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Beukenhorst AL, Frallicciardi J, Rice KL, Koldijk MH, Moreira de Mello JC, Klap JM, Hadjichrysanthou C, Koch CM, da Costa KAS, Temperton N, de Jong BA, Vietsch H, Ziere B, Julg B, Koudstaal W, Goudsmit J. A pan-influenza monoclonal antibody neutralizes H5 strains and prophylactically protects through intranasal administration. Sci Rep 2024; 14:3818. [PMID: 38360813 PMCID: PMC10869794 DOI: 10.1038/s41598-024-53049-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/27/2024] [Indexed: 02/17/2024] Open
Abstract
Avian A(H5N1) influenza virus poses an elevated zoonotic threat to humans, and no pharmacological products are currently registered for fast-acting pre-exposure protection in case of spillover leading to a pandemic. Here, we show that an epitope on the stem domain of H5 hemagglutinin is highly conserved and that the human monoclonal antibody CR9114, targeting that epitope, potently neutralizes all pseudotyped H5 viruses tested, even in the rare case of substitutions in its epitope. Further, intranasal administration of CR9114 fully protects mice against A(H5N1) infection at low dosages, irrespective of pre-existing immunity conferred by the quadrivalent seasonal influenza vaccine. These data provide a proof-of-concept for broad, pre-exposure protection against a potential future pandemic using the intranasal administration route. Studies in humans should assess if autonomous administration of a broadly-neutralizing monoclonal antibody is safe and effective and can thus contribute to pandemic preparedness.
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Affiliation(s)
- Anna L Beukenhorst
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Leyden Laboratories BV, Leiden, The Netherlands.
- Centre for Epidemiology, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | | | | | | | | | - Jaco M Klap
- Leyden Laboratories BV, Leiden, The Netherlands
| | | | | | - Kelly A S da Costa
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham, UK
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham, UK
| | | | | | | | - Boris Julg
- Leyden Laboratories BV, Leiden, The Netherlands
| | | | - Jaap Goudsmit
- Leyden Laboratories BV, Leiden, The Netherlands
- Departments of Epidemiology, Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
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Imsuwansri T, Jongthitinon T, Pojdoung N, Meesiripan N, Sakarin S, Boonkrai C, Wongtangprasert T, Phakham T, Audomsun T, Attakitbancha C, Saelao P, Muanwien P, Tian MT, Tongchusak S, Sangruji B, Wannigama DL, Sawangmake C, Rodprasert W, Le QD, Purbantoro SD, Vasuntrarak K, Nantavisai S, Sirilak S, Uppapong B, Sapsutthipas S, Trisiriwanich S, Somporn T, Usoo A, Mingngamsup N, Phumiamorn S, Aumklad P, Arunprasert K, Patrojanasophon P, Opanasopit P, Pesirikan N, Nitisaporn L, Pitchayakorn J, Narkthong T, Mahong B, Chaiyo K, Srisutthisamphan K, Viriyakitkosol R, Aeumjaturapat S, Jongkaewwattana A, Bunnag S, Pisitkun T. Assessment of safety and intranasal neutralizing antibodies of HPMC-based human anti-SARS-CoV-2 IgG1 nasal spray in healthy volunteers. Sci Rep 2023; 13:15648. [PMID: 37730833 PMCID: PMC10511465 DOI: 10.1038/s41598-023-42539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
An HPMC-based nasal spray solution containing human IgG1 antibodies against SARS-CoV-2 (nasal antibody spray or NAS) was developed to strengthen COVID-19 management. NAS exhibited potent broadly neutralizing activities against SARS-CoV-2 with PVNT50 values ranging from 0.0035 to 3.1997 μg/ml for the following variants of concern (ranked from lowest to highest): Alpha, Beta, Gamma, ancestral, Delta, Omicron BA.1, BA.2, BA.4/5, and BA.2.75. Biocompatibility assessment showed no potential biological risks. Intranasal NAS administration in rats showed no circulatory presence of human IgG1 anti-SARS-CoV-2 antibodies within 120 h. A double-blind, randomized, placebo-controlled trial (NCT05358873) was conducted on 36 healthy volunteers who received either NAS or a normal saline nasal spray. Safety of the thrice-daily intranasal administration for 7 days was assessed using nasal sinuscopy, adverse event recording, and self-reporting questionnaires. NAS was well tolerated, with no significant adverse effects during the 14 days of the study. The SARS-CoV-2 neutralizing antibodies were detected based on the signal inhibition percent (SIP) in nasal fluids pre- and post-administration using a SARS-CoV-2 surrogate virus neutralization test. SIP values in nasal fluids collected immediately or 6 h after NAS application were significantly increased from baseline for all three variants tested, including ancestral, Delta, and Omicron BA.2. In conclusion, NAS was safe for intranasal use in humans to increase neutralizing antibodies in nasal fluids that lasted at least 6 h.
