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Extremely potent human monoclonal antibodies from COVID-19 convalescent patients

Cell. 2021 Apr 1;184(7):1821-1835.e16. doi: 10.1016/j.cell.2021.02.035. | PubMed

Emanuele Andreano1, Emanuele Nicastri2, Ida Paciello1, Piero Pileri1, Noemi Manganaro1, Giulia Piccini3, Alessandro Manenti4, Elisa Pantano1, Anna Kabanova5, Marco Troisi6, Fabiola Vacca6, Dario Cardamone7, Concetta De Santi1, Jonathan L Torres8, Gabriel Ozorowski8, Linda Benincasa9, Hyesun Jang10, Cecilia Di Genova11, Lorenzo Depau12, Jlenia Brunetti12, Chiara Agrati2, Maria Rosaria Capobianchi2, Concetta Castilletti2, Arianna Emiliozzi13, Massimiliano Fabbiani14, Francesca Montagnani13, Luisa Bracci12, Giuseppe Sautto10, Ted M Ross15, Emanuele Montomoli16, Nigel Temperton11, Andrew B Ward8, Claudia Sala1, Giuseppe Ippolito2, Rino Rappuoli17

  1. Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy.
  2. National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy.
  3. VisMederi S.r.l, Siena, Italy.
  4. VisMederi S.r.l, Siena, Italy; VisMederi Research S.r.l., Siena, Italy.
  5. Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy; Tumour Immunology Unit, Fondazione Toscana Life Sciences, Siena, Italy.
  6. Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy; Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
  7. Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy; University of Turin, Turin, Italy.
  8. Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA.
  9. VisMederi Research S.r.l., Siena, Italy.
  10. Center for Vaccines and Immunology, University of Georgia, Athens, GA 30602, USA.
  11. Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent, Chatham, UK.
  12. MedBiotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
  13. Department of Medical Biotechnologies, University of Siena, Siena, Italy; Department of Medical Sciences, Infectious and Tropical Diseases Unit, University Hospital of Siena, Siena, Italy.
  14. Department of Medical Sciences, Infectious and Tropical Diseases Unit, University Hospital of Siena, Siena, Italy.
  15. Center for Vaccines and Immunology, University of Georgia, Athens, GA 30602, USA; Department of Infectious Diseases, University of Georgia, Athens, GA 30602, USA.
  16. VisMederi S.r.l, Siena, Italy; VisMederi Research S.r.l., Siena, Italy; Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
  17. Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy; Faculty of Medicine, Imperial College, London, UK. Electronic address: rino.r.rappuoli@gsk.com.

Abstract

Human monoclonal antibodies are safe, preventive, and therapeutic tools that can be rapidly developed to help restore the massive health and economic disruption caused by the coronavirus disease 2019 (COVID-19) pandemic. By single-cell sorting 4,277 SARS-CoV-2 spike protein-specific memory B cells from 14 COVID-19 survivors, 453 neutralizing antibodies were identified. The most potent neutralizing antibodies recognized the spike protein receptor-binding domain, followed in potency by antibodies that recognize the S1 domain, the spike protein trimer, and the S2 subunit. Only 1.4% of them neutralized the authentic virus with a potency of 1-10 ng/mL. The most potent monoclonal antibody, engineered to reduce the risk of antibody-dependent enhancement and prolong half-life, neutralized the authentic wild-type virus and emerging variants containing D614G, E484K, and N501Y substitutions. Prophylactic and therapeutic efficacy in the hamster model was observed at 0.25 and 4 mg/kg respectively in absence of Fc functions.

Presented By Emanuele Andreano | ORCID iD