INTRODUCTION
The first cases of COVID-19 were reported in December 2019. COVID-19 was declared a global pandemic by the World Health Organization (WHO) in March 2020. Vaccines were developed and administered to populations worldwide, including three vaccines that were approved or authorized for emergency use in the United States (
1). However, as the virus continues to circulate in the human population, several variants of concern (VOCs) emerged and continue to cause new and breakthrough infections (
2–6). Therefore, it is important to understand how these VOCs have influenced the effectiveness of immune response and previously employed prevention strategies.
COVID-19 infection is caused by the virus SARS-CoV-2, which is included in the sarbecovirus subgenus (
7). SARS-CoV-2 contains a single-stranded RNA inside its membrane. The predominant surface protein is the spike (S) protein (
8,
9). The S protein is trimeric, with each protomer consisting of an S1 and an S2 subunit. The S1 subunit can be further divided into four separate domains, including the N-terminal domain (NTD) and receptor binding domain (RBD) (
10). The receptor binding motif (RBM) of RBD can bind to the angiotensin-converting enzyme-2 (ACE-2) receptor on human airway epithelial cells, triggering separation of S1 and S2 subunits, membrane fusion, and subsequent infection steps (
11).
S protein can undergo drastic domain conformational changes. Most notably, RBD can be in either the open or the closed conformation (
12). Only the open conformation is compatible with ACE-2 binding, with the ACE-2 binding site overlapping with the top of RBD (
13). The three RBDs in a trimer can co-exist in open or closed conformation for each RBD.
Both RBD and NTD can be targeted by neutralizing monoclonal antibodies (mAbs). While neutralizing NTD-targeting antibodies were shown to primarily target a specific NTD supersite (
14–16), existing literature prevalently separate RBD-targeting mAbs into Class I to Class IV (
17,
18): Class I refers to mAbs that target binding sites that largely overlap with RBM and are only accessible when RBD is in the open conformation, with IGHV3-55 heavy chain antibodies typically targeting this site (
19,
20); Class 2 refers to mAbs that target the top of RBD and can typically bind to RBD in either the open or closed conformation; Class 3 refers to mAbs that bind more outwards onto RBD than Class 2, with S309 being one of the extreme cases (
21); Class 4 refers to mAbs that bind to the inner/cryptic site of RBD (
22), which is only accessible when RBD is in open conformation, with CR3022 mAb being a representative member of this class (
23).
There are other variations of binding site classification. Class 3 encompasses a large variety of epitopes arranged along the outer side of RBD. Yuan et al. separated Class 3 into three smaller groups, depending on the distance of the epitope from RBM (
20,
24). Deshpande et al. defined a new group called “Class I distinct,” which is essentially a sub-group of Class 2 that binds between the ACE-2 binding site and the center-top area of RBD (
25). Dejnirattisai et al. used a separate nomenclature and compared RBD to a human torso (
26), essentially separating the top of RBD into smaller areas as well as further separating Class 3 binders.
Several variants of concern (VOCs) emerged, including B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.617.2 (Delta), and B.1.1.529 (Omicron), and each was at a certain stage of the pandemic rapidly transmitted among the human population. Among the key mutations, mutation N501Y is shared by B.1.1.7, B.1.351, P.1, and B.1.1.529 and was shown to be the crucial mutation to enhance the affinity to ACE-2 (
27,
28). Mutations of K417 and E484 are shared by B.1.351 (K417N/E484K), P.1 (K417T/E484K), and B.1.1.529 (K417N/E484A). The mutation of K417N/T alone abolishes the stabilizing salt bridge formed by the Lysine and is unfavorable for ACE-2 binding (
27,
28). The mutation on position E484 does not significantly impact ACE-2 binding affinity (
29,
30), although the structure of the unbound spike containing E484K mutation suggests the mutation has a role in the local destabilization of RBD structure (
31). The combination of the three mutations in B.1.351 and P.1 has a net effect of increasing RBD affinity to ACE-2 (
28,
30).
