Analysis of a Therapeutic Antibody Cocktail Reveals Determinants for Cooperative and Broad Ebolavirus Neutralization

Summary Structural principles underlying the composition of protective antiviral monoclonal antibody (mAb) cocktails are poorly defined. Here, we exploited antibody cooperativity to develop a therapeutic mAb cocktail against Ebola virus. We systematically analyzed the antibody repertoire in human survivors and identified a pair of potently neutralizing mAbs that cooperatively bound to the ebolavirus glycoprotein (GP). High-resolution structures revealed that in a two-antibody cocktail, molecular mimicry was a major feature of mAb-GP interactions. Broadly neutralizing mAb rEBOV-520 targeted a conserved epitope on the GP base region. mAb rEBOV-548 bound to a glycan cap epitope, possessed neutralizing and Fc-mediated effector function activities, and potentiated neutralization by rEBOV-520. Remodeling of the glycan cap structures by the cocktail enabled enhanced GP binding and virus neutralization. The cocktail demonstrated resistance to virus escape and protected non-human primates (NHPs) against Ebola virus disease. These data illuminate structural principles of antibody cooperativity with implications for development of antiviral immunotherapeutics.
Graphical Abstract
Highlights • Human mAbs of two epitope specificities bind cooperatively to the ebolavirus GP • Cooperativity is mediated by a mAb that enhances binding to a vulnerable GP epitope • A two-mAb cocktail exhibits enhanced potency against heterologous ebolaviruses • Two 30 mg/kg doses of the cocktail fully protected non-human primates (NHPs) challenged with EBOV
Cooperative interactions of monoclonal antibodies (mAbs) with viral antigens are poorly understood. Gilchuk et al. perform structural and functional analysis of cooperativity in a cocktail of two human mAbs, recognizing major epitopes of ebolavirus glycoprotein (GP), and define cooperative binding of the GP as a mechanism for enhanced ebolavirus neutralization.