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Rayaprolu V, Fulton BO, Rafique A, Arturo E, Williams D, Hariharan C, Callaway H, Parvate A, Schendel SL, Parekh D, Hui S, Shaffer K, Pascal KE, Wloga E, Giordano S, Negron N, Ni M, Copin R, Atwal GS, Franklin M, Boytz RM, Donahue C, Davey R, Baum A, Kyratsous CA, Saphire EO. Structure of the Inmazeb cocktail and resistance to Ebola virus escape. Cell Host Microbe 2023; 31:260-272.e7. [PMID: 36708708 PMCID: PMC10375381 DOI: 10.1016/j.chom.2023.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 12/15/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023]
Abstract
Monoclonal antibodies can provide important pre- or post-exposure protection against infectious disease for those not yet vaccinated or in individuals that fail to mount a protective immune response after vaccination. Inmazeb (REGN-EB3), a three-antibody cocktail against Ebola virus, lessened disease and improved survival in a controlled trial. Here, we present the cryo-EM structure at 3.1 Å of the Ebola virus glycoprotein, determined without symmetry averaging, in a simultaneous complex with the antibodies in the Inmazeb cocktail. This structure allows the modeling of previously disordered portions of the glycoprotein glycan cap, maps the non-overlapping epitopes of Inmazeb, and illuminates the basis for complementary activities and residues critical for resistance to escape by these and other clinically relevant antibodies. We further provide direct evidence that Inmazeb protects against the rapid emergence of escape mutants, whereas monotherapies even against conserved epitopes do not, supporting the benefit of a cocktail versus a monotherapy approach.
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Affiliation(s)
| | | | | | - Emilia Arturo
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Dewight Williams
- Eyring Materials Center, Arizona State University, Tempe, AZ 85281, USA
| | | | | | - Amar Parvate
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | | | | | - Sean Hui
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Kelly Shaffer
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | | | | | | | | | - Min Ni
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | | | | | | | - Ruth Mabel Boytz
- Department of Microbiology, Boston University of Medicine and NEIDL, Boston University, Boston, MA 02118, USA
| | - Callie Donahue
- Department of Microbiology, Boston University of Medicine and NEIDL, Boston University, Boston, MA 02118, USA
| | - Robert Davey
- Department of Microbiology, Boston University of Medicine and NEIDL, Boston University, Boston, MA 02118, USA
| | - Alina Baum
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | | | - Erica Ollmann Saphire
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA.
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