Cited by 370SARS-CoV-2 and COVID-19 ResearchMonoclonal and Polyclonal Antibodies ResearchCOVID-19 Clinical Research Studies

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Human neutralizing antibodies against SARS-CoV-2 require intact Fc effector functions for optimal therapeutic protection

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Winkler, Emma S., Gilchuk, Pavlo, Yu, Jinsheng, Bailey, Adam L., Chen, Rita E., Chong, Zhenlu, Zost, Seth J., Jang, Hyesun, Huang, Ying, Allen, James D., Case, James Brett, Sutton, Rachel E., Carnahan, Robert H., Darling, Tamarand L., Boon, Adrianus C.M., Mack, Matthias, Head, Richard D., Ross, Ted M., Crowe, James E., Diamond, Michael S.·2021·Cell

DOI 10.1016/j.cell.2021.02.026PMC PMC7879018

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Abstract

SARS-CoV-2 has caused the global COVID-19 pandemic. Although passively delivered neutralizing antibodies against SARS-CoV-2 show promise in clinical trials, their mechanism of action in vivo is incompletely understood. Here, we define correlates of protection of neutralizing human monoclonal antibodies (mAbs) in SARS-CoV-2-infected animals. Whereas Fc effector functions are dispensable when representative neutralizing mAbs are administered as prophylaxis, they are required for optimal protection as therapy. When given after infection, intact mAbs reduce SARS-CoV-2 burden and lung disease in mice and hamsters better than loss-of-function Fc variant mAbs. Fc engagement of neutralizing antibodies mitigates inflammation and improves respiratory mechanics, and transcriptional profiling suggests these phenotypes are associated with diminished innate immune signaling and preserved tissue repair. Immune cell depletions establish that neutralizing mAbs require monocytes and CD8+ T cells for optimal clinical and virological benefit. Thus, potently neutralizing mAbs utilize Fc effector functions during therapy to mitigate lung infection and disease.

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Authors: Winkler, E. S., Gilchuk, P., Yu, J., Bailey, A. L., Chen, R. E., Chong, Z., Zost, S. J., Jang, H., Huang, Y., Allen, J. D., Case, J. B., Sutton, R. E., Carnahan, R. H., Darling, T. L., Boon, A. C. M., Mack, M., Head, R. D., Ross, T. M., Crowe, J. E., & Diamond, M. S.
Affiliations: Washington University in St. Louis (US)
Vanderbilt University Medical Center (US)
University of Georgia (US)
University Hospital Regensburg (DE)
Corresponding author: Crowe, James E.
Diamond, Michael S.
ORCID: Winkler, Emma S.
Gilchuk, Pavlo
Yu, Jinsheng
Bailey, Adam L.
Chen, Rita E.
Chong, Zhenlu
Zost, Seth J.
Jang, Hyesun
Huang, Ying
Allen, James D.
Case, James Brett
Carnahan, Robert H.
Darling, Tamarand L.
Boon, Adrianus C.M.
Mack, Matthias
Head, Richard D.
Ross, Ted M.
Crowe, James E.
Diamond, Michael S.
Venue: Cell
Publisher: Elsevier BV
Published: 2021-04
Volume: 184
Issue: 7
Pages: 1804-1820.e16
ISSN: 0092-8674 (ISSN-L)
DOI: 10.1016/j.cell.2021.02.026
PMC: PMC7879018
OpenAlex: W3132982761
Cited by: 366
References: 101
Citations by year: 2026: 13 · 2025: 34 · 2024: 40 · 2023: 69 · 2022: 99 · 2021: 109
FWCI: 25.26
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 365 d)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Cell (publishedVersion)
bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
PubMed Central (submittedVersion)
University of Regensburg Publication Server (University of Regensburg) (submittedVersion)
Funders: NIAID
Topics: Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Life Sciences › Immunology and Microbiology › Immunology › Monoclonal and Polyclonal Antibodies Research
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords: SARS-CoV-2, neutralizing monoclonal antibodies, Fc effector functions, passive immunotherapy, COVID-19 pandemic, pulmonary infection, monocytes, CD8+ T cells, innate immune signaling, tissue repair, inflammation, correlates of protection

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Human neutralizing antibodies against SARS-CoV-2 require intact Fc effector functions for optimal therapeutic protection

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