Development and structural basis of a two-MAb cocktail for treating SARS-CoV-2 infections

用于治疗 SARS-CoV-2 感染的双单克隆抗体混合物的开发和结构基础

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作者:Chao Zhang, Yifan Wang, Yuanfei Zhu, Caixuan Liu, Chenjian Gu, Shiqi Xu, Yalei Wang, Yu Zhou, Yanxing Wang, Wenyu Han, Xiaoyu Hong, Yong Yang, Xueyang Zhang, Tingfeng Wang, Cong Xu, Qin Hong, Shutian Wang, Qiaoyu Zhao, Weihua Qiao, Jinkai Zang, Liangliang Kong, Fangfang Wang, Haikun Wang, Di Qu, Dim

Abstract

The ongoing pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neutralizing antibodies against SARS-CoV-2 are an option for drug development for treating COVID-19. Here, we report the identification and characterization of two groups of mouse neutralizing monoclonal antibodies (MAbs) targeting the receptor-binding domain (RBD) on the SARS-CoV-2 spike (S) protein. MAbs 2H2 and 3C1, representing the two antibody groups, respectively, bind distinct epitopes and are compatible in formulating a noncompeting antibody cocktail. A humanized version of the 2H2/3C1 cocktail is found to potently neutralize authentic SARS-CoV-2 infection in vitro with half inhibitory concentration (IC50) of 12 ng/mL and effectively treat SARS-CoV-2-infected mice even when administered at as late as 24 h post-infection. We determine an ensemble of cryo-EM structures of 2H2 or 3C1 Fab in complex with the S trimer up to 3.8 Å resolution, revealing the conformational space of the antigen-antibody complexes and MAb-triggered stepwise allosteric rearrangements of the S trimer, delineating a previously uncharacterized dynamic process of coordinated binding of neutralizing antibodies to the trimeric S protein. Our findings provide important information for the development of MAb-based drugs for preventing and treating SARS-CoV-2 infections.

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