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Human neutralizing antibodies against SARS-CoV-2 require intact Fc effector functions for optimal therapeutic protection.

Emma S Winkler | Pavlo Gilchuk | Jinsheng Yu | Adam L Bailey | Rita E Chen | Zhenlu Chong | Seth J Zost | Hyesun Jang | Ying Huang | James D Allen | James Brett Case | Rachel E Sutton | Robert H Carnahan | Tamarand L Darling | Adrianus C M Boon | Matthias Mack | Richard D Head | Ted M Ross | James E Crowe | Michael S Diamond
Cell | 2021

SARS-CoV-2 has caused the global COVID-19 pandemic. Although passively delivered neutralizing antibodies against SARS-CoV-2 show promise in clinical trials, their mechanism of action in vivo is incompletely understood. Here, we define correlates of protection of neutralizing human monoclonal antibodies (mAbs) in SARS-CoV-2-infected animals. Whereas Fc effector functions are dispensable when representative neutralizing mAbs are administered as prophylaxis, they are required for optimal protection as therapy. When given after infection, intact mAbs reduce SARS-CoV-2 burden and lung disease in mice and hamsters better than loss-of-function Fc variant mAbs. Fc engagement of neutralizing antibodies mitigates inflammation and improves respiratory mechanics, and transcriptional profiling suggests these phenotypes are associated with diminished innate immune signaling and preserved tissue repair. Immune cell depletions establish that neutralizing mAbs require monocytes and CD8+ T cells for optimal clinical and virological benefit. Thus, potently neutralizing mAbs utilize Fc effector functions during therapy to mitigate lung infection and disease.

Pubmed ID: 33691139

Research resources used in this publication

None found

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Associated grants

  • Agency: NIAID NIH HHS, United States
    Id: F30 AI152327
  • Agency: NIAMS NIH HHS, United States
    Id: P30 AR073752
  • Agency: NIAID NIH HHS, United States
    Id: R01 AI157155
  • Agency: NIAID NIH HHS, United States
    Id: T32 AI007163

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Bio X Cell (tool)

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B6.Cg-Tg(K18-ACE2)2Prlmn/J (tool)

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