Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies
Open accessAbstract
An antibody cocktail against SARS-CoV-2: There is an urgent focus on antibodies that target the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral spike and prevent the virus from entering host cells. Hansen et al. generated a large panel of antibodies against the spike protein from humanized mice and recovered patients. From this panel, they identified several neutralizing antibodies, including pairs that do not compete for binding to the receptor binding domain. Baum et al. focused in on four of these antibodies. All four are effective against known spike variants. However, by growing a pseudovirus that expresses the spike in the presence of individual antibodies, the authors were able to select for spike mutants resistant to that antibody. In contrast, escape mutants are not selected when pseudovirus is grown in the presence of pairs of antibodies that either do not compete or only partially compete for binding to the RBD. Such a pair might be used in a therapeutic antibody cocktail. Science , this issue p. 1010 , p. 1014
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Selection involved K417N/E/T for six antibodies, E484K for five, and N501Y/T/H for three; these match mutations in circulating B.1.1.17/501Y.V1, B.1.351/501Y.V2, and B1.1.28/501.V3 (P.1) variants.
“Notably, 6 of the antibodies selected for K417N, E or T, 5 selected for E484K and 3 selected for N501Y, T or H, which coincide with mutations present in the circulating B.1.1.17/501Y.V1, B.1.351/501Y.V2 and B1.1.28/501.V3 (P.1) variants that have been associated with rapidly increasing case numbers in particular locales14,17,18,36.”
From mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants (2021) · cites this paper as [14]
Several circulating variants linked to rapidly rising case counts are especially prevalent in the UK (B.1.1.7/501Y.V1), South Africa (B.1.351/501Y.V2), and Brazil (P.1).
“A number of circulating SARS-CoV-2 variants that have been associated with rapidly increasing case numbers and have particular prevalence in the UK (B.1.1.7/501Y.V1), South Africa (B.1.351/501Y.V2) and Brazil (P.1)14,17,18,36.”
From mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants (2021) · cites this paper as [14]
The panel also included circulating variant residues K417N, Y453F, S477R, N501Y, and D614G, some linked to rapidly rising case counts.
“Additionally, K417N, Y453F, S477R, N501Y, and D614G represent circulating variants some of which have been associated with rapidly increasing case numbers14,15,19,33–35.”
From mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants (2021) · cites this paper as [14]
Mutations found in emergent S variants decrease sensitivity to neutralization by mAbs, convalescent plasma, and sera from vaccinated individuals.
“Mutations found in emergent S variants decrease sensitivity to neutralization by mAbs, convalescent plasma, and sera from vaccinated individuals (27, 37, 58, 61–70).”
From mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection (2021) · cites this paper as [62]
The E484K substitution alone confers resistance to several monoclonal antibodies.
“The E484K substitution alone confers resistance to several monoclonal antibodies 9,10 .”
From Neutralization of SARS-CoV-2 spike 69/70 deletion, E484K and N501Y variants by BNT162b2 vaccine-elicited sera (2021) · cites this paper as [10]
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“…incubated with single monoclonal antibodies, usually a combination of two mAbs is sufficient to eliminate the evolution of escape variants and because SARS-CoV-2 shows a very low estimated evolutionary rate of mutation as this virus encodes a proofreading exoribonuclease machinery (21, 22)(23, 24).”
SARS-CoV-2 mRNA vaccination induces functionally diverse antibodies to NTD, RBD, and S2
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Engineered ACE2 receptor traps potently neutralize SARS-CoV-2
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SARS-CoV-2 spreads through cell-to-cell transmission
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Recurrent emergence and transmission of a SARS-CoV-2 spike deletion H69/V70
Kemp, S. A., Meng, B., Ferriera, I. A., Datir, R., Harvey, W. T., Papa, G., Lytras, S., Collier, D. A., Mohamed, A., Gallo, G., et al. (2020) · doi:10.1101/2020.12.14.422555 · Cited by 252 · see citing works
De novo design of potent and resilient hACE2 decoys to neutralize SARS-CoV-2
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“, 2020), and both escape some monoclonal antibodies (Baum et al., 2020; Starr et al., 2020a; Thomson et al., 2020) but neither greatly impact serum antibody binding by the samples we tested.”
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Molecular determinants and mechanism for antibody cocktail preventing SARS-CoV-2 escape
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An engineered decoy receptor for SARS-CoV-2 broadly binds protein S sequence variants
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“In a number of separate in vitro studies using monoclonal 33 antibodies (mAbs), mutations at E484 have emerged as immune escape mutations, often conferring broad 34 cross-resistance to panels of mAbs [8, 9, 10, 11].”
BackgroundN-terminal domain antigenic mapping reveals a site of vulnerability for SARS-CoV-2
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Comparison of Four SARS-CoV-2 Neutralization Assays
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Approaches and Challenges in SARS-CoV-2 Vaccine Development
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Animal models in SARS-CoV-2 research
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Tackling COVID-19 with neutralizing monoclonal antibodies
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“One of the expected goals of our efforts was to identify elite antibodies for paired antibody cocktail therapies, with the goal of reducing the likelihood of ef fi cacy loss against future variants and viral escape mutants that may be selected under the pressure of single antibody treatment 36 .”
Shooting at a Moving Target—Effectiveness and Emerging Challenges for SARS-CoV-2 Vaccine Development
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- Authors
- Baum, A., Fulton, B. O., Wloga, E., Copin, R., Pascal, K. E., Russo, V., Giordano, S., Lanza, K., Negron, N., Ni, M., Wei, Y., Atwal, G. S., Murphy, A. J., Stahl, N., Yancopoulos, G. D., & Kyratsous, C. A.
- Affiliations
- Regeneron (United States) (US)
- Corresponding author
- Kyratsous, Christos A.
- ORCID
- Venue
- Science
- Published
- 2020-08-21
- Volume
- 369
- Issue
- 6506
- Pages
- 1014-1018
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- PMC
- PMC7299283
- OpenAlex
- W3034548712
- Cited by
- 1,253
- References
- 21
- Citations by year
- 2026: 23 · 2025: 49 · 2024: 102 · 2023: 132 · 2022: 328 · 2021: 492 · 2020: 125
- FWCI
- 35.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Cold Spring Harbor Laboratory Institutional Repository (Cold Spring Harbor Laboratory) (submittedVersion)
- Funders
- Biomedical Advanced Research and Development Authority (HHSO100201700020C)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › vaccines and immunoinformatics approaches
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Animal Virus Infections Studies
- Keywords
- SARS-CoV-2, spike protein, antibody cocktail, antibody resistance, neutralizing antibodies, escape mutants, COVID-19 pandemic, SARS-CoV-2 variants
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Antibodies, Viral, Epitopes, Humans, Mutation, Neutralization Tests, Pneumonia, Viral, Selection, Genetic, Genome, Viral, Coronavirus Infections, Mutant Proteins, Protein Interaction Domains and Motifs, Antibodies, Neutralizing, Pandemics, Spike Glycoprotein, Coronavirus
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