SARS-CoV-2 Monoclonal Antibody Treatment Followed by Vaccination Shifts Human Memory B-Cell Epitope Recognition, Suggesting Antibody Feedback
Nathaniel Bloom, Sydney I Ramirez, Hallie Cohn, Urvi M Parikh, Amy Heaps, Scott F Sieg, Alex Greninger, Justin Ritz, Carlee Moser, Joseph J Eron, Goran Bajic, Judith S Currier, Paul Klekotka, David A Wohl, Eric S Daar, Jonathan Li, Michael D Hughes, Kara W Chew, Davey M Smith, PhD Shane Crotty, PhD Camila H Coelho, Lara Hosey, Jhoanna Roa, Nilam Patel, Bill Erhardt, Stacey Adams
The Journal of Infectious Diseases, doi:10.1093/infdis/jiae371
Therapeutic monoclonal antibodies (mAbs) have been studied in humans, but the impact on immune memory of mAb treatment during an ongoing infection remains unclear. We evaluated the effect of infusion of the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (RBD) mAb bamlanivimab on memory B cells (MBCs) in SARS-CoV-2-infected individuals. Bamlanivimab treatment skewed the repertoire of MBCs targeting spike toward non-RBD epitopes. Furthermore, the relative affinity of RBD MBCs was weaker in mAb-treated individuals compared to placebo-treated individuals over time. Subsequently, after mRNA coronavirus disease 2019 vaccination, MBC differences persisted and mapped to a specific reduction in recognition of the class II RBD site, the same RBD epitope recognized by bamlanivimab. These findings indicate a substantial role of antibody feedback in regulating MBC responses to infection, and single mAb administration can continue to impact MBC responses to additional antigen exposures months later.
MBC Specificities We assessed the impact of mAb treatment on MBCs in greater detail by examining RBD MBC epitope specificity. SARS-CoV-2 RBD and spike antibody epitopes have been extensively characterized [27] [28] [29] [30] . We designed RBD epitope probe constructs by incorporating point mutations disrupting
Supplementary Data Supplementary materials are available at The Journal of Infectious Diseases online ( http://jid.oxfordjournals.org/ ). Supplementary materials consist of data provided by the author that are published to benefit the reader. The posted materials are not copyedited. The contents of all supplementary data ipants, site staff, site investigators, members of the ACTIV-2/ A5401 Study Team, the ACTIV-
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' <jats:p>Therapeutic monoclonal antibodies (mAbs) have been studied in humans, '
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'We evaluated the effect of infusion of the anti–severe acute respiratory syndrome coronavirus '
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