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Brocato RL, Wu H, Kwilas SA, Principe LM, Josleyn M, Shamblin J, Chivukula P, Bausch C, Luke T, Sullivan EJ, Hooper JW. Preclinical evaluation of a fully human, quadrivalent-hantavirus polyclonal antibody derived from a non-human source. mBio 2024:e0160024. [PMID: 39258903 DOI: 10.1128/mbio.01600-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/13/2024] [Indexed: 09/12/2024] Open
Abstract
Hantaviruses are rodent-borne viruses that cause severe disease in infected humans. In the New World, major hantaviruses include Andes virus (ANDV) and Sin Nombre virus (SNV) causing hantavirus pulmonary syndrome. In the Old World, major hantaviruses include Hantaan virus (HTNV) and Puumala virus (PUUV) causing hemorrhagic fever with renal syndrome. Here, we produced a pan-hantavirus therapeutic (SAB-163) comprised of fully human immunoglobulin purified from the plasma of transchromosomic bovines (TcB) vaccinated with hantavirus DNA plasmids coding for the major glycoproteins of ANDV, SNV, HTNV, and PUUV. SAB-163 has potent neutralizing antibodies (PRNT50 > 200,000) against the four targeted hantavirus and cross-neutralization against several other heterotypic hantaviruses. At a dosage of 10 mg/kg, SAB-163 is bioavailable in Syrian hamsters out to 70 days post-treatment with a half-life of 10-15 days. At this same dosage, SAB-163 administered 1 day before, or 5 days after exposure, protected all hamsters from lethal disease caused by ANDV. At a higher dose, partial but significant protection was achieved as late as day 6. SAB-163 also protected hamsters in the HTNV, PUUV, and SNV infection models when administered 1 day before or up to 3 days after challenge. This pan-hantavirus therapeutic is attractive because it is fully human, multi-targeted, safe, stable at 4°C, and effective in animal models. SAB-163 was evaluated for safety in GLP human tissue binding studies and a GLP rabbit toxicity study at 365 and 730 mg/kg and is investigational new drug enabled for phase 1 clinical trial(s). IMPORTANCE This candidate polyclonal human IgG product was produced using synthetic gene-based vaccines and transgenic cows. Having now gone through cGMP production, GLP safety testing, and efficacy testing in animals, SAB-163 is the world's most advanced anti-hantavirus antibody-based medical countermeasure, aside from convalescent human plasma. Importantly, SAB-163 targets the most prevalent hantaviruses on four continents.
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Affiliation(s)
- Rebecca L Brocato
- Virology Division, USA Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, USA
| | - Hua Wu
- SAB Biotherapeutics Inc., Sioux Falls, South Dakota, USA
| | - Steven A Kwilas
- Virology Division, USA Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, USA
| | - Lucia M Principe
- Virology Division, USA Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, USA
| | - Matthew Josleyn
- Virology Division, USA Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, USA
| | - Joshua Shamblin
- Virology Division, USA Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, USA
| | | | | | - Thomas Luke
- SAB Biotherapeutics Inc., Sioux Falls, South Dakota, USA
| | | | - Jay W Hooper
- Virology Division, USA Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, USA
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3
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Vial PA, Ferrés M, Vial C, Klingström J, Ahlm C, López R, Le Corre N, Mertz GJ. Hantavirus in humans: a review of clinical aspects and management. THE LANCET. INFECTIOUS DISEASES 2023; 23:e371-e382. [PMID: 37105214 DOI: 10.1016/s1473-3099(23)00128-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 04/29/2023]
Abstract
Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endemic regions. Transmission to humans occurs by exposure to infected rodents in endemic areas; however, Andes hantavirus is unique in that it can be transmitted from person to person. As hantaviruses target endothelial cells, they can affect diverse organ systems; increased vascular permeability is central to pathogenesis. The main clinical syndromes associated with hantaviruses are haemorrhagic fever with renal syndrome (HFRS), which is endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas. HCPS and HFRS are separate clinical entities, but they share several features and have many overlapping symptoms, signs, and pathogenic alterations. For HCPS in particular, clinical outcomes are highly associated with early clinical suspicion, access to rapid diagnostic testing or algorithms for presumptive diagnosis, and prompt transfer to a facility with critical care units. No specific effective antiviral treatment is available.
