WO2023143407A1 - 靶向冠状病毒的抗体在预防、治疗或改善covid-19中的应用 - Google Patents

靶向冠状病毒的抗体在预防、治疗或改善covid-19中的应用 Download PDF

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Publication number
WO2023143407A1
WO2023143407A1 PCT/CN2023/073265 CN2023073265W WO2023143407A1 WO 2023143407 A1 WO2023143407 A1 WO 2023143407A1 CN 2023073265 W CN2023073265 W CN 2023073265W WO 2023143407 A1 WO2023143407 A1 WO 2023143407A1
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seq
antibody
heavy chain
sequence
amino acid
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PCT/CN2023/073265
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English (en)
French (fr)
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黄贤明
杨晓蕾
张慧
李胜峰
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百奥泰生物制药股份有限公司
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Publication of WO2023143407A1 publication Critical patent/WO2023143407A1/zh

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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/08—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from viruses
    • C07K16/10—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from viruses from RNA viruses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • A61K39/42—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum viral
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/14—Antivirals for RNA viruses
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/46—Hybrid immunoglobulins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/54—Medicinal preparations containing antigens or antibodies characterised by the route of administration
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/30—Immunoglobulins specific features characterized by aspects of specificity or valency
    • C07K2317/31—Immunoglobulins specific features characterized by aspects of specificity or valency multispecific
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
    • C07K2317/565—Complementarity determining region [CDR]

Definitions

  • the invention belongs to the field of biotechnology, and in particular relates to the application of antibodies targeting coronaviruses in the prevention, treatment or improvement of COVID-19.
  • Coronavirus is a single-stranded positive-sense RNA virus that is not segmented. According to the serotype and genomic characteristics, the subfamily Coronaviridae is divided into four genera: ⁇ , ⁇ , ⁇ , and ⁇ . Protruding, shaped like a corolla and named after it.
  • the new coronavirus (SARS-CoV-2 or 2019-nCoV) discovered in 2019 belongs to the new coronavirus of the genus ⁇ , with an envelope, and the particles are round or oval, often pleomorphic, with a diameter of 60-140nm.
  • Chest imaging showed multiple small patchy shadows and interstitial changes in the early stage, especially in the extrapulmonary zone; then it developed into multiple ground-glass shadows and infiltration shadows in both lungs, and in severe cases, lung consolidation and dyspnea gradually appeared.
  • Acute Respiratory Distress Syndrome (ARDS) shock, and various tissue damage and dysfunction of lung tissue, heart, and kidney occurred in patients. Most patients with mild infection have a good prognosis, while those with severe infection are often in critical condition and even die.
  • the present invention provides a method or application of an antibody targeting a coronavirus for preventing, treating or improving a disease (COVID-19) caused by a novel coronavirus.
  • the antibody targeting coronavirus is an antibody with high affinity to the spike protein of SARS-CoV-2.
  • the antibody targeting coronavirus is a bispecific antibody, a single domain antibody or a heavy chain antibody or an antigen-binding fragment.
  • spike protein S protein or spike protein
  • ACE2 angiotensin-converting enzyme 2
  • SARS-CoV-2 enters the cell and uses the cell for its Synthesize new virus particles; the new virus particles are released outside the cell, and in the same way, the virus infects the surrounding normal Cell.
  • the bispecific antibody or antigen-binding fragment targeting the spike protein can block the binding of the spike protein to ACE2, thereby blocking the virus from entering the cell and exerting an antiviral effect.
  • the bispecific antibody or antigen-binding fragment of the present invention can also mediate immune cell phagocytosis and virus clearance.
  • Some embodiments provide a bispecific antibody targeting coronavirus, the bispecific antibody comprising a first binding moiety that binds a spike protein and a second binding moiety that binds a spike protein linked by a linker L1.
  • the first binding moiety that binds a spike protein comprises:
  • HCDR1 which comprises the amino acid sequence shown in SEQ ID NO: 1 or 2, or its variants with single or multiple site substitutions, deletions or insertions
  • HCDR2 which comprises such as SEQ ID NO : the amino acid sequence shown in 3 or 4, or its single or multiple site substitution, deletion or insertion variant
  • HCDR3 which comprises any one of SEQ ID NO:5-42 The amino acid sequences shown, or variants thereof with single or multiple site substitutions, deletions or insertions.
  • the first binding moiety comprises:
  • HCDR1 which comprises the amino acid sequence shown in SEQ ID NO: 1 or 2
  • HCDR2 which comprises the amino acid sequence shown in SEQ ID NO: 3 or 4
  • HCDR3 which comprises Amino acid sequence as shown in any one of SEQ ID NO:5-42.
  • the first binding moiety comprises:
  • the first binding moiety comprises:
  • HCDR1 which comprises the amino acid sequence shown in SEQ ID NO: 1 or 2, or its variants with single or multiple site substitutions, deletions or insertions
  • HCDR2 which comprises the amino acid sequence as shown in SEQ ID NO : Ammonia shown in 3 or 4 amino acid sequence, or variants with single or multiple site substitutions, deletions or insertions
  • HCDR3 which comprises the amino acid sequence shown in any one of SEQ ID NO:5-42, or has Single or multiple site substitutions, deletions or insertion variants
  • LCDR1 comprising the amino acid sequence shown in SEQ ID NO: 43 or 44, or single or multiple site substitutions, deletions or insertions thereof
  • LCDR2 which comprises the amino acid sequence shown in SEQ ID NO: 45 or 46, or its variants with single or multiple site substitutions, deletions or insertions
  • LCDR3 which Comprising an amino acid sequence as shown in SEQ ID NO: 47 or 48, or variants thereof with single or multiple site substitution
  • the substitution variants are conservative amino acid substitution variants.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO: 1 or 2, HCDR2 as shown in SEQ ID NO: 3 or 4, any of SEQ ID NOs: 5-42
  • HCDR1 shown in SEQ ID NO: 1 or 2
  • HCDR2 as shown in SEQ ID NO: 3 or 4
  • any of SEQ ID NOs: 5-42 One or two of HCDR3 shown in item, LCDR1 shown in SEQ ID NO: 43 or 44, LCDR2 shown in SEQ ID NO: 45 or 46, and LCDR3 shown in SEQ ID NO: 47 or 48 , three, four, five or all.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:5, HCDR3 as shown in SEQ ID NO LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:6, HCDR3 as shown in SEQ ID NO LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:7, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:8, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:10, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:11, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as set forth in SEQ ID NO:1, HCDR2 as set forth in SEQ ID NO:3, HCDR3 as set forth in SEQ ID NO:12, HCDR3 as set forth in SEQ ID NO: :43 LCDR1 as shown, LCDR2 as shown in SEQ ID NO:45 and LCDR3 as shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:13, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:14, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:15, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:16, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:17, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:18, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:20, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:22, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:23, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:25, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:26, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:27, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:28, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:29, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:30, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:34, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:36, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:37, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:38, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:1, HCDR2 as shown in SEQ ID NO:3, HCDR3 as shown in SEQ ID NO:39, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :43, LCDR2 shown in SEQ ID NO:45 and LCDR3 shown in SEQ ID NO:47.
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:2, HCDR2 as shown in SEQ ID NO:4, HCDR3 as shown in SEQ ID NO:42, HCDR3 as shown in SEQ ID NO: LCDR1 shown in :44, LCDR2 shown in SEQ ID NO:46 and LCDR3 shown in SEQ ID NO:48.
  • the first binding moiety comprises a heavy chain variable region and/or a light chain variable region.
  • the framework region of the heavy chain variable region of the first binding moiety comprises heavy chain FR1, heavy chain FR2, heavy chain FR3, and heavy chain FR4;
  • the heavy chain FR1 comprises SEQ ID NO: 49 or 50 The sequence shown, or a sequence having at least 90% identity to the sequence shown in SEQ ID NO: 49 or 50, or an amino acid having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 49 or 50 sequence;
  • the heavy chain FR2 comprises the sequence shown in SEQ ID NO: 51 or 52, or a sequence with at least 90% identity to the sequence shown in SEQ ID NO: 51 or 52, or a sequence shown in SEQ ID NO: 51 or 52 Amino acid sequences having one or more conservative amino acid substitutions compared to the sequence; and/or
  • the heavy chain FR3 comprises the sequence shown in SEQ ID NO: 53 or 54, or a sequence with at least 90% identity to the sequence shown in SEQ ID NO: 53 or 54, or a sequence shown in SEQ ID NO: 53 or 54 Amino acid sequences having one or more conservative amino acid substitutions compared to the sequence; and/or
  • the heavy chain FR4 comprises the sequence shown in SEQ ID NO:55, or a sequence having at least 90% identity with the sequence shown in SEQ ID NO:55, or has one or more of the sequences shown in SEQ ID NO:55. Amino acid sequence with multiple conservative amino acid substitutions.
