Antibody-dependent enhancement (ADE) or “immune enhancement” of viral entry has been observed for many viruses and is a major concern for vaccine development and antibody-based drug therapies.
ADE occurs when antibodies from a previous infection or vaccination facilitate viral entry into host cells and enhance viral infection in these cells. In other words, ADE is a process in which a virus leverages antibodies to aid infection. Therefore, the presence of specific antibodies can be beneficial to the virus.
As mentioned above, this phenomenon has been reported in vitro and in vivo for viruses representing numerous families and genera of public health and veterinary importance, most notably flaviviruses such as Dengue virus and alpha- and betacoronaviruses, including SARS-CoV-1 and MERS-CoV. As a consequence, this phenomenon has become a great concern to disease control by vaccination and numerous approaches have been made to the development of vaccines with minimum or no risk for ADE.
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