PreprintCited by 251

SARS-CoV-2 escape in vitro from a highly neutralizing COVID-19 convalescent plasma

Andreano, Emanuele, Piccini, Giulia, Licastro, Danilo, Casalino, Lorenzo, Johnson, Nicole V., Paciello, Ida, Monego, Simeone Dal, Pantano, Elisa +10 more·2020

Preprint — published as 10.1073/pnas.2103154118

Abstract

To investigate the evolution of SARS-CoV-2 in the immune population, we co-incubated authentic virus with a highly neutralizing plasma from a COVID-19 convalescent patient. The plasma fully neutralized the virus for 7 passages, but after 45 days, the deletion of F140 in the spike N-terminal domain (NTD) N3 loop led to partial breakthrough. At day 73, an E484K substitution in the receptor-binding domain (RBD) occurred, followed at day 80 by an insertion in the NTD N5 loop containing a new glycan sequon, which generated a variant completely resistant to plasma neutralization. Computational modeling predicts that the deletion and insertion in loops N3 and N5 prevent binding of neutralizing antibodies. The recent emergence in the United Kingdom and South Africa of natural variants with similar changes suggests that SARS-CoV-2 has the potential to escape an effective immune response and that vaccines and antibodies able to control emerging variants should be developed. One Sentence Summary: Three mutations allowed SARS-CoV-2 to evade the polyclonal antibody response of a highly neutralizing COVID-19 convalescent plasma.

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Crossref · 10.1101/2020.12.28.424451

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  • Nine of the 17 strongest antibodies lost at least ten-fold potency against pseudoviruses with E484K.

    “As seen in natural infection, a majority of the antibodies tested (9/17) were at least ten-fold less effective against pseudotyped viruses carrying the E484K mutation7,12,29.”
  • Neutralizing human mAbs against SARS-CoV-2 RBD fall into four classes according to their RBD target regions.

    “Human neutralizing monoclonal antibodies to the SARS-CoV-2 RBD can be categorized as belonging to 4 different classes based on their target regions on the RBD29.”
  • Antibody-spike complexes bound RBD in several orientations, either up/down or only up, matching classes defined structurally in natural infection.

    “Fab-S complexes exhibited multiple RBD-binding orientations recognizing either ‘up’/‘down’ (Fig 4a–j) or solely ‘up’ (Fig 4k–n) RBD conformations, consistent with structurally defined antibody classes from natural infection (Fig 4o)29.”
  • Class 1 antibodies are resisted by A475V; class 2 by E484K and Q493R; class 3 by R346S, N439K, and N440K.

    “A475V is resistant to class 1 antibodies (structurally defined as described29); E484K and Q493R are resistant to class 2 antibodies7,8,12,13,29,30,32,33; while R346S, N439K, and N440K are resistant to class 3 antibodies7,8,12,13,29,33.”
  • Their epitopes overlap or lie near RBD positions K417, E484, and N501.

    “These antibodies target epitopes that overlap or are closely associated with RBD residues K417, E484 and N501.”

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Authors
Andreano, E., Piccini, G., Licastro, D., Casalino, L., Johnson, N. V., Paciello, I., Monego, S. D., Pantano, E., Manganaro, N., Manenti, A., Manna, R., Casa, E., Hyseni, I., Benincasa, L., Montomoli, E., Amaro, R. E., McLellan, J. S., & Rappuoli, R.
Publisher
openRxiv
Published
2020-12-28
References
56
Type
Preprint

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