A human antibody that broadly neutralizes betacoronaviruses protects against SARS-CoV-2 by blocking the fusion machinery

Pinto, Dora; Sauer, Maximilian M.; Czudnochowski, Nadine; Low, Jun Siong; Tortorici, M. Alejandra; Housley, Michael P.; Noack, Julia; Walls, Alexandra C.; Bowen, John E.; Guarino, Barbara; Rosen, Laura E.; di Iulio, Julia; Jerak, Josipa; Kaiser, Hannah; Islam, Saiful; Jaconi, Stefano; Sprugasci, Nicole; Culap, Katja; Abdelnabi, Rana; Foo, Caroline; Coelmont, Lotte; Bartha, Istvan; Bianchi, Siro; Silacci-Fregni, Chiara; Bassi, Jessica; Marzi, Roberta; Vetti, Eneida; Cassotta, Antonino; Ceschi, Alessandro; Ferrari, Paolo; Cippà , Pietro E.; Giannini, Olivier; Ceruti, Samuele; Garzoni, Christian; Riva, Agostino; Benigni, Fabio; Cameroni, Elisabetta; Piccoli, Luca; Pizzuto, Matteo S.; Smithey, Megan; Hong, David; Telenti, Amalio; Lempp, Florian A.; Neyts, Johan; Havenar-Daughton, Colin; Lanzavecchia, Antonio; Sallusto, Federica; Snell, Gyorgy; Virgin, Herbert W.; Beltramello, Martina; Corti, Davide; Veesler, David

The repeated spillovers of β-coronaviruses in humans along with the rapid emergence of SARS-CoV-2 escape variants highlight the need to develop broad coronavirus therapeutics and vaccines. Five monoclonal antibodies (mAbs) were isolated from COVID-19 convalescent individuals and found to cross-react with multiple β-coronavirus spike (S) glycoproteins by targeting the stem helix. One of these mAbs, S2P6, cross-reacts with more than twenty human and animal β-coronavirus S glycoproteins and broadly neutralizes SARS-CoV-2 and pseudotyped viruses from the sarbecovirus, merbecovirus and embecovirus subgenera. Structural and functional studies delineate the molecular basis of S2P6 cross-reactivity and broad neutralization and indicate that this mAb blocks viral entry by inhibiting membrane fusion. S2P6 protects hamsters challenged with SARS-CoV-2 (including the B.1.351 variant of concern) through direct viral neutralization and Fc-mediated effector functions. Serological and B cell repertoire analyses indicate that antibodies targeting the stem helix are found in some convalescent donors and vaccinees but are predominantly of narrow specificity. Germline reversion of the identified cross-reactive mAbs revealed that their unmutated ancestors are specific for the endemic OC43 or HKU1 viruses and acquired enhanced affinity and breadth through somatic mutations. These data demonstrate that conserved epitopes in the coronavirus fusion machinery can be targeted by protective antibodies and provide a framework for structure-guided design of pan-β-coronavirus vaccines eliciting broad protection.