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Variant-proof high affinity ACE2 antagonist limits SARS-CoV-2 replication in upper and lower airways

Title: Variant-proof high affinity ACE2 antagonist limits SARS-CoV-2 replication in upper and lower airways
Authors: Matthew Gagne; Barbara J. Flynn; Christopher Cole Honeycutt; Dillon R. Flebbe; Shayne F. Andrew; Samantha J. Provost; Lauren McCormick; Alex Van Ry; Elizabeth McCarthy; John-Paul M. Todd; Saran Bao; I-Ting Teng; Shir Marciano; Yinon Rudich; Chunlin Li; Shilpi Jain; Bushra Wali; Laurent Pessaint; Alan Dodson; Anthony Cook; Mark G. Lewis; Hanne Andersen; Jiří Zahradník; Mehul S. Suthar; Martha C. Nason; Kathryn E. Foulds; Peter D. Kwong; Mario Roederer; Gideon Schreiber; Robert A. Seder; Daniel C. Douek
Source: Nature Communications, Vol 15, Iss 1, Pp 1-13 (2024)
Publisher Information: Nature Portfolio
Publication Year: 2024
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Science
Description: SARS-CoV-2 has the capacity to evolve mutations that escape vaccine- and infection-acquired immunity and antiviral drugs. A variant-agnostic therapeutic agent that protects against severe disease without putting selective pressure on the virus would thus be a valuable biomedical tool that would maintain its efficacy despite the ongoing emergence of new variants. Here, we challenge male rhesus macaques with SARS-CoV-2 Delta—the most pathogenic variant in a highly susceptible animal model. At the time of challenge, we also treat the macaques with aerosolized RBD-62, a protein developed through multiple rounds of in vitro evolution of SARS-CoV-2 RBD to acquire 1000-fold enhanced ACE2 binding affinity. RBD-62 treatment equivalently suppresses virus replication in both upper and lower airways, a phenomenon not previously observed with clinically approved vaccines. Importantly, RBD-62 does not block the development of virus-specific T- and B-cell responses and does not elicit anti-drug immunity. These data provide proof-of-concept that RBD-62 can prevent severe disease from a highly virulent variant.
Document Type: article in journal/newspaper
Language: English
Relation: https://doi.org/10.1038/s41467-024-51046-w; https://doaj.org/toc/2041-1723; https://doaj.org/article/398a2dfd9ac6483f881f1a81f6f17840
DOI: 10.1038/s41467-024-51046-w
Availability: https://doi.org/10.1038/s41467-024-51046-w; https://doaj.org/article/398a2dfd9ac6483f881f1a81f6f17840
Accession Number: edsbas.84618AD2
Database: BASE