  • the heavy chain FR1 comprises the sequence shown in SEQ ID NO: 49 or 50, or a sequence having at least 90% identity with the sequence shown in SEQ ID NO: 49 or 50, or a sequence with SEQ ID NO: 49 or 50 Compared with the sequence shown in: 49 or 50, there is an amino acid sequence with one or more conservative amino acid substitutions;
  • the heavy chain FR2 comprises the sequence shown in SEQ ID NO: 51 or 52, or with the sequence shown in SEQ ID NO: 51 or 52 A sequence having at least 90% identity, or an amino acid sequence having one or more conservative amino acid substitutions compared with the sequence shown in SEQ ID NO: 51 or 52;
  • the heavy chain FR3 comprises SEQ ID NO: 53 or 54 or a sequence having at least 90% identity with the sequence shown in SEQ ID NO: 53 or 54, or an amino acid sequence with one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 53 or 54 ;
  • the heavy chain FR4 comprises the sequence shown in SEQ ID NO:55, or a sequence with
  • the heavy chain FR1 comprises the sequence shown in SEQ ID NO:49
  • the heavy chain FR2 comprises the sequence shown in SEQ ID NO:51
  • the heavy chain FR3 comprises the sequence shown in SEQ ID NO:53
  • the sequence shown, the heavy chain FR4 comprises the sequence shown in SEQ ID NO:55.
  • the heavy chain FR1 comprises the sequence shown in SEQ ID NO:50
  • the heavy chain FR2 comprises the sequence shown in SEQ ID NO:52
  • the heavy chain FR3 comprises the sequence shown in SEQ ID NO:54
  • the sequence shown, the heavy chain FR4 comprises the sequence shown in SEQ ID NO:55.
  • the heavy chain variable region comprises the structure FR1-HCDR1-FR2-HCDR2-FR3-HCDR3-FR4.
  • the first binding portion heavy chain variable region comprises FR1 as shown in SEQ ID NO:49, HCDR1 as shown in SEQ ID NO:1, FR2 as shown in SEQ ID NO:51 , HCDR2 as shown in SEQ ID NO:3, FR3 as shown in SEQ ID NO:53, HCDR3 as shown in any one of SEQ ID NO:5-41 and FR4 as shown in SEQ ID NO:55 .
  • the first binding portion heavy chain variable region comprises FR1 as shown in SEQ ID NO:50, HCDR1 as shown in SEQ ID NO:2, FR2 as shown in SEQ ID NO:52 , HCDR2 as shown in SEQ ID NO:4, FR3 as shown in SEQ ID NO:54, HCDR3 as shown in SEQ ID NO:42 and FR4 as shown in SEQ ID NO:55.
  • the heavy chain variable region of the first binding portion comprises the sequence shown in any one of SEQ ID NOs: 56, 57, 83-105, and any of SEQ ID NOs: 56, 57, 83-105 A sequence having at least 80% identity to one of the sequences shown, or an amino acid sequence having one or more conservative amino acid substitutions compared to any of the sequences shown in SEQ ID NO: 56, 57, 83-105.
  • the light chain variable region of the first binding moiety comprises a sequence set forth in SEQ ID NO: 58 or 59, a sequence having at least 80% identity to the sequence set forth in SEQ ID NO: 58 or 59, Or an amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 58 or 59.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:56, and the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding moiety heavy chain variable region comprises the sequence shown in SEQ ID NO:57 row
  • the light chain variable region of the first binding portion comprises the sequence shown in SEQ ID NO:59.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:83, and the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:84, and the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:85
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:86
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:87, and the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:88
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:89
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:90
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:91
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:92
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:93
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:94
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:95
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:96
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:97
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:98
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding moiety heavy chain variable region comprises the sequence set forth in SEQ ID NO:99
  • the first binding moiety light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:100
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO: 101
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:102
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:103, and the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:104
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding portion heavy chain variable region comprises the sequence set forth in SEQ ID NO:105
  • the first binding portion light chain variable region comprises the sequence set forth in SEQ ID NO:58.
  • the first binding moiety further comprises a heavy chain constant region, a light chain constant region, an Fc region, or a combination thereof.
  • the light chain constant region is a kappa or lambda chain constant region.
  • the first binding moiety is an isotype of IgG, IgM, IgA, IgE, or IgD, or a fragment thereof.
  • the isotype is IgGl, IgG2, IgG3 or IgG4, or a fragment thereof.
  • the C-terminus of the heavy chain constant region in the first binding moiety is truncated.
  • the Fc is a variant Fc region.
  • the variant Fc region has one or more amino acid modifications, such as substitutions, deletions or insertions, relative to the parental Fc region.
  • the amino acid modification of the Fc region alters effector function activity relative to the activity of the parental Fc region.
  • the variant Fc region may have altered (i.e., increased or decreased) antibody-dependent cellular cytotoxicity (ADCC), complement-mediated cytotoxicity (CDC), phagocytosis, opsonization, or cell binding .
  • ADCC antibody-dependent cellular cytotoxicity
  • CDC complement-mediated cytotoxicity
  • phagocytosis opsonization
  • cell binding i.e., phagocytosis
  • amino acid modifications of the Fc region can alter the affinity of the variant Fc region for Fc ⁇ R (Fc ⁇ receptor) relative to the parent Fc region.
  • the Fc region is derived from IgGl or IgG4. In some embodiments, the Fc region mutation is N297A. In some embodiments, the Fc region mutation is N297A, L234A, or L235A (Eu numbering). In some embodiments, the Fc region mutation is E345R or S440Y (Eu numbering).
  • the heavy chain constant region comprises an amino acid sequence as set forth in SEQ ID NO: 60 or 61, a sequence having at least 80% identity to the sequence set forth in SEQ ID NO: 60 or 61, or a sequence with An amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 60 or 61; and/or
  • the light chain constant region comprises an amino acid sequence as shown in SEQ ID NO:62, a sequence having at least 80% identity with the sequence shown in SEQ ID NO:62, or compared with the sequence shown in SEQ ID NO:62 An amino acid sequence having one or more conservative amino acid substitutions.
  • the heavy chain constant region comprises an amino acid sequence as shown in SEQ ID NO:60 or 61, and/or the light chain constant region comprises an amino acid sequence as shown in SEQ ID NO:62 .
  • the heavy chain constant region comprises an amino acid sequence as shown in SEQ ID NO:60, and the light chain constant region comprises an amino acid sequence as shown in SEQ ID NO:62.
  • the heavy chain constant region comprises an amino acid sequence as shown in SEQ ID NO:61, and the light chain constant region comprises an amino acid sequence as shown in SEQ ID NO:62.
  • the heavy chain constant region comprises an amino acid sequence such as the sequence shown in amino acid 1 to amino acid 328 in SEQ ID NO: 60 or 61, or the sequence shown in amino acid 1 to amino acid 328 in SEQ ID NO: 60 or 61.
  • a sequence having at least 80% identity compared to the sequence shown in amino acid 1 to amino acid 328, or one or more sequences compared to the sequence shown in amino acid 1 to amino acid 328 in SEQ ID NO: 60 or 61 Amino acid sequences with conservative amino acid substitutions; and/or
  • the light chain constant region comprises an amino acid sequence as shown in SEQ ID NO: 62, or a sequence with at least 80% identity compared with the sequence shown in SEQ ID NO: 62, or a sequence shown in SEQ ID NO: 62
  • the sequences are compared to amino acid sequences having one or more conservative amino acid substitutions.
