Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA.
Nature. 2021 May;593(7857):130-135. doi: 10.1038/s41586-021-03398-2. Epub 2021 Mar 8.
The COVID-19 pandemic has had widespread effects across the globe, and its causative agent, SARS-CoV-2, continues to spread. Effective interventions need to be developed to end this pandemic. Single and combination therapies with monoclonal antibodies have received emergency use authorization, and more treatments are under development. Furthermore, multiple vaccine constructs have shown promise, including two that have an approximately 95% protective efficacy against COVID-19. However, these interventions were directed against the initial SARS-CoV-2 virus that emerged in 2019. The recent detection of SARS-CoV-2 variants B.1.1.7 in the UK and B.1.351 in South Africa is of concern because of their purported ease of transmission and extensive mutations in the spike protein. Here we show that B.1.1.7 is refractory to neutralization by most monoclonal antibodies against the N-terminal domain of the spike protein and is relatively resistant to a few monoclonal antibodies against the receptor-binding domain. It is not more resistant to plasma from individuals who have recovered from COVID-19 or sera from individuals who have been vaccinated against SARS-CoV-2. The B.1.351 variant is not only refractory to neutralization by most monoclonal antibodies against the N-terminal domain but also by multiple individual monoclonal antibodies against the receptor-binding motif of the receptor-binding domain, which is mostly due to a mutation causing an E484K substitution. Moreover, compared to wild-type SARS-CoV-2, B.1.351 is markedly more resistant to neutralization by convalescent plasma (9.4-fold) and sera from individuals who have been vaccinated (10.3-12.4-fold). B.1.351 and emergent variants with similar mutations in the spike protein present new challenges for monoclonal antibody therapies and threaten the protective efficacy of current vaccines.
新冠疫情在全球范围内造成了广泛影响,其病原体 SARS-CoV-2 仍在继续传播。需要开发有效的干预措施来结束这场大流行。单克隆抗体的单一和联合疗法已获得紧急使用授权,更多的治疗方法正在开发中。此外,多种疫苗结构都显示出了希望,其中两种对 COVID-19 的保护效力约为 95%。然而,这些干预措施是针对 2019 年出现的最初的 SARS-CoV-2 病毒的。最近在英国和南非检测到的 SARS-CoV-2 变体 B.1.1.7 和 B.1.351 令人担忧,因为它们据称具有易于传播的特性,以及在刺突蛋白上有广泛的突变。在这里,我们表明 B.1.1.7 对大多数针对刺突蛋白 N 端结构域的单克隆抗体的中和作用具有抗性,并且对少数针对受体结合域的单克隆抗体具有相对抗性。它对从 COVID-19 中康复的个体的血浆或接种过 SARS-CoV-2 的个体的血清没有更高的抵抗力。B.1.351 变体不仅对大多数针对刺突蛋白 N 端结构域的单克隆抗体具有抗性,而且对针对受体结合域受体结合基序的多种单克隆抗体也具有抗性,这主要是由于一个导致 E484K 取代的突变造成的。此外,与野生型 SARS-CoV-2 相比,B.1.351 对恢复期血浆的中和作用(9.4 倍)和接种疫苗个体的血清(10.3-12.4 倍)的抵抗力明显增强。B.1.351 和具有类似刺突蛋白突变的新兴变体给单克隆抗体治疗带来了新的挑战,并威胁到当前疫苗的保护效力。
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