In recent years the global market for monoclonal antibodies (mAbs) became a multi-billion-dollar business. This success is mainly driven by treatments in the oncology and autoimmune space. Instead, development of effective mAbs against infectious diseases has been lagging behind. For years the high production cost and limited efficacy have blocked broader application of mAbs in the infectious disease space, which instead has been dominated for almost a century by effective and cheap antibiotics and vaccines. Only very few mAbs against RSV, anthrax, Clostridium difficile or rabies have reached the market. This is about to change. The development of urgently needed and highly effective mAbs as preventive and therapeutic treatments against a variety of pathogens is gaining traction. Vast advances in mAb isolation, engineering and production have entirely shifted the cost-efficacy balance. MAbs against devastating diseases like Ebola, HIV and other complex pathogens are now within reach. This trend is further accelerated by ongoing or imminent health crises like COVID-19 and antimicrobial resistance (AMR), where antibodies could be the last resort. In this review we will retrace the history of antibodies from the times of serum therapy to modern mAbs and lay out how the current run for effective treatments against COVID-19 will lead to a quantum leap in scientific, technological and health care system innovation around mAb treatments for infectious diseases.

近年来，单克隆抗体 (mAb) 的全球市场已成为一个价值数十亿美元的市场。这一成功主要得益于肿瘤学和自身免疫领域的治疗。相反，针对传染病的有效单克隆抗体的开发一直滞后。多年来，高昂的生产成本和有限的功效阻碍了单克隆抗体在传染病领域的更广泛应用，近一个世纪以来，该领域一直由有效且廉价的抗生素和疫苗主导。只有极少数针对 RSV、炭疽、艰难梭菌或狂犬病的单克隆抗体已进入市场。这种情况即将改变。开发急需且高效的单克隆抗体作为针对多种病原体的预防和治疗方法正在获得越来越多的关注。单克隆抗体分离、工程和生产方面的巨大进步彻底改变了成本效益平衡。针对埃博拉、艾滋病毒和其他复杂病原体等毁灭性疾病的单克隆抗体现在已经触手可及。 COVID-19 和抗菌素耐药性 (AMR) 等持续或迫在眉睫的健康危机进一步加速了这一趋势，而抗体可能是最后的手段。在这篇综述中，我们将追溯从血清疗法时代到现代单克隆抗体的抗体历史，并阐述当前针对 COVID-19 的有效治疗方法将如何导致围绕单克隆抗体的科学、技术和医疗保健系统创新的巨大飞跃传染病的治疗。