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Affiliation(s)
- Pablo A Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Pediatría Clínica Alemana de Santiago, Santiago, Chile.
| | - Marcela Ferrés
- Department of Pediatric Infectious Disease and Immunology, Infectious Disease and Molecular Virology Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Jonas Klingström
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - René López
- Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Paciente Crítico Clínica Alemana, Santiago, Chile
| | - Nicole Le Corre
- Department of Pediatric Infectious Disease and Immunology, Infectious Disease and Molecular Virology Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gregory J Mertz
- Department of Internal Medicine, UNM Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
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Mittler E, Serris A, Esterman ES, Florez C, Polanco LC, O'Brien CM, Slough MM, Tynell J, Gröning R, Sun Y, Abelson DM, Wec AZ, Haslwanter D, Keller M, Ye C, Bakken RR, Jangra RK, Dye JM, Ahlm C, Rappazzo CG, Ulrich RG, Zeitlin L, Geoghegan JC, Bradfute SB, Sidoli S, Forsell MNE, Strandin T, Rey FA, Herbert AS, Walker LM, Chandran K, Guardado-Calvo P. Structural and mechanistic basis of neutralization by a pan-hantavirus protective antibody. Sci Transl Med 2023; 15:eadg1855. [PMID: 37315110 DOI: 10.1126/scitranslmed.adg1855] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/18/2023] [Indexed: 06/16/2023]
Abstract
Emerging rodent-borne hantaviruses cause severe diseases in humans with no approved vaccines or therapeutics. We recently isolated a monoclonal broadly neutralizing antibody (nAb) from a Puumala virus-experienced human donor. Here, we report its structure bound to its target, the Gn/Gc glycoprotein heterodimer comprising the viral fusion complex. The structure explains the broad activity of the nAb: It recognizes conserved Gc fusion loop sequences and the main chain of variable Gn sequences, thereby straddling the Gn/Gc heterodimer and locking it in its prefusion conformation. We show that the nAb's accelerated dissociation from the divergent Andes virus Gn/Gc at endosomal acidic pH limits its potency against this highly lethal virus and correct this liability by engineering an optimized variant that sets a benchmark as a candidate pan-hantavirus therapeutic.
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Affiliation(s)
- Eva Mittler
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Alexandra Serris
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Structural Virology Unit, F-75015 Paris, France
| | | | - Catalina Florez
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
- The Geneva Foundation, Tacoma, WA 98402, USA
| | - Laura C Polanco
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Cecilia M O'Brien
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
- The Geneva Foundation, Tacoma, WA 98402, USA
| | - Megan M Slough
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Janne Tynell
- Department of Clinical Microbiology, Umeå University, 90187 Umeå, Sweden
- Zoonosis Unit, Department of Virology, Medical Faculty, University of Helsinki, 00290 Helsinki, Finland
| | - Remigius Gröning
- Department of Clinical Microbiology, Umeå University, 90187 Umeå, Sweden
| | - Yan Sun
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | | | - Denise Haslwanter
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Markus Keller
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, 17493 Greifswald-Insel Riems, Germany
| | - Chunyan Ye
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Science Center, Albuquerque, NM 87131, USA
| | - Russel R Bakken
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - Rohit K Jangra
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - John M Dye
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, 90187 Umeå, Sweden
| | | | - Rainer G Ulrich
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, 17493 Greifswald-Insel Riems, Germany
- Partner site: Hamburg-Lübeck-Borstel-Riems, German Centre for Infection Research (DZIF), 17493 Greifswald-Insel Riems, Germany
| | - Larry Zeitlin
- Mapp Biopharmaceutical Inc., San Diego, CA 92121, USA
| | | | - Steven B Bradfute
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Science Center, Albuquerque, NM 87131, USA
| | - Simone Sidoli
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Tomas Strandin
- Zoonosis Unit, Department of Virology, Medical Faculty, University of Helsinki, 00290 Helsinki, Finland
| | - Felix A Rey
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Structural Virology Unit, F-75015 Paris, France
| | - Andrew S Herbert
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | | | - Kartik Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Pablo Guardado-Calvo
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Structural Virology Unit, F-75015 Paris, France
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Engdahl TB, Binshtein E, Brocato RL, Kuzmina NA, Principe LM, Kwilas SA, Kim RK, Chapman NS, Porter MS, Guardado-Calvo P, Rey FA, Handal LS, Diaz SM, Zagol-Ikapitte IA, Tran MH, McDonald WH, Meiler J, Reidy JX, Trivette A, Bukreyev A, Hooper JW, Crowe JE. Antigenic mapping and functional characterization of human New World hantavirus neutralizing antibodies. eLife 2023; 12:e81743. [PMID: 36971354 PMCID: PMC10115451 DOI: 10.7554/elife.81743] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
Hantaviruses are high-priority emerging pathogens carried by rodents and transmitted to humans by aerosolized excreta or, in rare cases, person-to-person contact. While infections in humans are relatively rare, mortality rates range from 1 to 40% depending on the hantavirus species. There are currently no FDA-approved vaccines or therapeutics for hantaviruses, and the only treatment for infection is supportive care for respiratory or kidney failure. Additionally, the human humoral immune response to hantavirus infection is incompletely understood, especially the location of major antigenic sites on the viral glycoproteins and conserved neutralizing epitopes. Here, we report antigenic mapping and functional characterization for four neutralizing hantavirus antibodies. The broadly neutralizing antibody SNV-53 targets an interface between Gn/Gc, neutralizes through fusion inhibition and cross-protects against the Old World hantavirus species Hantaan virus when administered pre- or post-exposure. Another broad antibody, SNV-24, also neutralizes through fusion inhibition but targets domain I of Gc and demonstrates weak neutralizing activity to authentic hantaviruses. ANDV-specific, neutralizing antibodies (ANDV-5 and ANDV-34) neutralize through attachment blocking and protect against hantavirus cardiopulmonary syndrome (HCPS) in animals but target two different antigenic faces on the head domain of Gn. Determining the antigenic sites for neutralizing antibodies will contribute to further therapeutic development for hantavirus-related diseases and inform the design of new broadly protective hantavirus vaccines.
