Beyond neutralization: Fc-dependent antibody effector functions in SARS-CoV-2 infection

Nat Rev Immunol. 2023 Jun;23(6):381-396. doi: 10.1038/s41577-022-00813-1. Epub 2022 Dec 19.

Abstract

Neutralizing antibodies are known to have a crucial role in protecting against SARS-CoV-2 infection and have been suggested to be a useful correlate of protection for vaccine clinical trials and for population-level surveys. In addition to neutralizing virus directly, antibodies can also engage immune effectors through their Fc domains, including Fc receptor-expressing immune cells and complement. The outcome of these interactions depends on a range of factors, including antibody isotype-Fc receptor combinations, Fc receptor-bearing cell types and antibody post-translational modifications. A growing body of evidence has shown roles for these Fc-dependent antibody effector functions in determining the outcome of SARS-CoV-2 infection. However, measuring these functions is more complicated than assays that measure antibody binding and virus neutralization. Here, we examine recent data illuminating the roles of Fc-dependent antibody effector functions in the context of SARS-CoV-2 infection, and we discuss the implications of these data for the development of next-generation SARS-CoV-2 vaccines and therapeutics.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Immunoglobulin Fc Fragments
  • Receptors, Fc
  • SARS-CoV-2

Substances

  • COVID-19 Vaccines
  • Antibodies, Viral
  • Antibodies, Neutralizing
  • Immunoglobulin Fc Fragments
  • Receptors, Fc