抗新型冠状病毒单克隆中和抗体药物研发进展*

随着新型冠状病毒肺炎(COVID-19)疫情在全球的不断蔓延,开发有效的治疗药物迫在眉睫。中和抗体作为最有希望的新型冠状病毒特异性治疗药物,已经在临床研究中展现很好的治疗效果。对抗新冠病毒单克隆中和抗体药物研发的进展、涉及的主要技术和主要临床试验结果进行了总结,以期为包括COVID-19在内的新发、突发传染病中和抗体药物研发提供参考。     

新型冠状病毒抗体和小分子抑制剂的研究现状

世界卫生组织已宣布新型冠状病毒感染（coronavirus disease 2019,COVID-19）的爆发为全球大流行。中和抗体和小分子抑制剂在预防及治疗COVID-19中发挥重要作用。尽管已开发出了多种中和抗体以及疫苗,但是随着病原体严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)的不断变异,现有的抗体及疫苗面临巨大的挑战。小分子抑制剂主要通过干扰病毒与宿主的结合以及病毒自身的复制达到消灭病毒以及抑制病毒感染的作用,并且对SARS-CoV-2突变株具有广谱抑制作用,是当前研究的热点。近年来国内外学者对SARS-CoV-2的小分子抑制剂做了大量的研究工作,本文根据中和抗体识别的抗原表位以及小分子抑制剂的作用机制分别对用于预防及治疗COVID-19的中和抗体和小分子抑制剂进行综述,讨论其研究现状,并展望小分子抑制剂的应用前景,以期为该领域的进一步研究提供参考。     

新型冠状病毒假病毒的制备及血浆中和抗体检测

新型冠状病毒（SARS-CoV-2）引发新型冠状病毒肺炎（COVID-19）全球大流行。由于SARS-CoV-2生物安全管理的要求,高效制备获得高滴度的新型冠状病毒假病毒对基于S蛋白研发疫苗、中和抗体、病毒入侵抑制剂药物以及人群血清学调查等十分重要。本研究基于慢病毒系统,对制备新型冠状病毒假病毒过程中的重要参数进行优化,用Western Blot检测假病毒S蛋白和p24蛋白的表达及假病毒包装情况,用荧光素酶报告系统检测假病毒感染入侵效率。利用制备好的假病毒对恢复期血浆的中和抗体水平进行检测。结果显示骨架质粒与野生型Spike质粒为2∶1比例,在转染后48h收集上清为SARS-CoV-2野生型假病毒包装的最佳条件。与野生型相比,恢复期血浆对四种突变株的中和抗体滴度均降低,对B.1.351株中和能力最弱,B.1.617.2株其次,重型患者恢复期血浆对野生型和突变株的中和抗体滴度高于轻型与普通型患者。本研究优化了新型冠状病毒假病毒包装的实验室条件,评估了COVID-19患者恢复期血浆对野生型及四种突变株的中和抗体水平,提示未来对突变株的免疫逃逸进一步加强监测的重要性。     

广谱抗冠状病毒疫苗及抗冠状病毒多肽的研究进展

由严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染引起的2019冠状病毒病(coronavirus disease 2019,COVID-19)暴发,给人类公共卫生安全和全球经济发展造成了严重威胁。疫苗和药物是防治疫情的重要手段,但目前研发的针对冠状病毒的疫苗和药物大多以SARS-CoV-2为靶点,该病毒若发生重大突变或出现新的高致病性冠状病毒,目前研发的有效疫苗或药物可能会无效,而且疫苗和新药的研发往往比较滞后,难以在疫情发生早期投入使用。因此,亟须研发高效、安全、广谱的冠状病毒疫苗和药物,以应对未来可能出现的冠状病毒疫情。本文对广谱冠状病毒疫苗和抗冠状病毒多肽的研究进展进行综述,期望为研发此类疫苗和药物提供参考。     

新型冠状病毒疫苗接种与疫情进展

新型冠状病毒肺炎(简称新冠)疫情仍在发展,新型冠状病毒变异株的出现致使其传染性和致病性增强,部分国家的政府和民众防控措施松懈导致某些地区疫情加剧。新型冠状病毒疫苗广泛使用后,接种情况会影响疫情发展。本文主要阐述新冠疫情与疫苗接种、病毒变异的关联性,接种疫苗存在的问题及其应对措施,并建议在加快疫苗接种的同时应做好各项新冠防控工作。     