  • the heavy chain constant region comprises an amino acid sequence as shown in amino acid 1 to amino acid 328 in SEQ ID NO:60, and the light chain constant region comprises an amino acid sequence such as SEQ ID NO: The sequence shown in 62. In some embodiments, the heavy chain constant region comprises an amino acid sequence as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61, and the light chain constant region comprises an amino acid sequence such as SEQ ID NO: The sequence shown in 62.
  • the first binding moiety comprises a heavy chain and/or a light chain.
  • the first binding moiety heavy chain comprises a heavy chain variable region as set forth in any one of SEQ ID NO:56, 57, 83-105 and a heavy chain as set forth in SEQ ID NO:60 or 61 A heavy chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 or 59 and a light chain constant region as shown in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 83 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:84 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:85 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as set forth in SEQ ID NO:86 and a heavy chain constant region as set forth in SEQ ID NO:61; the first binding portion The light chain contains such as SEQ ID The light chain variable region shown in NO:58 and the light chain constant region shown in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 87 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:88 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:89 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:91 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:92 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:93 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:94 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:95 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:96 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:97 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the heavy chain of the first binding moiety comprises a heavy chain as shown in SEQ ID NO: 98. variable region and a heavy chain constant region as shown in SEQ ID NO:61; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a heavy chain as shown in SEQ ID NO:62 Light chain constant region.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:99 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 100 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 102 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding part heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 103 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding part The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 104 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO: 105 and a heavy chain constant region as shown in SEQ ID NO: 61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:56 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding moiety The light chain comprises a light chain variable region set forth in SEQ ID NO:58 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding portion heavy chain comprises a heavy chain variable region as shown in SEQ ID NO:57 and a heavy chain constant region as shown in SEQ ID NO:61; the first binding portion The light chain comprises a light chain variable region set forth in SEQ ID NO:59 and a light chain constant region set forth in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain variable region as shown in any one of SEQ ID NOs: 56, 57, 83-105 and SEQ ID NO: 60 or 61.
  • the heavy chain constant region shown in amino acid 328 to amino acid 328; the light chain of the first binding moiety comprises the light chain variable region shown in SEQ ID NO: 58 or 59 and the light chain variable region shown in SEQ ID NO: 62 Light chain constant region.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:84 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:85 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:87 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:88 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO: 89 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO: 61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:90 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:91 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the first binding moiety heavy chain comprises a heavy chain as shown in SEQ ID NO: 92 may a variable region and a heavy chain constant region as set forth in amino acid 1 to amino acid 328 of SEQ ID NO:61; the light chain of the first binding moiety comprises a light chain variable region as set forth in SEQ ID NO:58 and the light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:93 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:94 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:96 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:97 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:98 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO: 101 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO: 61. chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO: 102 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO: 61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO: 104 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO: 61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:56 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61. chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:58 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain of the first binding portion comprises a heavy chain variable region as shown in SEQ ID NO:57 and a heavy chain as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61.
  • chain constant region; the first binding moiety light chain comprises a light chain variable region as shown in SEQ ID NO:59 and a light chain constant region as shown in SEQ ID NO:62.
  • the heavy chain comprises an amino acid sequence as shown in SEQ ID NO: 71 or 72, a sequence having at least 80% identity with the sequence shown in SEQ ID NO: 71 or 72, or a sequence with SEQ ID NO: 71 or 72 An amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in NO: 71 or 72; and/or
  • the light chain comprises an amino acid sequence as shown in SEQ ID NO: 73 or 74, a sequence having at least 80% identity with the sequence shown in SEQ ID NO: 73 or 74, or a sequence with SEQ ID NO: 73 or 74 Amino acid sequences having one or more conservative amino acid substitutions compared to the indicated sequence.
  • the heavy chain of the first binding moiety comprises an amino acid sequence such as SEQ ID NO:71 or the sequence shown in 72, and/or the light chain of the first binding moiety comprises an amino acid sequence as shown in SEQ ID NO:73 or 74.
  • the heavy chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:71, and the light chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:73 sequence. In some embodiments, the heavy chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:72, and the light chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:74 sequence.
  • the light chain comprises an amino acid sequence as shown in SEQ ID NO: 73 or 74, a sequence having at least 80% identity with the sequence shown in SEQ ID NO: 73 or 74, or a sequence with SEQ ID NO: 73 or 74 Amino acid sequences having one or more conservative amino acid substitutions compared to the indicated sequence.
  • the heavy chain of the first binding portion comprises an amino acid sequence such as amino acid 1 to amino acid 450 in SEQ ID NO:71 or amino acid 1 to amino acid 451 in SEQ ID NO:72
  • the sequence shown, and/or the light chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:73 or 74.
  • the heavy chain of the first binding portion comprises an amino acid sequence as shown in amino acid 1 to amino acid 450 in SEQ ID NO:71, and the light chain of the first binding portion comprises amino acid The sequence is as shown in SEQ ID NO:73. In some embodiments, the heavy chain of the first binding portion comprises an amino acid sequence as shown in amino acid 1 to amino acid 451 in SEQ ID NO:72, and the light chain of the first binding portion comprises amino acid The sequence is as shown in SEQ ID NO:74.
  • the first binding moiety comprises 2 heavy chains with the same sequence and 2 light chains with the same sequence.
  • the linker L1 is a polypeptide comprising glycine and serine.
  • the sequence of the linker L1 is (G m S ) n , wherein each m is independently 2, 3, 4 or 5, and n is independently 1, 2, 3, 4 or 5. In some embodiments, the sequence of the linker L1 is (GGGGS) n , and the n is 1, 2, 3, 4 or 5 independently. In some embodiments, the linker L1 is GGGGS. In some embodiments, the linker L1 is (GGGGS) 2 , as shown in SEQ ID NO:65. In some embodiments, the linker L1 is (GGGGS) 3 . In some embodiments, the linker L1 is (GGGGS) 4 , as shown in SEQ ID NO:63. In some embodiments, the linker L1 is (GGGGS) 5 , as shown in SEQ ID NO:64.
  • the second binding moiety is a single domain antibody.
  • the single domain antibody is VHH.
  • the second binding moiety is a single domain antibody and comprises:
  • HCDR1 it comprises the aminoacid sequence shown in SEQ ID NO:66, or its variant that single or multiple positions are substituted, deleted or inserted
  • HCDR2 it comprises such as SEQ ID NO:67 The amino acid sequence shown, or its single or multiple site substitution, deletion or insertion variant
  • HCDR3 which comprises the amino acid sequence shown in SEQ ID NO: 68, or its single or variants with substitutions, deletions or insertions at multiple sites.
  • the second binding moiety is a single domain antibody and comprises:
  • HCDR1 it comprises the aminoacid sequence shown in SEQ ID NO:66, or its variant that single or multiple positions are substituted, deleted or inserted
  • HCDR2 it comprises such as SEQ ID NO:67 The amino acid sequence shown, or its single or multiple site substitution, deletion or insertion variant
  • HCDR3 which comprises the amino acid sequence shown in SEQ ID NO: 68, or its single or multiple variants of substitutions, deletions or insertions.
  • the second binding moiety is a single domain antibody and comprises:
  • HCDR1 which comprises the amino acid sequence shown in SEQ ID NO:66
  • HCDR2 which comprises the amino acid sequence shown in SEQ ID NO:67
  • HCDR3 which comprises the amino acid sequence shown in SEQ ID NO : the amino acid sequence shown in 68.
  • the second binding moiety is a single domain antibody and comprises the amino acid sequence shown in SEQ ID NO:69.
  • the bispecific antibody comprises the above-mentioned first binding portion that binds to the spike protein and the second binding portion that binds to the spike protein, connected through the above-mentioned linker L1.
