Immune molecules from a llama could provide protection against a vast array of SARS-like viruses including COVID-19, researchers say

New York, NY (June 23, 2022) – Mount Sinai-led researchers have shown that tiny, robust immune particles derived from the blood of a llama could provide strong protection against every COVID-19 variant, including Omicron, and 18 similar viruses including SARS-CoV-2 and SARS-CoV-1, which was responsible for the 2003 SARS outbreak.

In a paper published in Cell Reports on June 28, the team suggests that these “super-immunity” molecules, known as nanobodies, could be precursors to a fast-acting, inhalable antiviral treatment or spray that could potentially be stockpiled and used globally against the evolving pandemic and future viruses.

Compared to the rest of the animal kingdom, llamas, camels, and alpacas have unique immune systems: they produce antibodies with a single polypeptide chain instead of two. This construct results in antibodies that are roughly one-tenth the size of normal ones, are exceptionally stable, and can firmly bind to disease targets. Because of these unique properties, researchers can readily link multiple nanobodies like a daisy chain, so if a virus attempts to escape by mutating, another nanobody is ready to keep it in check.

“Because of their small size and broad neutralizing activities, these camelid nanobodies are likely to be effective against future variants and outbreaks of SARS-like viruses,” says lead author Yi Shi, PhD, Associate Professor of Pharmacological Sciences and Director of the Center of Protein Engineering and Therapeutics at the Icahn School of Medicine at Mount Sinai. “Their superior stability, low production costs, and the ability to protect both the upper and lower respiratory tracts against infection mean they could provide a critical therapeutic to complement vaccines and monoclonal antibody drugs if and when a new COVID-19 variant or SARS-CoV-3 emerges.”

As a critical part of their study, Dr. Shi’s team immunized the llama, named “Wally,” with the SARS-CoV-2 receptor binding domain (RBD), the short fragment or spike of the virus that latches onto the protein on the surface of human cells to gain entry and spread infection. They found that repeated immunization with the RBD resulted in Wally producing nanobodies that recognized not just SARS-CoV-2, the virus that causes COVID-19, but a vast array of other coronaviruses—conferring what researchers referred to as “super-immunity.” From this discovery, the team isolated and validated a large repertoire of highly potent antiviral nanobodies effective against a broad spectrum of SARS-like viruses.

“We learned that the tiny size of these nanobodies gives them a crucial advantage against a rapidly mutating virus,” explains co-author Ian Wilson, PhD, Hansen Professor of Structural Biology and Chair of the Department of Integrative Structural and Computational Biology at Scripps Research in La Jolla, California. “Specifically, it allows them to penetrate more of the recesses, nooks, and crannies of the virus surface, and thus bind to multiple regions to prevent the virus from escaping and mutating.”

From this structural information, the team designed an ultrapotent nanobody that can simultaneously bind to two regions on the RBD of SARS-like viruses to prevent mutational escape. The resulting molecule (PiN-31) is extremely stable and, in its aerosolized form, can be used as an inhaled treatment or spray, which the same team showed in previous work can be effective against SARS-CoV-2.

“While more research is needed, we believe that the broad protection, ultrapotent nanobodies we were able to isolate in the lab can be harnessed for use in humans,” says Dr. Shi, who conducted most of the research at the University of Pittsburgh before moving his lab to Icahn Mount Sinai. Increasing the attractiveness of this potential form of treatment, these highly versatile antiviral agents can be rapidly produced virtually anywhere from microbes such as E.coli or yeast cells, he adds. In the past, nanobody therapies have been clinically proven as safe and effective against human diseases, such as a blood clotting disorder and cancer.

“Winning the race against the current pandemic, as well as future viral outbreaks, will depend on fast development and equitable distribution of an arsenal of cost-effective and convenient technologies,” Dr. Shi emphasizes. “We strongly believe that the novel, inhalable, and extremely potent nanobodies we’ve discovered can meet that demand on a global scale, particularly in developing countries that are most vulnerable to viruses and the lack of therapies to treat them.”

In addition to Scripps Research, experts from Case Western Reserve University in Cleveland, the University of Pittsburgh, Hebrew University in Jerusalem, and Tel Aviv University in Israel contributed to this study.

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Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.

Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report’s Best Hospitals, receiving high “Honor Roll” status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children’s Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Reports “Best Medical Schools,” aligned with a U.S. News & World Report “Honor Roll” Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

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