抗新型冠状病毒中和抗体药物临床研究进展北大核心CSCD

自1998年预防呼吸合胞病毒的帕利珠单抗药物上市以来,多种靶向病毒的治疗性抗体药物已成功用于感染性疾病的临床治疗。新型冠状病毒肺炎疫情暴发后,多种中和抗体药物快速进入临床研究阶段,展现出积极的治疗及预防效果,并以紧急使用授权的方式用于疫情防控。本文对抗新型冠状病毒中和抗体药物的临床进展和主要临床试验结果进行总结,以期为包括新型冠状病毒肺炎在内的新发、突发传染病中和抗体药物研发提供参考。     

新型冠状病毒肺炎:实验室检测、治疗及疫苗

新型冠状病毒肺炎（2019 novel coronavirus disease, COVID-19）,一种由动物来源的新型冠状病毒（severe acute respiratory syndrome coronavirus 2, SRAS-CoV-2）感染所致的疾病在全球范围内急速传播,严重的危害人类的健康。快速、准确的诊断,安全有效的治疗方案及疫苗的研发对控制新冠病毒的传播具有重要的意义。为控制新冠病毒的传播,全世界的科学家和研究者投入了极大的精力去开发、研制快速准确的诊断试剂,治疗方案和疫苗,并取得了较大的进展。目前,基于各种检测平台的诊断试剂已在临床实验室应用,多种治疗方案已应用于临床治疗并取得不错的治疗效果。快速准确的样本采集和实验室检测是COVID-19临床治疗及有效控制病毒传染的两大重要支撑。虽然在多种类型的样本中均检测出了新冠病毒,但上呼吸道和下呼吸道样本尤其是鼻咽拭子依旧是目前检测最多的样本类型。随着疫情的发展,大量的基于核酸扩增的分子检测试剂和基于抗原或抗体的快速检测试剂已被研发并商业化获批。目前,实时荧光定量PCR检测依旧是新冠病毒检测最常用的和被认为是“金标准”的方法。虽然较多标签外用药药物和同情治疗方案取得了一定的临床疗效或改善,但目前针对新型冠状病毒肺炎尚无有效的治疗方案。目前在研究中针对新冠病毒的疫苗主要有：灭活或减毒病毒疫苗、基于蛋白质的疫苗、载体疫苗及DNA和RNA疫苗等。在全球,已有47个疫苗进入临床评估阶段,其中,10个疫苗处于临床Ⅲ期试验。本文简要介绍了目前新冠病毒肺炎的实验室诊断、治疗方案及疫苗研制所取得的进展。     

基于专利的冠状病毒技术发展分析

新型冠状病毒(SARS-CoV-2)是目前已知的第7种可以感染人的冠状病毒,尚无用于预防和治疗的药物。本文以全球人类冠状病毒的技术专利为研究对象,采用专利分析和文本挖掘的方法,分析了专利的技术发展趋势和技术分布特点,梳理了关键技术的最新发展动向,以期为SARS-CoV-2检测技术、药物筛选、疫苗及抗体研发提供参考。     

新型冠状病毒致病机理及其疫苗的研发进展

新型冠状病毒(severe acute respiratory syndrome coronavirus-2, SARS-CoV-2)是一种可引起人新型冠状病毒肺炎(novel coronavirus pneumonia, NCP;亦称为COVID-19)的新发呼吸道病原体,与中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus, MERS-CoV)和严重急性呼吸综合征冠状病毒(severe acute respiratory syndrome coronavirus, SARS-CoV)同属β-冠状病毒,其受体与SARS-CoV的受体相同,均利用血管紧张素转化酶2(angiotensin-converting enzyme 2, ACE2)受体入侵人体细胞。SARS-CoV-2主要通过呼吸系统和消化系统感染,具有较高的传染性和致死率。目前,新冠病毒引起的肺炎已在全球范围内大规模蔓延,接种疫苗是根除病毒性传染病最有效的方法,国内外各大科研机构已快速展开COVID-19疫苗的研制工作,这是有效控制疫情的重点和难点。现就新冠病毒的致病机理、感染途径及疫苗研发作一综述,旨在为相关研究人员提供参考。     