  • the bispecific antibody comprises the following characteristics:
  • the first binding moiety at least comprises HCDR1 as shown in SEQ ID NO:2, HCDR2 as shown in SEQ ID NO:4, HCDR3 as shown in SEQ ID NO:42, HCDR3 as shown in SEQ ID NO:44
  • HCDR1 as shown in SEQ ID NO:2
  • HCDR2 as shown in SEQ ID NO:4
  • HCDR3 as shown in SEQ ID NO:42
  • HCDR3 as shown in SEQ ID NO:44
  • the second binding part is VHH, and the second binding part at least comprises HCDR1 shown in SEQ ID NO: 66, HCDR2 shown in SEQ ID NO: 67, and HCDR3 shown in SEQ ID NO: 68 one, two or three; and/or
  • the C-terminal of the first binding part is connected to the N-terminal of the second binding part through the linker L1, and the C-terminal of the first binding part is the C-terminal of the heavy chain or the light chain of the first binding part. the C-terminus of the chain; and/or
  • the amino acid sequence of the linker L1 is (GGGGS) n , and the n is 1, 2, 3, 4 or 5 independently.
  • the bispecific antibody comprises a first binding portion that binds a spike protein and a second binding portion that binds a spike protein, and the bispecific antibody comprises the following features:
  • the first binding moiety comprises HCDR1 as shown in SEQ ID NO:2, HCDR2 as shown in SEQ ID NO:4, HCDR3 as shown in SEQ ID NO:42, LCDR1 as shown in SEQ ID NO:44 , LCDR2 as shown in SEQ ID NO:46 and LCDR3 as shown in SEQ ID NO:48; and/or
  • the second binding moiety is VHH, the second binding moiety comprises HCDR1 as shown in SEQ ID NO:66, HCDR2 as shown in SEQ ID NO:67, and HCDR3 as shown in SEQ ID NO:68; and /or
  • the C-terminal of the first binding part is connected to the N-terminal of the second binding part through the linker L1, and the C-terminal of the first binding part is the C-terminal of the heavy chain or the light chain of the first binding part. the C-terminus of the chain; and/or
  • the sequence of the linker L1 is (GGGGS) n , and the n is 1, 2, 3, 4 or 5 independently.
  • the first binding moiety heavy chain variable region comprises the sequence set forth in SEQ ID NO:57, a sequence at least 80% identical to the sequence set forth in SEQ ID NO:57, or An amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO:57.
  • the first binding moiety light chain variable region comprises the sequence set forth in SEQ ID NO:59, a sequence at least 80% identical to the sequence set forth in SEQ ID NO:59, or An amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO:59.
  • the first binding moiety comprises a heavy chain constant region, a light chain constant region, an Fc region, or a combination thereof.
  • the light chain constant region is a kappa or lambda chain constant region.
  • the first binding moiety is of the IgG, IgM, IgA, IgE or IgD type, or a fragment thereof.
  • the first binding moiety is of the IgGl, IgG2, IgG3 or IgG4 type, or a fragment thereof.
  • the C-terminus of the heavy chain constant region in the first binding moiety is truncated.
  • the C-terminus of the heavy chain constant region in the first binding portion of type IgGl or IgG4 lacks amino acid residues G and K.
  • the Fc is a variant Fc region.
  • the variant Fc region has one or more amino acid modifications, such as substitutions, deletions or insertions, relative to the parental Fc region.
  • the first binding moiety is scFv, Fab, Fab', F(ab) 2 or F(ab) 2 '.
  • the first binding moiety and/or the second binding moiety is a chimeric antibody, a humanized antibody, or a fully human antibody.
  • the heavy chain constant region of the first binding part comprises an amino acid sequence such as the sequence shown in amino acid 1 to amino acid 328 in SEQ ID NO: 60 or 61, or with SEQ ID NO: 60 or A sequence having at least 80% identity compared to the sequence shown in amino acid 1 to amino acid 328 in 61, or a sequence with amino acid 1 to amino acid 328 in SEQ ID NO: 60 or 61 Amino acid sequences with one or more conservative amino acid substitutions; and/or
  • the heavy chain constant region of the first binding moiety comprises an amino acid sequence such as SEQ ID The sequence shown from amino acid 1 to amino acid 328 in NO:60, the light chain constant region of the first binding part includes the amino acid sequence shown in SEQ ID NO:62.
  • the heavy chain constant region of the first binding portion comprises an amino acid sequence as shown in amino acid 1 to amino acid 328 in SEQ ID NO:61, and the light chain of the first binding portion The constant region comprises the amino acid sequence shown in SEQ ID NO:62.
  • the heavy chain constant region of the first binding moiety comprises an amino acid sequence as set forth in SEQ ID NO: 60 or 61, or has at least 80% amino acid sequence compared to the sequence set forth in SEQ ID NO: 60 or 61 A sequence of identity, or an amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 60 or 61; and/or
  • the light chain constant region of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO: 62, a sequence having at least 80% identity compared with the sequence shown in SEQ ID NO: 62, or a sequence with SEQ ID NO:
  • the sequence shown in 62 is compared to the amino acid sequence having one or more conservative amino acid substitutions.
  • the heavy chain constant region of the first binding portion comprises the amino acid sequence shown in SEQ ID NO:60, and the light chain constant region of the first binding portion comprises the amino acid sequence shown in SEQ ID NO:62 sequence. In some embodiments, the heavy chain constant region of the first binding portion comprises the amino acid sequence shown in SEQ ID NO:61, and the light chain constant region of the first binding portion comprises the amino acid sequence shown in SEQ ID NO:62 sequence.
  • the second binding moiety is VHH. In some embodiments, the second binding moiety comprises a sequence as set forth in SEQ ID NO: 69, or a sequence having at least 80% identity to the sequence set forth in SEQ ID NO: 69, or to a sequence set forth in SEQ ID NO: 69 Amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in :69.
  • Some embodiments provide a bispecific antibody comprising a first binding moiety and a single domain antibody, and comprising the following features:
  • the first binding part comprises a heavy chain and a light chain;
  • the heavy chain of the first binding part comprises an amino acid sequence such as the sequence shown in amino acid 1 to amino acid 451 in SEQ ID NO: 72, or the sequence shown in SEQ ID NO:72 A sequence having at least 80% identity compared to the sequence shown in amino acid 1 to amino acid 451 in NO:72, or compared to the sequence shown in amino acid 1 to amino acid 451 in SEQ ID NO:72 Amino acid sequence with one or more conservative amino acid substitutions; and/or
  • the light chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:74, a sequence having at least 80% identity compared with the sequence shown in SEQ ID NO:74, or a sequence with SEQ ID NO:74 Amino acid sequences having one or more conservative amino acid substitutions compared to the indicated sequence; and/or
  • the C-terminus of the heavy chain of the first binding moiety is covalently linked to the single domain antibody via a linker L1 as shown in SEQ ID NO:63; and/or
  • the single domain antibody comprises a sequence as shown in SEQ ID NO:69, or a sequence having at least 80% identity compared to the sequence shown in SEQ ID NO:69, or compared to the sequence shown in SEQ ID NO:69 An amino acid sequence with one or more conservative amino acid substitutions.
  • Some embodiments provide a bispecific antibody comprising a first binding moiety and a single domain antibody, and comprising the following features:
  • the first binding part comprises a heavy chain and a light chain; the heavy chain of the first binding part comprises an amino acid sequence as shown in SEQ ID NO:72, or has an amino acid sequence compared with the sequence shown in SEQ ID NO:72 A sequence of at least 80% identity, or an amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 72; and/or
  • the light chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:74, or a sequence having at least 80% identity compared with the sequence shown in SEQ ID NO:74, or with SEQ ID NO: An amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in 74; and/or
  • the C-terminus of the light chain of the first binding moiety is covalently linked to the single domain antibody via a linker L1 as shown in SEQ ID NO:64; and/or
  • the heavy chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:72, and the light chain of the first binding portion comprises an amino acid sequence as shown in SEQ ID NO:74 Sequence; the C-terminus (i.e. CL terminus) of the light chain of the first binding moiety is covalently linked to a single domain antibody comprising a single domain antibody comprising SEQ ID NO: The sequence shown in 69.
  • a bispecific antibody comprises a first polypeptide and a second polypeptide. In some embodiments, the bispecific antibody comprises two first polypeptides with the same sequence and two second polypeptides with the same sequence.
  • the first polypeptide comprises, or consists of, the heavy chain of the first binding moiety, the linker L1, the single domain antibody sequentially from the N-terminus to the C-terminus; the second polypeptide comprises Light chains, or consisting of them.