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Affiliation(s)
- Thanarath Imsuwansri
- Department of Medical Services, National Cancer Institute, Ministry of Public Health, Bangkok, Thailand.
| | - Thitinan Jongthitinon
- Department of Medical Services, National Cancer Institute, Ministry of Public Health, Bangkok, Thailand
| | - Niramon Pojdoung
- Department of Medical Services, National Cancer Institute, Ministry of Public Health, Bangkok, Thailand
| | - Nuntana Meesiripan
- Department of Medical Services, National Cancer Institute, Ministry of Public Health, Bangkok, Thailand
| | - Siriwan Sakarin
- Department of Medical Services, National Cancer Institute, Ministry of Public Health, Bangkok, Thailand
| | - Chatikorn Boonkrai
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Tossapon Wongtangprasert
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
- The Excellence Chulalongkorn Comprehensive Cancer Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tanapati Phakham
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Thittaya Audomsun
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Chadaporn Attakitbancha
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Pijitra Saelao
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Phijitra Muanwien
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Maoxin Tim Tian
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Songsak Tongchusak
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand
| | - Bhrus Sangruji
- School of Arts and Sciences, Tufts University, Massachusetts, USA
| | - Dhammika Leshan Wannigama
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Chenphop Sawangmake
- Department of Pharmacology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Faculty of Veterinary Science, Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Watchareewan Rodprasert
- Faculty of Veterinary Science, Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Quynh Dang Le
- Faculty of Veterinary Science, Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Steven Dwi Purbantoro
- Faculty of Veterinary Science, Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Kananuch Vasuntrarak
- Department of Pharmacology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sirirat Nantavisai
- Faculty of Veterinary Science, Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Academic Affairs, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Supakit Sirilak
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Ballang Uppapong
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Sompong Sapsutthipas
- Department of Medical Sciences, Institute of Biological Products, Ministry of Public Health, Nonthaburi, Thailand
| | - Sakalin Trisiriwanich
- Department of Medical Sciences, Institute of Biological Products, Ministry of Public Health, Nonthaburi, Thailand
| | - Thitiporn Somporn
- Department of Medical Sciences, Institute of Biological Products, Ministry of Public Health, Nonthaburi, Thailand
| | - Asmah Usoo
- Department of Medical Sciences, Institute of Biological Products, Ministry of Public Health, Nonthaburi, Thailand
| | - Natthakarn Mingngamsup
- Department of Medical Sciences, Institute of Biological Products, Ministry of Public Health, Nonthaburi, Thailand
| | - Supaporn Phumiamorn
- Department of Medical Sciences, Institute of Biological Products, Ministry of Public Health, Nonthaburi, Thailand
| | - Porawan Aumklad
- Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand
| | | | | | | | | | | | | | - Thana Narkthong
- The Government Pharmaceutical Organization, Bangkok, Thailand
| | - Bancha Mahong
- The Government Pharmaceutical Organization, Bangkok, Thailand
| | - Kumchol Chaiyo
- The Government Pharmaceutical Organization, Bangkok, Thailand
| | - Kanjana Srisutthisamphan
- Virology and Cell Technology Research Team, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Ratchanont Viriyakitkosol
- Virology and Cell Technology Research Team, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | | | - Anan Jongkaewwattana
- Virology and Cell Technology Research Team, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Sakarn Bunnag
- Department of Medical Services, National Cancer Institute, Ministry of Public Health, Bangkok, Thailand
| | - Trairak Pisitkun
- Faculty of Medicine, Center of Excellence in Systems Biology, Chulalongkorn University, Bangkok, Thailand.
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Beukenhorst AL, Koch CM, Hadjichrysanthou C, Alter G, de Wolf F, Anderson RM, Goudsmit J. SARS-CoV-2 elicits non-sterilizing immunity and evades vaccine-induced immunity: implications for future vaccination strategies. Eur J Epidemiol 2023; 38:237-242. [PMID: 36738380 PMCID: PMC9898703 DOI: 10.1007/s10654-023-00965-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/07/2023] [Indexed: 02/05/2023]
Abstract
Neither vaccination nor natural infection result in long-lasting protection against SARS-COV-2 infection and transmission, but both reduce the risk of severe COVID-19. To generate insights into optimal vaccination strategies for prevention of severe COVID-19 in the population, we extended a Susceptible-Exposed-Infectious-Removed (SEIR) mathematical model to compare the impact of vaccines that are highly protective against severe COVID-19 but not against infection and transmission, with those that block SARS-CoV-2 infection. Our analysis shows that vaccination strategies focusing on the prevention of severe COVID-19 are more effective than those focusing on creating of herd immunity. Key uncertainties that would affect the choice of vaccination strategies are: (1) the duration of protection against severe disease, (2) the protection against severe disease from variants that escape vaccine-induced immunity, (3) the incidence of long-COVID and level of protection provided by the vaccine, and (4) the rate of serious adverse events following vaccination, stratified by demographic variables.
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Affiliation(s)
- Anna L Beukenhorst
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
- Leyden Laboratories BV, Amsterdam, The Netherlands.
| | | | | | - Galit Alter
- Ragon Institute of MGH MIT and Harvard, Cambridge, MA, USA
| | - Frank de Wolf
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Jaap Goudsmit
- Leyden Laboratories BV, Amsterdam, The Netherlands
- Departments of Epidemiology, Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
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