SARS-CoV-2 RBD antibodies that maximize breadth and resistance to escape

An ideal therapeutic anti-SARS-CoV-2 antibody would resist viral escape(1-3), have activity against diverse sarbecoviruses(4-7), and be highly protective through viral neutralization(8-11) and effector functions(12,13). Understanding how these properties relate to each other and vary across epitopes would aid the development of therapeutic antibodies and guide vaccine design. Here we comprehensively characterize escape, breadth and potency across a panel of SARS-CoV-2 antibodies targeting the receptor-binding domain (RBD). Despite a trade-off between in vitro neutralization potency and breadth of sarbecovirus binding, we identify neutralizing antibodies with exceptional sarbecovirus breadth and a corresponding resistance to SARS-CoV-2 escape. One of these antibodies, S2H97, binds with high affinity across all sarbecovirus clades to a cryptic epitope and prophylactically protects hamsters from viral challenge. Antibodies that target the angiotensin-converting enzyme 2 (ACE2) receptor-binding motif (RBM) typically have poor breadth and are readily escaped by mutations despite high neutralization potency. Nevertheless, we also characterize a potent RBM antibody (S2E12(8)) with breadth across sarbecoviruses related to SARS-CoV-2 and a high barrier to viral escape. These data highlight principles underlying variation in escape, breadth and potency among antibodies that target the RBD, and identify epitopes and features to prioritize for therapeutic development against the current and potential future pandemics.

Automated summary

An ideal therapeutic anti-SARS-CoV-2 antibody should have resistance to viral escape, activity against diverse sarbecoviruses, and provide high protection through viral neutralization and effector functions. Studies have found a trade-off between in vitro neutralization potency and breadth of sarbecovirus binding in SARS-CoV-2 antibodies targeting the RBD, but identified some antibodies with exceptional sarbecovirus breadth and resistance to SARS-CoV-2 escape.