  • the first polypeptide comprises an amino acid sequence as shown in SEQ ID NO: 77, or a sequence having at least 80% identity with the sequence shown in SEQ ID NO: 77, or with SEQ ID NO: 77.
  • the second polypeptide comprises an amino acid sequence as shown in SEQ ID NO: 74, or a sequence having at least 80% identity compared with the sequence shown in SEQ ID NO: 74, or a sequence shown in SEQ ID NO: 74 An amino acid sequence having, or consisting of, one or more conservative amino acid substitutions compared to the sequence.
  • the first polypeptide comprises an amino acid sequence as shown in SEQ ID NO:77
  • the second polypeptide comprises an amino acid sequence as shown in SEQ ID NO:74.
  • the second polypeptide comprises an amino acid sequence as shown in SEQ ID NO:78, or a sequence with at least 80% identity compared with the sequence shown in SEQ ID NO:78, or a sequence similar to the sequence shown in SEQ ID NO:78 An amino acid sequence having, or consisting of, one or more conservative amino acid substitutions.
  • the diabody is an isolated diabody.
  • the bispecific antibody is a bispecific monoclonal antibody.
  • the isolated bispecific antibody is a monoclonal antibody.
  • the present invention also provides a single-domain antibody with high affinity for the spike protein of SARS-CoV-2.
  • Single-domain antibodies can bind to spike proteins, prevent virus particles from binding to cells, and mediate immune cell phagocytosis and clearance of virus particles.
  • Single domain antibodies can be used to prevent, treat or improve COVID-19, and can also be used to diagnose COVID-19.
  • the single domain antibody comprises:
  • HCDR1 which comprises the amino acid sequence shown in SEQ ID NO:66, or its variants with single site substitutions, deletions or insertions
  • HCDR2 which comprises the amino acid sequence shown in SEQ ID NO:67 Amino acid sequence, or variants thereof with single site substitutions, deletions or insertions
  • HCDR3 comprising the amino acid sequence shown in SEQ ID NO: 68, or variants thereof with single site substitutions, deletions or insertions Variants.
  • the single domain antibody comprises HCDR1 as set forth in SEQ ID NO:66, HCDR2 as set forth in SEQ ID NO:67, and HCDR3 as set forth in SEQ ID NO:68.
  • the single domain antibody is VHH. In some embodiments, the single domain antibody comprises the sequence set forth in SEQ ID NO: 69, or a sequence at least 80% identical to the sequence set forth in SEQ ID NO: 69, or to SEQ ID NO: The sequence shown in 69 is compared to the amino acid sequence having one or more conservative amino acid substitutions.
  • the single domain antibody comprises, or consists of, the sequence shown in SEQ ID NO: 69.
  • single domain antibodies are isolated antibodies. In some embodiments, a single domain antibody is an isolated monoclonal antibody.
  • the invention also provides a heavy chain antibody comprising a single domain antibody that can bind a spike protein, such as a single domain antibody as described herein.
  • Heavy chain antibodies prevent virus particles from binding to cells, and can mediate immune cell phagocytosis and clearance of virus particles. Heavy chain antibodies can be used to prevent, treat or improve COVID-19, and can also be used to diagnose COVID-19.
  • variable region of the heavy chain antibody comprising:
  • HCDR1 which comprises the amino acid sequence shown in SEQ ID NO:66, or its variants with single site substitutions, deletions or insertions
  • HCDR2 which comprises the amino acid sequence shown in SEQ ID NO:67 Amino acid sequence, or variants thereof with single site substitutions, deletions or insertions
  • HCDR3 comprising the amino acid sequence shown in SEQ ID NO: 68, or variants thereof with single site substitutions, deletions or insertions Variants.
  • variable region of the heavy chain antibody comprises HCDR1 as set forth in SEQ ID NO:66, HCDR2 as set forth in SEQ ID NO:67, and HCDR3 as set forth in SEQ ID NO:68.
  • variable region of the heavy chain antibody comprises a sequence as set forth in SEQ ID NO: 69, or a sequence having at least 80% identity to the sequence set forth in SEQ ID NO: 69, or to An amino acid sequence having one or more conservative amino acid substitutions compared to the sequence shown in SEQ ID NO: 69, or consisting of it.
  • the linker L2 is a polypeptide comprising glycine and serine.
  • the sequence of the linker L2 is (G m S ) n , wherein each m is independently 2, 3, 4 or 5, and n is independently 1, 2, 3, 4 or 5.
  • the sequence of the linker L2 is (GGGGS) n , and the n is 1, 2, 3, 4 or 5 independently.
  • the linker L2 is GGGGS.
  • the linker L2 is (GGGGS) 2 , as shown in SEQ ID NO:65.
  • the linker L2 is (GGGGS) 3 .
  • the linker L2 is (GGGGS) 4 , as shown in SEQ ID NO:63.
  • the linker L2 is (GGGGS) 5 , as shown in SEQ ID NO:64.
  • the Fc region comprises an amino acid sequence as set forth in SEQ ID NO:70, or a sequence that is at least 80% identical to the sequence set forth in SEQ ID NO:70, or a sequence that is at least 80% identical to the sequence set forth in SEQ ID NO:70 sequence shown Amino acid sequences having one or more conservative amino acid substitutions are compared.
  • the heavy chain antibody comprises an amino acid sequence as set forth in SEQ ID NO:79, or a sequence at least 80% identical to the sequence set forth in SEQ ID NO:79, or to SEQ ID NO: The sequence shown in 79 is compared to the amino acid sequence having one or more conservative amino acid substitutions.
  • the antibody specifically binds a spike protein.
  • the present invention also provides nucleic acid encoding the antibody (including bispecific antibody, single domain antibody and heavy chain antibody).
  • the nucleic acid is an isolated nucleic acid.
  • the nucleic acid is as shown in Table 5 and Table 7.
  • the present invention also provides a vector comprising the nucleic acid.
  • the vector is an isolated vector.
  • the vector comprising the nucleic acid is a nucleic acid fragment, plasmid, phage, or virus.
  • the vector is an isolated plasmid.
  • the present invention also provides a host cell comprising the nucleic acid or the vector.
  • the host cell is an isolated host cell.
  • the host cells are CHO cells, HEK293 cells, Cos1 cells, Cos7 cells, CV1 cells, and murine L cells.
  • the present invention provides the effect of the antibody (such as bispecific antibody, single domain antibody, heavy chain antibody, etc.) or antigen-binding fragment or a pharmaceutical composition comprising it in preventing, treating or improving COVID-19. application.
  • the antibody such as bispecific antibody, single domain antibody, heavy chain antibody, etc.
  • antigen-binding fragment or a pharmaceutical composition comprising it in preventing, treating or improving COVID-19. application.
  • the present invention provides a method for preventing, treating or ameliorating COVID-19, which comprises administering an effective amount of about 10 mg to 2000 mg of the antibodies described herein (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the patient has a disease caused by a novel coronavirus.
  • the patient is mild, moderate, severe or critically infected with novel coronavirus pneumonia.
  • the patient is admitted to an ICU prior to treatment by the method.
  • the patient requires extracorporeal ECMO and/or IMV therapy prior to treatment by the method.
  • the patient requires oxygen therapy prior to treatment by the method.
  • the patient requires NIV/HFNC treatment prior to treatment by the method.
  • the method reduces the patient's status score by at least 1 grade. In some embodiments, the method reduces the patient's status score by at least 2 grades. In some embodiments, the method heals the patient.
  • the antibody eg, bispecific antibody, single domain antibody, or heavy chain antibody
  • the antibody is administered in an amount of about 1 mg/kg to 35 mg/kg.
  • the dosage schedule and mode of administration depend on the benefit-risk assessment and General Clinical Practice Guidelines.
  • the anti- An antibody is any one or a combination of antibodies 1-23.
  • the antibody is antibody 2F8.
  • the antibody is single domain antibody VHH18.
  • the antibody is heavy chain antibody VHH18-Fc.
  • the antibody is the bispecific antibody 2F8-VH-VHH18 or 2F8-VL-VHH18.
