Article
Author: Anand, Sai Priya ; Piszczek, Grzegorz ; Kumar, Priti ; Finzi, Andrés ; Tolbert, William D. ; Moran, Sean ; Gottumukkala, Suneetha ; Sun, Lulu ; Ullah, Irfan ; Ding, Shilei ; Hederman, Andrew P. ; Marchitto, Lorie ; Luo, Yuhong ; Wu, Di ; Gonzalez, Frank J. ; Pazgier, Marzena ; Uchil, Pradeep D. ; Chen, Yaozong ; Sherburn, Rebekah ; Ackerman, Margaret E. ; Mothes, Walther ; Nguyen, Dung N. ; Beaudoin-Bussières, Guillaume
Soluble angiotensin-converting enzyme 2 (ACE2) constitutes an attractive antiviral capable of targeting a wide range of coronaviruses using ACE2 as their receptor. Using structure-guided approaches, we developed a series of bivalent ACE2-Fcs harboring functionally and structurally validated mutations that enhance severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain recognition by up to ~12-fold and remove angiotensin enzymatic activity. The lead variant M81 potently cross-neutralized SARS-CoV-2 variants of concern (VOCs), including Omicron, at subnanomolar half-maximal inhibitory concentration and was capable of robust Fc-effector functions, including antibody-dependent cellular cytotoxicity, phagocytosis, and complement deposition. When tested in a stringent K18-hACE2 mouse model, Fc-enhanced ACE2-Fc delayed death by 3 to 5 days or effectively resolved lethal SARS-CoV-2 infection in both prophylactic and therapeutic settings via the combined effects of neutralization and Fc-effector functions. These data add to the demonstrated utility of soluble ACE2 as a valuable SARS-CoV-2 antiviral and indicate that Fc-effector functions may constitute an important component of ACE2-Fc therapeutic activity.