新型冠状病毒主蛋白酶抑制剂的筛选方法研究进展

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)席卷全球,具有较高的传染性和死亡率,但目前尚缺乏安全有效的COVID-19疫苗与治疗药物。新型冠状病毒主蛋白酶(main protease,Mpro)的进化高度保守,在调控新冠病毒RNA复制中具有重要的生物学功能,已成为新型广谱抗冠状病毒药物开发的理想靶标之一。简便、快速、灵敏、经济的药物高通量筛选模型的建立是高选择性Mpro抑制剂高效筛选与开发的重要基础和关键技术。本文对Mpro分子结构及其抑制剂的筛选方法研究进展进行了综述和展望,以期为靶向Mpro广谱抗冠状病毒药物的筛选与开发提供有益的借鉴和参考。     

Humoral Immunity against SARS-CoV-2 and the Impact on COVID-19 Pathogenesis

It has been more than a year since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first emerged. Many studies have provided insights into the various aspects of the immune response in coronavirus disease 2019 (COVID-19). Especially for antibody treatment and vaccine development, humoral immunity to SARS-CoV-2 has been studied extensively, though there is still much that is unknown and controversial. Here, we introduce key discoveries on the humoral immune responses in COVID-19, including the immune dynamics of antibody responses and correlations with disease severity, neutralizing antibodies and their cross-reactivity, how long the antibody and memory B-cell responses last, aberrant autoreactive antibodies generated in COVID-19 patients, and the efficacy of currently available therapeutic antibodies and vaccines against circulating SARS-CoV-2 variants, and highlight gaps in the current knowledge.     

新型冠状病毒的糖基化、糖受体识别及糖链抑制剂的发现北大核心CSCD

新型冠状病毒疫情(COVID-19)是21世纪截至目前人类面对的最为严重的公共卫生事件。疫苗、中和抗体以及小分子化合药物的出现有效预防和阻止了COVID-19的快速传播,而不断出现的病毒突变体却使这些疫苗及药物的效价降低,这对COVID-19的预防及治疗提出了新的挑战。新型冠状病毒(SARS-CoV-2)通常会先黏附于呼吸道表面的大分子糖链——硫酸乙酰肝素,进而与特异性受体人血管紧张素转化酶2(human angiotensin-converting enzyme 2,hACE2)结合,从而实现对人体的侵入。SARS-CoV-2的刺突(spike,S)蛋白是高度糖基化的,而糖基化对于hACE2与S蛋白的结合也有着重要影响,S蛋白在宿主体内还会被一系列凝集素受体所结合,这意味着糖链在SARS-CoV-2的入侵及感染过程中有着重要的作用。基于SARS-CoV-2的糖基化及糖受体识别机制开发糖链抑制剂可能是预防或治疗新型冠状病毒感染的有效手段,相关研究发现海洋来源的硫酸化多糖、肝素分子及其他的一些糖类具有抗SARS-CoV-2的活性。本文系统阐述了新型冠状病毒的糖基化及其糖链在入侵、感染中的作用,并对抗SARS-CoV-2糖链抑制剂的发现和机制研究现状进行了总结,在此基础上还对糖类抗病毒药物的机遇与挑战进行了展望。     

Nasal delivery of broadly neutralizing antibodies protects mice from lethal challenge with SARS-CoV-2 delta and omicron variants

