Theoretical Biology & Biophysics, Los Alamos National Laboratory, Los Alamos, United States of America.
New Mexico Consortium, Los Alamos, United States of America.
PLoS Pathog. 2018 Mar 5;14(3):e1006860. doi: 10.1371/journal.ppat.1006860. eCollection 2018 Mar.
There is great interest in passive transfer of broadly neutralizing antibodies (bnAbs) and engineered bispecific antibodies (Abs) for prevention of HIV-1 infections due to their in vitro neutralization breadth and potency against global isolates and long in vivo half-lives. We compared the potential of eight bnAbs and two bispecific Abs currently under clinical development, and their 2 Ab combinations, to prevent infection by dominant HIV-1 subtypes in sub-Saharan Africa. Using in vitro neutralization data for Abs against 25 subtype A, 100 C, and 20 D pseudoviruses, we modeled neutralization by single Abs and 2 Ab combinations assuming realistic target concentrations of 10μg/ml total for bnAbs and combinations, and 5μg/ml for bispecifics. We used IC80 breadth-potency, completeness of neutralization, and simultaneous coverage by both Abs in the combination as metrics to characterize prevention potential. Additionally, we predicted in vivo protection by Abs and combinations by modeling protection as a function of in vitro neutralization based on data from a macaque simian-human immunodeficiency virus (SHIV) challenge study. Our model suggests that nearly complete neutralization of a given virus is needed for in vivo protection (~98% neutralization for 50% relative protection). Using the above metrics, we found that bnAb combinations should outperform single bnAbs, as expected; however, different combinations are optimal for different subtypes. Remarkably, a single bispecific 10E8-iMAb, which targets HIV Env and host-cell CD4, outperformed all combinations of two conventional bnAbs, with 95-97% predicted relative protection across subtypes. Combinations that included 10E8-iMAb substantially improved protection over use of 10E8-iMAb alone. Our results highlight the promise of 10E8-iMAb and its combinations to prevent HIV-1 infections in sub-Saharan Africa.
人们对广泛中和抗体(bnAbs)和工程双特异性抗体(Abs)的被动转移非常感兴趣,因为它们具有针对全球分离株的体外中和广度和效力,以及较长的体内半衰期。我们比较了目前处于临床开发阶段的八种 bnAbs 和两种双特异性 Abs,以及它们的 2 种 Ab 组合,以预防撒哈拉以南非洲地区主要 HIV-1 亚型的感染。我们使用针对 25 种亚型 A、100 种 C 和 20 种 D 假病毒的 Abs 的体外中和数据,根据假设的 10μg/ml 总 bnAbs 和组合的目标浓度以及 5μg/ml 的双特异性 Abs,对单 Abs 和 2 Ab 组合的中和作用进行了建模。我们使用 IC80 广度-效力、中和的完整性以及组合中两个 Abs 的同时覆盖作为指标来描述预防潜力。此外,我们通过根据猕猴模拟人免疫缺陷病毒 (SHIV) 挑战研究的数据,将 Abs 和组合的体内保护作用建模为体外中和作用的函数,来预测体内保护作用。我们的模型表明,体内保护作用需要对给定病毒进行近乎完全的中和(50%相对保护的 98%中和)。使用上述指标,我们发现 bnAb 组合应该比单个 bnAbs 表现更好,这是意料之中的;然而,不同的组合对于不同的亚型是最优的。值得注意的是,一种单一的双特异性 10E8-iMAb,它针对 HIV Env 和宿主细胞 CD4,优于所有两种常规 bnAbs 的组合,对所有亚型的预测相对保护率为 95-97%。包含 10E8-iMAb 的组合与单独使用 10E8-iMAb 相比,大大提高了保护作用。我们的研究结果突出了 10E8-iMAb 及其组合在预防撒哈拉以南非洲地区 HIV-1 感染方面的潜力。
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