Administering antibody cocktails is a great option to target multiple antigen epitopes simultaneously. Several commercially available antibody cocktails were developed to treat individuals with COVID-19 (
21,
32–39). Additional cocktail formulations have also been proposed by other research groups (
40–42). All major clinical mAbs under clinical trials and previously under FDA emergency use authorization (EUA) (
43) (Bamlanivimab, Etesivimab, Casirivimab, Imdevimab, Cilgavimab, Tixagevimab, Amubarvimab, Romlusevimab, Bebtelovimab, Regdanvimab, Sotrovimab, and Adintrevimab) can be classified as Classes 1–3, but none are Class 4 (cryptic site) mAbs that bind similar to CR3022 (
44,
45).
Class I and class II antibodies predominantly form stabilizing contacts with K417 and E484, respectively (
20,
46,
47). Therefore, a significant number of clinically available mAbs showed weaker binding or neutralization to VOCs due to loss of stabilizing interactions (
48–53). It is thus important to further characterize the impact of the binding affinity of mAbs due to variant mutations. This will help elucidate how antigen-targeting by antibodies might evolve during a pandemic and prepare for potential future sarbecovirus outbreaks.
The Coronavirus Immunotherapeutics Consortium (CoVIC) collected more than 400 candidate therapeutic antibody constructs (IgG and other forms) to study their biophysical and functional properties and their resistance to VOCs. The first 300 antibody constructs were collected prior to the emergence of the Delta variant while the remaining antibody constructs were collected by the fall of 2022 and at least include antibodies isolated from individuals infected with the Delta variant. The majority of the RBD-specific CoVIC constructs were separated into seven major communities based on competition profiles against isolated RBD domain molecules (
54). These communities encompass the four epitope classes (
17,
18), with further separation into sub-communities for each class. In particular, a specific area on the top of RBD termed the “mesa” area, similar to the “right shoulder” in the human torso analogy (
26), is shared by multiple communities as part of the binding interface. Representative CoVIC constructs were then selected from each community for further structural and functional studies, including characterizing the RBD target site(s) for each community as well as assessing the impact of variant mutations on neutralization.
When RBD is presented as an integral part of the trimeric S protein, the competition profile may change due to factors such as steric hindrance and the open/closed state of RBD (
12). Here, we report the competition profile for CoVIC constructs against HexaPro, a trimeric prefusion-stabilized S protein containing six stabilizing proline residues (
55), using an epitope binning method by high-throughput surface plasmon resonance (SPR), and how this competition profile relates to binding affinities and ACE-2 blocking ability of CoVIC antibodies. We also report the impact of B.1.351 and BA.1 mutations on antibody affinities for the spike protein and neutralization function.
DISCUSSION
Several groups have attempted to separate a panel of mAbs, Fabs, or nanobodies into groups or down-select mAbs based on competition profiles: some panels were competed against a small number of known-epitope mAbs (
34,
61), some used RBD to probe competition profile (
26,
62,
63), while the majority used spike trimer to probe competition profile (
15,
32,
64–68). Although the epitope classification of classes 1–4 is the most prevalently adopted nomenclature and provides a broad-stroke separation of antibody binding specificities, the competition assays done here and by others show the complexity of the epitope targets. When interpreting binning results, it is important to understand how the antigen molecule used impacts the competition profile and to combine other types of data to determine the most appropriate categorization. Here, we have attempted to provide a more comprehensive landscape of binding epitopes using a large antibody panel and linking the binning communities to previously reported structural data, binding affinity changes, and neutralization ability changes. The biophysical and functional data enabled us to better define the binding footprint and characteristics each binning community represents. We also compared the competition profile probed using a spike trimer to previously reported competition using RBD (
54) and showed that varying antigen probes may lead to differences in the competition profiles. In the context of the trimeric spike, epitope accessibility on RBD will vary due to steric hindrance from surrounding domains or the opening and closing of RBD, influencing competition outcome. Expectedly, the CoVIC antibody constructs separated into nine communities when binned against HexaPro trimer compared to seven main communities identified by RBD binning, although the non-RBD binders segregated away from the exclusively RBD-binding communities.
