immune responses; identify correlates of protection; and inform important decisions on the screening, development, and use of therapeutic antibodies. Neutralisation assays are useful tools that provide the gold standard for measuring the potency of neutralising antibodies, but they are not without limitations. Common methods such as the heat-inactivation of plasma samples prior to neutralisation assays, or the use of anticoagulants such as EDTA for blood collection, can inactivate the complement system. Even in non-heat-inactivated samples, the levels of complement activity can vary between samples. This can significantly impact the conclusions regarding neutralising antibody potency. Restoration of the complement system in these samples can be achieved using an exogenous source of plasma with preserved complement activity or with purified complement proteins. This can significantly enhance the neutralisation titres for some antibodies depending on characteristics such as antibody isotype and the epitope they bind, enable neutralisation with otherwise non-neutralising antibodies, and demonstrate a better relationship between in vitro and in vivo findings. In this review, we discuss the evidence for complement-mediated enhancement of antibody neutralisation against a range of viruses, explore the potential mechanisms which underpin this enhancement, highlight current gaps in the literature, and provide a brief summary of considerations for adopting this approach in future research applications.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s00018-023-05074-2

Authors

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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0001-7761-8341
More by this author
Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-7026-7187


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Funder identifier:
10.13039/100000038
Grant:
75F40120C00085


Publisher:
Springer
Journal:
Cellular and Molecular Life Sciences More from this journal
Volume:
81
Issue:
1
Pages:
22-22
Article number:
22
Publication date:
2024-01-11
DOI:
EISSN:
1420-9071
ISSN:
1420-682X


Language:
English
Keywords:
Pubs id:
1601684
Local pid:
pubs:1601684
Source identifiers:
W4390745322
Deposit date:
2026-06-05
ARK identifier:
This ORA record was generated from metadata provided by an external service. It has not been edited by the ORA Team.

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