Multiple new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have constantly emerged, as the delta and omicron variants, which have developed resistance to currently gained neutralizing antibodies. This highlights a critical need to discover new therapeutic agents to overcome the variants mutations. Despite the availability of vaccines against coronavirus disease 2019 (COVID-19), the use of broadly neutralizing antibodies has been considered as an alternative way for the prevention or treatment of SARS-CoV-2 variants infection. Here, we show that the nasal delivery of two previously characterized broadly neutralizing antibodies (F61 and H121) protected K18-hACE2 mice against lethal challenge with SARS-CoV-2 variants. The broadly protective efficacy of the F61 or F61/F121 cocktail antibodies was evaluated by lethal challenge with the wild strain (WIV04) and multiple variants, including beta (B.1.351), delta (B.1.617.2), and omicron (B.1.1.529) at 200 or 1000 TCID50, and the minimum antibody administration doses (5-1.25 mg/kg body weight) were also evaluated with delta and omicron challenge. Fully prophylactic protections were found in all challenged groups with both F61 and F61/H121 combination at the administration dose of 20 mg/kg body weight, and corresponding mice lung viral RNA showed negative, with almost all alveolar septa and cavities remaining normal. Furthermore, low-dose antibody treatment induced significant prophylactic protection against lethal challenge with delta and omicron variants, whereas the F61/H121 combination showed excellent results against omicron infection. Our findings indicated the potential use of broadly neutralizing monoclonal antibodies as prophylactic and therapeutic agent for protection of current emerged SARS-CoV-2 variants infection.     

DNA vaccination induced protective immunity against SARS CoV-2 infection in hamsterss

The development of efficient vaccines against COVID-19 is an emergent need for global public health. The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major target for the COVID-19 vaccine. To quickly respond to the outbreak of the SARS-CoV-2 pandemic, a nucleic acid-based vaccine is a novel option, beyond the traditional inactivated virus vaccine or recombinant protein vaccine. Here, we report a DNA vaccine containing the spike gene for delivery via electroporation. The spike genes of SARS-CoV and SARS-CoV-2 were codon optimized for mammalian cell expression and then cloned into mammalian cell expression vectors, called pSARS-S and pSARS2-S, respectively. Spike protein expression was confirmed by immunoblotting after transient expression in HEK293T cells. After immunization, sera were collected for antigen-specific antibody and neutralizing antibody titer analyses. We found that both pSARS-S and pSARS2-S immunization induced similar levels of antibodies against S2 of SARS-CoV-2. In contrast, only pSARS2-S immunization induced antibodies against the receptor-binding domain of SARS-CoV-2. We further found that pSARS2-S immunization, but not pSARS-S immunization, could induce very high titers of neutralizing antibodies against SARS-CoV-2. We further analyzed SARS-CoV-2 S protein-specific T cell responses and found that the immune responses were biased toward Th1. Importantly, pSARS2-S immunization in hamsters could induce protective immunity against SARS-CoV-2 challenge in vivo. These data suggest that DNA vaccination could be a promising approach for protecting against COVID-19.     

Modeling coronavirus spike protein dynamics: implications for immunogenicity and immune escape

The ongoing COVID-19 pandemic is a global public health emergency requiring urgent development of efficacious vaccines. While concentrated research efforts have focused primarily on antibody-based vaccines that neutralize SARS-CoV-2, and several first-generation vaccines have either been approved or received emergency use authorization, it is forecasted that COVID-19 will become an endemic disease requiring updated second-generation vaccines. The SARS-CoV-2 surface spike (S) glycoprotein represents a prime target for vaccine development because antibodies that block viral attachment and entry, i.e., neutralizing antibodies, bind almost exclusively to the receptor-binding domain. Here, we develop computational models for a large subset of S proteins associated with SARS-CoV-2, implemented through coarse-grained elastic network models and normal mode analysis. We then analyze local protein domain dynamics of the S protein systems and their thermal stability to characterize structural and dynamical variability among them. These results are compared against existing experimental data and used to elucidate the impact and mechanisms of SARS-CoV-2 S protein mutations and their associated antibody binding behavior. We construct a SARS-CoV-2 antigenic map and offer predictions about the neutralization capabilities of antibody and S mutant combinations based on protein dynamic signatures. We then compare SARS-CoV-2 S protein dynamics to SARS-CoV and MERS-CoV S proteins to investigate differing antibody binding and cellular fusion mechanisms that may explain the high transmissibility of SARS-CoV-2. The outbreaks associated with SARS-CoV, MERS-CoV, and SARS-CoV-2 over the last two decades suggest that the threat presented by coronaviruses is ever-changing and long term. Our results provide insights into the dynamics-driven mechanisms of immunogenicity associated with coronavirus S proteins and present a new, to our knowledge, approach to characterize and screen potential mutant candidates for immunogen design, as well as to characterize emerging natural variants that may escape vaccine-induced antibody responses.     

