Nasal delivery of an IgM offers broad protection from SARS-CoV-2 variants

Link to article at PubMed

Nature. 2021 Jun 3. doi: 10.1038/s41586-021-03673-2. Online ahead of print.

ABSTRACT

Resistance represents a major challenge for antibody-based therapy for coronavirus disease 2019 (COVID-19)1-4. Here we engineered an immunoglobulin M (IgM) neutralizing antibody (IgM-14) to overcome the resistance encountered by IgG-based therapeutics. IgM-14 is >230-fold more potent than its parental IgG-14 in neutralizing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). IgM-14 potently neutralizes the resistant virus raised by its corresponding IgG-14, the newly emerged United Kingdom B.1.1.7, Brazilian P.1, and South African B.1.351 variants of concern (VOCs), and 21 other receptor-binding domain (RBD) mutants, many of which are resistant to the IgGs that have been authorized for emergency use. Although engineering IgG into IgM enhances antibody potency in general, selection of an optimal epitope is critical for identifying the most effective IgM that can overcome resistance. One single intranasal (IN) dose of 0.044 and 0.4 mg/kg IgM-14 confers prophylactic and therapeutic efficacy against SARS-CoV-2 in mice, respectively. IgM-14, but not IgG-14, also confers potent therapeutic protection against the P.1 and B.1.351 variants. IgM-14 exhibits desirable IN pharmacokinetics and safety in rodents. Our results demonstrate that IN administration of an engineered IgM can improve efficacy, reduce resistance, and simplify the prophylactic and therapeutic treatment of COVID-19.

PMID:34082438 | DOI:10.1038/s41586-021-03673-2

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