While we separated the binding footprints into multiple regions based on distinct competition patterns, the different RBD binding footprints are very close spatially as indicated by the competition among RBD-binding communities. Especially, the CoVIC constructs that share the mesa/valley area in binding footprints show competition with communities targeting other RBD binding sites. It is therefore likely not optimal to pair mesa/valley targeting antibodies with other RBD-targeting antibodies for cooperative binding. Interestingly, Adintrevimab (ADG-20), a clinical mAb currently under evaluation, uses the inner-mesa interface (
69). By contrast, cryptic site and top targeting antibodies are the two groups that showed the least amount of competition with each other while both generally strongly blocked ACE-2 interaction.
In addition to footprint proximity, RBD is both linked to and surrounded by other domains. Unlike an isolated RBD molecule, cooperative binding on RBD in the context of trimeric spike protein may require more than non-overlapping epitopes. Not only can the closed state of RBD preclude binding access to the cryptic site, but the open state of RBD could restrict the access to the outer face. This may explain the competition between some mesa/valley targeting constructs and outer face targeting constructs. Some antibodies targeting the outer face of RBD were shown to lock RBD in the closed conformation (
36,
42). Therefore, some outer face RBD binders can potentially prevent RBD binders targeting other footprints from accessing preferred binding sites, including the cryptic-site.
Antibody constructs that bind to the cryptic site of RBD make up a unique group. The majority of cryptic-site binders effectively block ACE-2 and consistently show enhanced binding and retained neutralization to the B.1.351 variant, with some maintaining a reasonable level of binding to the BA.1 variant (
Fig. 4d). Notably, some cryptic-site binders showed neutralization activity without blocking ACE-2 (
70). Based on the competition profile, these antibody constructs very likely bind cooperatively with top-RBD-targeting antibodies. Currently, no clinical mAb that received EUA previously from the FDA is known to target the cryptic site (
44,
45), likely in part due to the weaker binding affinities compared to other RBD binding footprints, which, in turn, may associate with weak neutralization activity. However, the binding of cryptic-site-targeting antibodies could be enhanced through molecular engineering, for example, into a multivalent antibody construct. Strategies of this type such as creating multimers from VHH were used by others and were shown to retain neutralization to multiple VOCs including Omicron (
71).
Interestingly, most of the NTD-specific antibody constructs in this panel lost the ability to bind to B.1.351 HexaPro, with only 11 out of the 43 NTD-specific constructs within CoVIC 1–405 showing enhanced affinity or less than threefold decreased affinity (Fig. S7). It was shown that the majority of the neutralizing activity in convalescent patients is contributed by RBD targeting antibodies (
18,
68,
72). However, the B.1.351 variant seems to have also evolved to escape binding and neutralization by NTD-targeting antibodies. This highlights the need to expand research on the importance of virus neutralization by NTD targeting antibodies.
While each type of binding footprint presented an overall trend in affinity for the B.1.351 VOC, it is worth noting that select constructs from each binding footprint type retained binding affinity and neutralization activity against VOCs. For example, while antibody constructs targeting the top of RBD show prevalently weakened binding to the B.1.351 variant, a few constructs are escape profile “outliers” and retained or even had enhanced binding, possibly due to distinct residue contacts on the epitope. Escape profile “outliers” can be observed in other communities in the CoVIC panel as well. It was shown by others that antibodies with similar epitope footprints can have very different escape profiles due to differences in key residue contacts (
73,
74). Structural investigation of these resistant antibody constructs in the future can reveal binding interactions that are less affected by VOC mutations.
Conclusion
In this work, we provide a new way to examine epitope footprints on RBD and NTD based on the HexaPro binning profile and have shown that cooperative antibody binding on RBD requires more than non-overlapping binding surfaces. Among the different binding footprints, antibodies sharing the mesa/valley area as binding sites are not very likely to bind cooperatively with other RBD binders. The antibodies binding to the cryptic site of RBD consistently resist mutations in the B.1.351 variant and show a certain level of affinity retention toward the BA.1 variant which can be particularly explored further. We also showed that antibodies that retain neutralization of the B.1.351 variant are those with retained affinities for B.1.351 HexaPro compared to D614 HexaPro and that Fab binding affinities for D614 HexaPro directly correlate with neutralization of the WT virus. In each type of binding footprint, select constructs retain binding and neutralization toward the B.1.351 VOC. These insights are useful in providing guidance for prevention and treatment options for potential future sarbecovirus outbreaks.