From SARS-CoV to SARS-CoV-2: safety and broad-spectrum are important for coronavirus vaccine development

The global pandemic of COVID-19 caused by SARS-CoV-2 (also known as 2019-nCoV and HCoV-19) has posed serious threats to public health and economic stability worldwide, thus calling for development of vaccines against SARS-CoV-2 and other emerging and reemerging coronaviruses. Since SARS-CoV-2 and SARS-CoV have high similarity of their genomic sequences and share the same cellular receptor (ACE2), it is essential to learn the lessons and experiences from the development of SARS-CoV vaccines for the development of SARS-CoV-2 vaccines. In this review, we summarized the current knowledge on the advantages and disadvantages of the SARS-CoV vaccine candidates and prospected the strategies for the development of safe, effective and broad-spectrum coronavirus vaccines for prevention of infection by currently circulating SARS-CoV-2 and other emerging and reemerging coronaviruses that may cause future epidemics or pandemics.     

Structural basis for SARS-CoV-2 neutralizing antibodies with novel binding epitopes

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) threatens global public health and economy unprecedentedly, requiring accelerating development of prophylactic and therapeutic interventions. Molecular understanding of neutralizing antibodies (NAbs) would greatly help advance the development of monoclonal antibody (mAb) therapy, as well as the design of next generation recombinant vaccines. Here, we applied H2L2 transgenic mice encoding the human immunoglobulin variable regions, together with a state-of-the-art antibody discovery platform to immunize and isolate NAbs. From a large panel of isolated antibodies, 25 antibodies showed potent neutralizing activities at sub-nanomolar levels by engaging the spike receptor-binding domain (RBD). Importantly, one human NAb, termed PR1077, from the H2L2 platform and 2 humanized NAb, including PR953 and PR961, were further characterized and subjected for subsequent structural analysis. High-resolution X-ray crystallography structures unveiled novel epitopes on the receptor-binding motif (RBM) for PR1077 and PR953, which directly compete with human angiotensin-converting enzyme 2 (hACE2) for binding, and a novel non-blocking epitope on the neighboring site near RBM for PR961. Moreover, we further tested the antiviral efficiency of PR1077 in the Ad5-hACE2 transduction mouse model of COVID-19. A single injection provided potent protection against SARS-CoV-2 infection in either prophylactic or treatment groups. Taken together, these results shed light on the development of mAb-related therapeutic interventions for COVID-19.

This study characterizes novel neutralizing antibodies against the SARS-CoV-2 spike protein. Co-crystal structures of the spike protein receptor-binding domain and humanised mouse antibodies identify novel epitopes on the spike protein; binding to these epitopes competes with the ACE2 receptor, and one of the antibodies provides protection against SARS-CoV-2 infection in a mouse model of COVID-19.     

Novel virus-like nanoparticle vaccine effectively protects animal model from SARS-CoV-2 infection

The key to battling the COVID-19 pandemic and its potential aftermath is to develop a variety of vaccines that are efficacious and safe, elicit lasting immunity, and cover a range of SARS-CoV-2 variants. Recombinant viral receptor-binding domains (RBDs) are safe vaccine candidates but often have limited efficacy due to the lack of virus-like immunogen display pattern. Here we have developed a novel virus-like nanoparticle (VLP) vaccine that displays 120 copies of SARS-CoV-2 RBD on its surface. This VLP-RBD vaccine mimics virus-based vaccines in immunogen display, which boosts its efficacy, while maintaining the safety of protein-based subunit vaccines. Compared to the RBD vaccine, the VLP-RBD vaccine induced five times more neutralizing antibodies in mice that efficiently blocked SARS-CoV-2 from attaching to its host receptor and potently neutralized the cell entry of variant SARS-CoV-2 strains, SARS-CoV-1, and SARS-CoV-1-related bat coronavirus. These neutralizing immune responses induced by the VLP-RBD vaccine did not wane during the two-month study period. Furthermore, the VLP-RBD vaccine effectively protected mice from SARS-CoV-2 challenge, dramatically reducing the development of clinical signs and pathological changes in immunized mice. The VLP-RBD vaccine provides one potentially effective solution to controlling the spread of SARS-CoV-2.