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Affiliation(s)
- Taylor B Engdahl
- Department of Pathology, Microbiology and Immunology, Vanderbilt UniversityNashvilleUnited States
| | - Elad Binshtein
- Vanderbilt Vaccine Center, Vanderbilt University Medical CenterNashvilleUnited States
| | - Rebecca L Brocato
- Virology Division, United States Army Medical Research Institute of Infectious DiseasesFt DetrickUnited States
| | - Natalia A Kuzmina
- Department of Pathology, The University of Texas Medical Branch at GalvestonGalvestonUnited States
- Galveston National LaboratoryGalvestonUnited States
| | - Lucia M Principe
- Virology Division, United States Army Medical Research Institute of Infectious DiseasesFt DetrickUnited States
| | - Steven A Kwilas
- Virology Division, United States Army Medical Research Institute of Infectious DiseasesFt DetrickUnited States
| | - Robert K Kim
- Virology Division, United States Army Medical Research Institute of Infectious DiseasesFt DetrickUnited States
| | - Nathaniel S Chapman
- Department of Pathology, Microbiology and Immunology, Vanderbilt UniversityNashvilleUnited States
| | - Monique S Porter
- Department of Pathology, Microbiology and Immunology, Vanderbilt UniversityNashvilleUnited States
| | | | - Félix A Rey
- Institut Pasteur, Université Paris CitéParisFrance
| | - Laura S Handal
- Vanderbilt Vaccine Center, Vanderbilt University Medical CenterNashvilleUnited States
| | - Summer M Diaz
- Vanderbilt Vaccine Center, Vanderbilt University Medical CenterNashvilleUnited States
| | - Irene A Zagol-Ikapitte
- Department of Biochemistry and Mass Spectrometry Research Center, Vanderbilt UniversityNashvilleUnited States
| | - Minh H Tran
- Department of Biochemistry and Mass Spectrometry Research Center, Vanderbilt UniversityNashvilleUnited States
| | - W Hayes McDonald
- Department of Biochemistry and Mass Spectrometry Research Center, Vanderbilt UniversityNashvilleUnited States
| | - Jens Meiler
- Department of Chemistry, Vanderbilt UniversityNashvilleUnited States
| | - Joseph X Reidy
- Vanderbilt Vaccine Center, Vanderbilt University Medical CenterNashvilleUnited States
| | - Andrew Trivette
- Vanderbilt Vaccine Center, Vanderbilt University Medical CenterNashvilleUnited States
| | - Alexander Bukreyev
- Department of Pathology, The University of Texas Medical Branch at GalvestonGalvestonUnited States
- Galveston National LaboratoryGalvestonUnited States
- Department of Microbiology and Immunology, University of Texas Medical BranchGalvestonUnited States
| | - Jay W Hooper
- Virology Division, United States Army Medical Research Institute of Infectious DiseasesFt DetrickUnited States
| | - James E Crowe
- Department of Pathology, Microbiology and Immunology, Vanderbilt UniversityNashvilleUnited States
- Vanderbilt Vaccine Center, Vanderbilt University Medical CenterNashvilleUnited States
- Department of Pediatrics, Vanderbilt University Medical CenterNashvilleUnited States
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