  • antibodies such as bispecific antibodies, single domain antibodies, or heavy chain antibodies
  • antigen-binding fragments can be formulated into pharmaceutical compositions and administered to patients in a variety of forms suitable for the chosen route of administration , routes of administration such as oral administration, rectal administration, parenteral administration, intracisternal administration, intravaginal administration, intraperitoneal administration, external application (such as by powder, ointment, drops or transdermal patch), Orally or by oral or nasal spray.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment may be administered intravenously or subcutaneously or intramuscularly.
  • an antibody e.g., a bispecific antibody, a single domain antibody, or a heavy chain antibody
  • an antigen-binding fragment or a dose containing the antibody e.g., a bispecific antibody
  • a dose containing the antibody e.g., a bispecific antibody
  • Antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments are administered to a patient in need thereof.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 1 mg/kg, about 1.5 mg/kg, about 2 mg/kg, about 3 mg/kg , about 5mg/kg, about 6mg/kg, about 7mg/kg, about 8mg/kg, about 9mg/kg, about 10mg/kg, about 11mg/kg, about 13mg/kg, about 15mg/kg, about 17mg/kg , about 21 mg/kg, about 23 mg/kg, about 25 mg/kg, about 27 mg/kg, about 28 mg/kg, about 29 mg/kg, about 30 mg/kg, about 35 mg/kg, or any two of these values range (inclusive) or any value therein, or preparations containing such doses of antibodies (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • about 100 mg to 1500 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment or a dose containing the antibody (e.g., bispecific antibody, single domain antibody) is administered to a patient in need thereof.
  • antibody or heavy chain antibody) or antigen-binding fragments are administered to a patient in need thereof.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 100 mg, about 200 mg, about 300 mg, about 400 mg, about 500 mg, about 600 mg, about 700 mg , about 800mg, about 900mg, about 1000mg, about 1100mg, about 1200mg, about 1500mg, or a range between any two of these values (inclusive) or any value therein, or containing such a dose of antibody (e.g. bispecific Antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • about 100 mg to 1000 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment or a dose containing the antibody (e.g., bispecific antibody, single domain antibody) is administered to a patient in need thereof.
  • antibody or heavy chain antibody) or antigen-binding fragments are administered to a patient in need thereof.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 100 mg, about 200 mg, about 300 mg, about 400 mg, about 500 mg, about 600 mg, about 700 mg , about 800mg, about 900mg, about 1000mg, or the range between any two of these values (including the end value) or any value therein, or preparations containing such doses of antibodies (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • an antibody e.g., a bispecific antibody, single domain antibody, or heavy chain antibody
  • an antibody e.g., a bispecific antibody, single domain antibody, or heavy chain antibody
  • a dose of an antibody e.g., a bispecific antibody, single domain antibody, etc.
  • antibody or heavy chain antibody or antigen-binding fragments.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 100 mg, about 200 mg, about 300 mg, about 400 mg, about 500 mg, about 600 mg, or A range (inclusive) between any two values in a value, or any value therein, or a preparation containing such a dose of an antibody (such as a diabody, a single domain antibody or a heavy chain antibody) or an antigen-binding fragment.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment or a dose containing the antibody (e.g., bispecific antibody, single domain antibody) is administered to a patient in need thereof.
  • antibody or heavy chain antibody) or antigen-binding fragments are administered in an amount of about 100 mg, about 200 mg, about 300 mg, or between any two of these values. Range (inclusive) or any value therein, or formulations containing such doses of antibodies (eg diabodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • about 300 mg to 1500 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment or a dose containing the antibody (e.g., bispecific antibody, single domain antibody) is administered to a patient in need thereof.
  • antibody or heavy chain antibody) or antigen-binding fragments are administered to a patient in need thereof.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 300 mg, about 400 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg , about 1000mg, about 1200mg, about 1300mg, about 1500mg, or a range between any two of these values (inclusive) or any value therein, or containing such a dose of antibody (such as a bispecific antibody, a single domain antibody, or heavy chain antibody) or antigen-binding fragment preparations.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • about 300 mg to 1000 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment or a dose containing the antibody (e.g., bispecific antibody, single domain antibody) is administered to a patient in need thereof.
  • antibody or heavy chain antibody) or antigen-binding fragments are administered to a patient in need thereof.
  • the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 300 mg, about 400 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg , about 1000mg, or the range between any two values in these values (including the end value) or any value therein, or containing this dose of antibody (such as bispecific antibody antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • the antibody (e.g., diabody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 300 mg, about 400 mg, about 500 mg, about 600 mg, or any two of these values Ranges between (inclusive) or any value therein, or preparations containing such doses of antibodies (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • about 600 mg to 1000 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment or a dose containing the antibody (e.g., bispecific antibody, single domain antibody) is administered to a patient in need thereof.
  • antibody or heavy chain antibody) or antigen-binding fragments are administered to a patient in need thereof.
  • the antibody (e.g., diabody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, or any of these values A range between two values, inclusive, or any value therein, or a formulation containing such a dose of antibody (eg, diabody, single domain antibody, or heavy chain antibody) or antigen-binding fragment.
  • the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in a single dose.
  • about 180 mg to 320 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered to a patient in need thereof, or a dose of the antibody (e.g., bispecific antibody, monoclonal antibody, domain antibodies or heavy chain antibodies) or antigen-binding fragments; for example, a single dose of about 300 mg to a patient in need.
  • about 300 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered to a patient in need thereof in a single dose, or a dose of the antibody (e.g., bispecific antibody, monoclonal antibody, etc. domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • about 600 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered to a patient in need thereof in a single dose, or a dose of the antibody (e.g., bispecific antibody, monoclonal antibody, etc. domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • about 1450 mg to 1550 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment, or a dose containing the antibody (e.g., bispecific antibody, monoclonal antibody) is administered to a patient in need thereof.
  • domain antibodies or heavy chain antibodies) or antigen-binding fragments for example, a single dose of about 1500 mg to a patient in need.
  • a single dose of about 1500 mg of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment, or a dose containing the antibody (e.g., bispecific antibody, monoclonal antibody) is administered to a patient in need thereof.
  • domain antibodies or heavy chain antibodies) or antigen-binding fragments for example, a single dose of about 1500 mg to a patient in need.
  • antibody e.g., bispecific antibody, single domain antibody, or heavy chain antibody
  • antigen-binding fragment is administered to a patient in need thereof, or a dose of antibody (e.g., bispecific antibody) Specific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments.
  • the antibody (such as a bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment is administered in an amount of about 1 mg/kg to 25 mg/kg, about 1.7 mg/kg to 25 mg/kg, about 1.7mg/kg to 16.7mg/kg, about 1.7mg/kg to 5mg/kg, about 5mg/kg to 25mg/kg, about 5mg/kg to 16.7mg/kg, about 16.7mg/kg to 25mg/kg, about 1.4mg/kg to 21.4mg/kg, about 1.4mg/kg to 14.3mg/kg, about 1.4mg/kg to 4.3mg/kg, about 4.3mg/kg to 21.4mg/kg, about 4.3mg/kg to 14.3 mg/kg, about 14.3mg/kg to 21.4mg/kg.
  • the patient's symptoms are relieved. In some embodiments, following a single administration of the antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment, the patient's symptoms are relieved. In some embodiments, the patient's symptoms are not relieved as expected after a single administration of the antibody (e.g., bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment, Re-administer the drug to the patient.
  • the antibody eg., bispecific antibody, single domain antibody, or heavy chain antibody
  • the antibody is selected from antibodies 1-24, antibody 2F8.
  • the antibody is single domain antibody VHH18.
  • the antibody is heavy chain antibody VHH18-Fc.
  • the antibody is the bispecific antibody 2F8-VH-VHH18.
  • the antibody is the bispecific antibody 2F8-VL-VHH18.
  • the antibody eg, bispecific antibody, single domain antibody, or heavy chain antibody
  • antigen-binding fragment (or formulation) is administered by intravenous (i.v.) infusion.
  • the duration of the intravenous infusion is about 20 minutes, about 25 minutes, about 30 minutes, about 35 minutes, about 45 minutes, about 50 minutes, about 55 minutes, about 60 minutes, about 65 minutes, about 70 minutes minutes, about 75 minutes, about 80 minutes, about 85 minutes, about 90 minutes, or a range between any two of these values, inclusive, or any value therein.
