Structural basis for the synergistic neutralization of coxsackievirus B1 by a triple-antibody cocktail.
Zheng, Q., Zhu, R., Yin, Z., Xu, L., Sun, H., Yu, H., Wu, Y., Jiang, Y., Huang, Q., Huang, Y., Zhang, D., Liu, L., Yang, H., He, M., Zhou, Z., Jiang, Y., Chen, Z., Zhao, H., Que, Y., Kong, Z., Zhou, L., Li, T., Zhang, J., Luo, W., Gu, Y., Cheng, T., Li, S., Xia, N.(2022) Cell Host Microbe 30: 1279-1294.e6
- PubMed: 36002016 
- DOI: https://doi.org/10.1016/j.chom.2022.08.001
- Primary Citation of Related Structures:  
7X2G, 7X2I, 7X2O, 7X2T, 7X2W, 7X35, 7X37, 7X38, 7X3C, 7X3D, 7X3E, 7X3F, 7X3Y, 7X40, 7X42, 7X46, 7X47, 7X49, 7X4K, 7X4M - PubMed Abstract: 
Coxsackievirus B1 (CVB1) is an emerging pathogen associated with severe neonatal diseases including aseptic meningitis, myocarditis, and pancreatitis and also with the development of type 1 diabetes. We characterize the binding and therapeutic efficacies of three CVB1-specific neutralizing antibodies (nAbs) identified for their ability to inhibit host receptor engagement. High-resolution cryo-EM structures showed that these antibodies recognize different epitopes but with an overlapping region in the capsid VP2 protein and specifically the highly variable EF loop. Moreover, they perturb capsid-receptor interactions by binding various viral particle forms. Antibody combinations achieve synergetic neutralization via a stepwise capsid transition and virion disruption, indicating dynamic changes in the virion in response to multiple nAbs targeting the receptor-binding site. Furthermore, this three-antibody cocktail protects against lethal challenge in neonatal mice and limits pancreatitis and viral replication in a non-obese diabetic mouse model. These results illustrate the utility of nAbs for rational design of therapeutics against picornaviruses such as CVB.
Organizational Affiliation: 
State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Sciences & School of Public Health, Xiamen University, Xiamen, Fujian 361102, People's Republic of China.