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Ameratunga R, Mears E, Leung E, Snell R, Woon ST, Kelton W, Medlicott N, Jordan A, Abbott W, Steele R, Rolleston W, Longhurst H, Lehnert K. Soluble wild-type ACE2 molecules inhibit newer SARS-CoV-2 variants and are a potential antiviral strategy to mitigate disease severity in COVID-19. Clin Exp Immunol 2023; 214:289-295. [PMID: 37565297 PMCID: PMC10719217 DOI: 10.1093/cei/uxad096] [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: 06/08/2023] [Revised: 07/26/2023] [Indexed: 08/12/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease of 2019 (COVID-19), has caused havoc around the world. While several COVID-19 vaccines and drugs have been authorized for use, these antiviral drugs remain beyond the reach of most low- and middle-income countries. Rapid viral evolution is reducing the efficacy of vaccines and monoclonal antibodies and contributing to the deaths of some fully vaccinated persons. Others with normal immunity may have chosen not to be vaccinated and remain at risk if they contract the infection. Vaccines may not protect some immunodeficient patients from SARS-CoV-2, who are also at increased risk of chronic COVID-19 infection, a dangerous stalemate between the virus and a suboptimal immune response. Intra-host viral evolution could rapidly lead to the selection and dominance of vaccine and monoclonal antibody-resistant clades of SARS-CoV-2. There is thus an urgent need to develop new treatments for COVID-19. The NZACE2-Pātari project, comprising modified soluble angiotensin-converting enzyme 2 (ACE2) molecules, seeks to intercept and block SARS-CoV-2 infection of the respiratory mucosa. In vitro data presented here show that soluble wild-type ACE2 molecules retain the ability to effectively block the Spike (S) glycoprotein of SARS-CoV-2 variants including the ancestral Wuhan, delta (B.1.617.2) and omicron (B.1.1.529) strains. This therapeutic strategy may prove effective if implemented early during the nasal phase of the infection and may act synergistically with other antiviral drugs such as Paxlovid to further mitigate disease severity.
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Affiliation(s)
- Rohan Ameratunga
- Department of Clinical immunology, Auckland Hospital, AucklandNew Zealand
- Department of Virology and Immunology, Auckland Hospital, Auckland, New Zealand
- Department of Molecular Medicine and Pathology, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Emily Mears
- Applied Translational Genetic Group, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Euphemia Leung
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Russell Snell
- Applied Translational Genetic Group, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - See-Tarn Woon
- Department of Virology and Immunology, Auckland Hospital, Auckland, New Zealand
| | - William Kelton
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
- Te Aka Mātuatua School of Science, University of Waikato, Hamilton, New Zealand
| | | | - Anthony Jordan
- Department of Clinical immunology, Auckland Hospital, AucklandNew Zealand
| | - William Abbott
- Department of Surgery, Auckland Hospital, Auckland, New Zealand
| | - Richard Steele
- Department of Respiratory Medicine, Wellington Hospital, Wellington, New Zealand
- Department of Virology and Immunology, Auckland Hospital, Auckland, New Zealand
| | | | - Hilary Longhurst
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Klaus Lehnert
- Applied Translational Genetic Group, School of Biological Sciences, University of Auckland, Auckland, New Zealand
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Benjakul S, Anthi AK, Kolderup A, Vaysburd M, Lode HE, Mallery D, Fossum E, Vikse EL, Albecka A, Ianevski A, Kainov D, Karlsen KF, Sakya SA, Nyquist-Andersen M, Gjølberg TT, Moe MC, Bjørås M, Sandlie I, James LC, Andersen JT. A pan-SARS-CoV-2-specific soluble angiotensin-converting enzyme 2-albumin fusion engineered for enhanced plasma half-life and needle-free mucosal delivery. PNAS NEXUS 2023; 2:pgad403. [PMID: 38077689 PMCID: PMC10703496 DOI: 10.1093/pnasnexus/pgad403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/13/2023] [Indexed: 02/29/2024]
Abstract
Immunocompromised patients often fail to raise protective vaccine-induced immunity against the global emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Although monoclonal antibodies have been authorized for clinical use, most have lost their ability to potently neutralize the evolving Omicron subvariants. Thus, there is an urgent need for treatment strategies that can provide protection against these and emerging SARS-CoV-2 variants to prevent the development of severe coronavirus disease 2019. Here, we report on the design and characterization of a long-acting viral entry-blocking angiotensin-converting enzyme 2 (ACE2) dimeric fusion molecule. Specifically, a soluble truncated human dimeric ACE2 variant, engineered for improved binding to the receptor-binding domain of SARS-CoV-2, was fused with human albumin tailored for favorable engagement of the neonatal fragment crystallizable receptor (FcRn), which resulted in enhanced plasma half-life and allowed for needle-free transmucosal delivery upon nasal administration in human FcRn-expressing transgenic mice. Importantly, the dimeric ACE2-fused albumin demonstrated potent neutralization of SARS-CoV-2 immune escape variants.
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Affiliation(s)
- Sopisa Benjakul
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
| | - Aina Karen Anthi
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
| | - Anette Kolderup
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
| | - Marina Vaysburd
- Protein and Nucleic Acid Chemistry Division, Medical Research Council, Laboratory of Molecular Biology, Cambridge CB2 0QH, UK
| | - Heidrun Elisabeth Lode
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Department of Ophthalmology, Oslo University Hospital and University of Oslo, Oslo 0450, Norway
| | - Donna Mallery
- Protein and Nucleic Acid Chemistry Division, Medical Research Council, Laboratory of Molecular Biology, Cambridge CB2 0QH, UK
| | - Even Fossum
- Department of Virology, Norwegian Institute of Public Health, Oslo 0213, Norway
| | - Elisabeth Lea Vikse
- Department of Virology, Norwegian Institute of Public Health, Oslo 0213, Norway
| | - Anna Albecka
- Protein and Nucleic Acid Chemistry Division, Medical Research Council, Laboratory of Molecular Biology, Cambridge CB2 0QH, UK
| | - Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Denis Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway
- Institute of Technology, University of Tartu, Tartu 50411, Estonia
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki 00290, Finland
| | - Karine Flem Karlsen
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
| | - Siri Aastedatter Sakya
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
| | - Mari Nyquist-Andersen
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
| | - Torleif Tollefsrud Gjølberg
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
- Department of Ophthalmology, Oslo University Hospital and University of Oslo, Oslo 0450, Norway
| | - Morten C Moe
- Department of Ophthalmology, Oslo University Hospital and University of Oslo, Oslo 0450, Norway
| | - Magnar Bjørås
- Department of Virology, Norwegian Institute of Public Health, Oslo 0213, Norway
| | - Inger Sandlie
- Department of Biosciences, University of Oslo, Oslo 0371, Norway
| | - Leo C James
- Protein and Nucleic Acid Chemistry Division, Medical Research Council, Laboratory of Molecular Biology, Cambridge CB2 0QH, UK
| | - Jan Terje Andersen
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo 0372, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo 0372, Norway
- Precision Immunotherapy Alliance (PRIMA), University of Oslo, Oslo 0372, Norway
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