  • the duration of the intravenous infusion is > 60 minutes.
  • the duration of the IV infusion is ⁇ 60 minutes.
  • the duration of the IV infusion is > 30 minutes.
  • antibodies such as bispecific antibodies, single domain antibodies or heavy chain antibodies
  • antigen-binding fragments or preparations
  • other therapeutic methods to prevent, treat or improve COVID-19, such as hormones, in vitro ECMO, IMV, NIV, HFNC and/or oxygen therapy.
  • the present invention also discloses the application of the antibody (such as bispecific antibody, single domain antibody or heavy chain antibody) or antigen-binding fragment in the preparation of drugs for preventing, treating or improving COVID-19.
  • the drug for preventing, treating or ameliorating COVID-19 includes an antibody (such as a bispecific antibody, a single domain antibody or a heavy chain antibody) or an antigen-binding fragment.
  • the present invention also discloses a kit comprising an antibody (such as a bispecific antibody, a single domain antibody, or a heavy chain antibody) or an antigen-binding fragment (or preparation) and an antibody used to guide patients in need of administration. (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments (or preparations).
  • an antibody such as a bispecific antibody, a single domain antibody, or a heavy chain antibody
  • an antigen-binding fragment or preparation
  • an antibody used to guide patients in need of administration such as bispecific antibodies, single domain antibodies or heavy chain antibodies
  • antigen-binding fragments or preparations.
  • the invention also provides diagnostic methods and uses.
  • a method of detecting expression of SARS-CoV-2 in a sample by contacting the sample with an antibody (e.g., a bispecific antibody, a single domain antibody, or a heavy chain antibody) or an antigen-binding fragment described herein such that the Said antibody (such as bispecific antibody, single domain antibody or heavy chain antibody) or antigen-binding fragment binds spike protein, and detects its binding, that is, the content of spike protein in the sample.
  • the use of the antibody (such as bispecific antibody, single domain antibody or heavy chain antibody) or antigen-binding fragment in the preparation of a kit for diagnosing COVID-19 is provided.
  • providing Diagnostic kits comprising said antibodies (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments are provided.
  • the present invention also discloses a pharmaceutical composition comprising the antibody or antigen-binding fragment described herein and pharmaceutically acceptable auxiliary materials.
  • the pharmaceutical composition is a pharmaceutical composition suitable for injection, such as a push injection type pharmaceutical composition or an infusion (drip) type pharmaceutical composition or a spray type pharmaceutical composition.
  • Pharmaceutical compositions suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersion.
  • suitable carriers include solvents or dispersions of physiological saline, dextrose injection, sterile water, or phosphate-buffered saline (PBS), ethanol, polyols (e.g., glycerol, propylene glycol, and liquid polyethylene glycol, etc.). media, and suitable mixtures thereof.
  • the pharmaceutical composition further includes a pharmaceutically acceptable carrier.
  • pharmaceutically acceptable carriers can be accomplished by including antibacterial and/or antifungal agents, such as parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, benzyl alcohol, and the like.
  • pharmaceutically acceptable carriers may contain isotonic agents, such as sugars, polyalcohols (such as mannitol, sorbitol), sodium chloride.
  • the pharmaceutical composition comprises at least 0.1% of an antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment.
  • the percentage of antibody can vary and is between about 2% and about 90% by weight of a given dosage form.
  • the amount of antibody (eg, bispecific antibody, single domain antibody, or heavy chain antibody) or antigen-binding fragment in such therapeutically useful pharmaceutical compositions may be an effective amount for administration.
  • the present invention also discloses the preparation method of the above pharmaceutical composition: combining the antibody (such as bispecific antibody, single domain antibody or heavy chain antibody) or antigen-binding fragment described herein with a pharmaceutically acceptable carrier (such as Water for injection, physiological saline, glucose injection, etc.) mixed.
  • a pharmaceutically acceptable carrier such as Water for injection, physiological saline, glucose injection, etc.
  • the method of mixing the above antibodies (such as bispecific antibodies, single domain antibodies or heavy chain antibodies) or antigen-binding fragments with pharmaceutically acceptable carriers is generally known in the art.
  • Figure 1 is a graph showing the inhibition of the binding of SARS-CoV-2 to ACE2 by some anti-spike protein antibodies of the present invention in an ELISA experiment.
  • the abscissa represents the concentration, and the ordinate represents the OD value; among them, 1 represents antibody 1, 7 represents antibody 7, 8 represents antibody 8, 9 represents antibody 9, 12 represents antibody 12, 18 represents antibody 18, and 19 represents antibody 19 , 20 represents antibody 20, 21 represents antibody 21, and 22 represents antibody 22.
  • Figure 2 shows that the antibody blocks the binding of spike RBD to ACE2; wherein, no antibody was added to the ACE2 control group.
  • Figure 3 shows the inhibition curves of the antibody 2F8-VH-VHH18 against pseudoviruses of different strains of the new coronavirus.
  • Fig. 5 shows the effect of the antibody on the body weight of the mice; in the figure, the ordinate indicates the percentage of the mouse body weight, and the abscissa indicates the days.
  • polypeptide is intended to encompass the singular as well as the plural “polypeptides” and refers to a molecule formed of amino acid monomers linked linearly by amide bonds (also known as peptide bonds).
  • polypeptide refers to any chain or chains of two or more amino acids, and does not refer to a specific length of the product.
  • the definition of “polypeptide” includes peptide, dipeptide, tripeptide, oligopeptide, "protein”, “amino acid chain” or any other term used to refer to a chain of two or more amino acids, and the term “polypeptide” may Used in place of, or interchangeably with, any of the above terms.
  • polypeptide is also intended to refer to the products of post-expression modifications of the polypeptide, including but not limited to glycosylation, acetylation, phosphorylation, amidation, derivatization by known protecting/blocking groups, proteolytic cleavage, or non-natural Amino acid modifications that occur.
  • a polypeptide may be derived from a natural biological source or produced by recombinant techniques, but it need not be translated from a specified nucleic acid sequence, it may be produced by any means including chemical synthesis.
  • amino acid refers to an organic compound containing both amino and carboxyl groups, such as an ⁇ -amino acid, which can be encoded by a nucleic acid directly or in the form of a precursor.
  • a single amino acid is encoded by a nucleic acid consisting of three nucleotides (so-called codons or base triplets). Each amino acid is encoded by at least one codon. The fact that the same amino acid is encoded by different codons is called “degeneracy of the genetic code”.
  • Amino acids include natural amino acids and unnatural amino acids.
  • the number of amino acids in "conservative amino acid substitutions of VL, VH, VHH" is about 1, about 2, about 3, about 4, about 5, about 6, about 8, about 9, about 10 , about 11, about 13, about 14, about 15 conservative amino acid substitutions, or a range between any two of these values (inclusive), or any value therein.
  • the number of amino acids in the "heavy chain constant region, light chain constant region, heavy chain or light chain, fusion protein first polypeptide or second polypeptide conservative amino acid substitution" is about 1, about 2, about 3, about 4, about 5, about 6, about 8, about 9, about 10, about 11, about 13, about 14, about 15, about 18, about 19, about 22 , about 24, about 25, about 29, about 31, about 35, about 38, about 41, about 45 conservative amino acid substitutions, or a range between any two of these values ( inclusive) or any value in it.
  • isolated used in the present invention with respect to cells, nucleic acids, polypeptides, antibodies, etc., for example, "isolated" DNA, RNA, polypeptides, antibodies refers to the isolated components of the cell's natural environment, such as DNA or RNA. One or more of the isolated molecules.
  • isolated as used herein also refers to a nucleic acid or peptide that is substantially free of cellular material, viral material, or cell culture medium when produced by recombinant DNA techniques, or chemical precursors or other chemicals when chemically synthesized.
  • isolated nucleic acid is intended to include fragments of nucleic acid that do not occur in nature, and do not exist in nature.
  • isolated is also used herein to refer to cells or polypeptides that are separated from other cellular proteins or tissues.
  • Isolated polypeptide is intended to include purified and recombinant polypeptides.
  • Isolated polypeptides, antibodies, etc. will usually be prepared by at least one purification step.
  • the purity of the isolated nucleic acid, polypeptide, antibody, etc. is at least about 50%, about 60%, about 70%, about 80%, about 90%, about 95%, about 99%, or some of these values The range between any two values of , including the endpoints, or any value therein.
  • polypeptides or polynucleotides refers to polypeptides or polynucleotides, meaning forms of polypeptides or polynucleotides that do not occur in nature, non-limiting examples may be produced by combination of polynucleotides or polynucleotides that do not normally exist or peptide.
  • Homology refers to the sequence similarity between two peptides or between two nucleic acid molecules. Homology or identity can be determined by comparing the alignable positions in each sequence. When a position in the sequences being compared is occupied by the same base or amino acid, then the molecules are homologous or identical at that position. The degree of homology between sequences is a function of the number of matching or homologous positions shared by the sequences.
  • At least 80% identity is about 80% identity, about 81% identity, about 82% identity, about 83% identity, about 85% identity, about 86% identity, about 87% identity, About 88% identity, about 90% identity, about 91% identity, about 92% identity, about 94% identity, about 95% identity, about 98% identity, about 99% identity, or these A range (inclusive) between any two values in Numeric or any value therein.
  • This alignment percent identity or sequence identity can be determined visually or using software programs known in the art, such as those described by Ausubel et al. eds. (2007) in Current Protocols in Molecular Biology. It is preferred to use the default parameters for the alignment.
  • Biologically equivalent polynucleotides are polynucleotides that share the above indicated percentages of identity and encode polypeptides having the same or similar biological activity.
  • a polynucleotide is composed of a specific sequence of four nucleotide bases: adenine (A), cytosine (C), guanine (G), thymine (T), or when a polynucleotide In the case of RNA, thymine is replaced by uracil (U).
  • a "polynucleotide sequence” may be denoted by the letters of the polynucleotide molecule. This letter designation can be entered into a database in a computer with a central processing unit and used in bioinformatics applications such as for functional genomics and homology searches.
  • polynucleotide refers to a polymeric form of nucleotides of any length, whether deoxyribonucleotides or ribonucleotides or their analog.
  • a polynucleotide can have any three-dimensional structure and can perform any function, known or unknown.
  • polynucleotides genes or gene fragments (e.g., probes, primers, EST or SAGE tags), exons, introns, messenger RNA (mRNA), transfer RNA, ribose Somatic RNA, ribozyme, cDNA, dsRNA, siRNA, miRNA, recombinant polynucleotides, branched polynucleotides, plasmids, vectors, isolated DNA of any sequence, isolated RNA of any sequence, nucleic acid probes and primers.
  • a polynucleotide may comprise modified nucleotides, such as methylated nucleotides and nucleotide analogs.
  • nucleotides can be made before or after assembly of the polynucleotide.
  • the sequence of nucleotides may be interrupted by non-nucleotide components.
  • Polynucleotides may be further modified after polymerization, for example by conjugation with labeling components.
  • the term also refers to double-stranded and single-stranded molecules. Unless otherwise stated or required, any embodiment of a polynucleotide of the present disclosure includes the double-stranded form and each of the two complementary single-stranded forms known or predicted to constitute the double-stranded form.
  • encoding when applied to a polynucleotide refers to a polynucleotide which is said to "encode” a polypeptide which, in its native state or when manipulated by methods well known to those skilled in the art, can be transcribed and/or translated to produce The polypeptide and/or fragments thereof.
  • Antibody refers to a polypeptide or polypeptide complex that specifically recognizes and binds an antigen.
  • Antibodies can be whole antibodies and any antigen-binding fragments thereof or single chains thereof.
  • the term "antibody” thus includes any protein or peptide whose molecule contains at least a portion of an immunoglobulin molecule that has the biological activity to bind an antigen.
  • Antibodies and antigen-binding fragments include, but are not limited to, complementarity determining regions (CDRs), heavy chain variable regions (VH), light chain variable regions (VL) of heavy or light chains or their ligand-binding portions described in the Examples.
  • CDRs complementarity determining regions
  • VH heavy chain variable regions
  • VL light chain variable regions
  • heavy chain constant region (CH), light chain constant region (CL), framework region (F R) or any part thereof, or at least a part of a binding protein.
  • the CDR regions include the CDR regions of the light chain (LCDR1-3) and the CDR regions of the heavy chain (HCDR1-3).
  • a variable region may comprise the structure FR1-CDR1-FR2-CDR2-FR3-CDR3-FR4.
  • Single-chain variable fragment refers to a fusion protein of the variable regions of the heavy (VH) and light (VL) chains of an immunoglobulin. In some aspects, these regions are linked to short linker peptides of 10 to about 25 amino acids. Linkers can be rich in glycine for flexibility, and serine or threonine for solubility, and can connect the N-terminus of VH to the C-terminus of VL, or vice versa. Although the protein has had its constant regions removed and a linker introduced, it retains the specificity of the original immunoglobulin. ScFv molecules are generally known in the art, for example as described in US Pat. No. 5,892,019.
  • single domain antibody or “sdAb” refers to a single antigen-binding polypeptide having three complementarity determining regions (CDRs). An sdAb alone is capable of binding the antigen but not paired with the corresponding CDR-containing polypeptide. In some cases, sdAbs were engineered from camelid HCAbs, and their heavy chain variable domains are referred to herein as "VHH".
  • Camelid sdAbs are one of the smallest known antigen-binding antibody fragments (see, e.g., Hamers-Casterman et al., Nature 363:446-8 (1993); Greenberg et al., Nature 374:168-73 (1995); Hassanzadeh- Ghassabeh et al., Nanomedicine (Lond), 8:1013-26 (2013)).
  • HcAb heavy chain antibody
  • VHH, CH2 and CH3 heavy chains
  • Camelids such as camels, llamas or alpacas are known to produce HcAbs.
  • the first binding moiety in the bispecific antibody is an antibody targeting spike protein, which is a whole antibody or an antigen-binding fragment. In some embodiments, the first binding moiety is an IgG type antibody. In some embodiments, the first binding moiety is an IgG type antibody, and the C-terminus of its heavy chain is truncated.
  • the second binding moiety in the bispecific antibody is an antibody targeting spike protein, which is a whole antibody or an antigen-binding fragment. In some embodiments, the second binding moiety in the bispecific antibody is a single domain antibody.
  • antibody includes a wide variety of polypeptides that can be distinguished biochemically.
  • classes of heavy chains include gamma, mu, alpha, delta or epsilon ( ⁇ , ⁇ , ⁇ , ⁇ , ⁇ ), with some subclasses (eg ⁇ 1- ⁇ 4).
  • the nature of this chain determines the "class” of the antibody as IgG, IgM, IgA, IgG or IgE, respectively.
  • the immunoglobulin subclasses (isotypes), eg, IgGl, IgG2, IgG3, IgG4, IgG5, etc., are well characterized and the functional specificities conferred are also known.
  • the immunoglobulin molecule is of the IgG class.
  • IgG typically comprises two identical light chain polypeptides with a molecular weight of about 23,000 Daltons and two identical heavy chain polypeptides with a molecular weight of about 53,000-70,000.
  • the four chains are connected by disulfide bonds in a "Y" configuration, where the light chain starts at the mouth of the "Y” and continues through the available The variable region surrounds the heavy chain.
  • Antibodies, antigen-binding fragments, or derivatives disclosed in the present invention include but are not limited to polyclonal, monoclonal, multispecific, fully human, humanized, primatized, chimeric antibody/single chain antibody, epitope Binding fragments such as Fab, Fab' and F(ab') 2 , Fd, Fvs, single-chain Fvs (scFv), disulfide-linked Fvs (sdFv), fragments comprising VK or VH domains, or expression libraries from Fab Generated fragments and anti-idiotypic (anti-Id) antibodies.
  • epitope Binding fragments such as Fab, Fab' and F(ab') 2 , Fd, Fvs, single-chain Fvs (scFv), disulfide-linked Fvs (sdFv), fragments comprising VK or VH domains, or expression libraries from Fab Generated fragments and anti-idiotypic (anti-Id) antibodies.
  • immunoglobulins or antibody molecules disclosed herein can be of any type (e.g., IgG, IgE, IgM, IgD, IgA, and IgY) or class (e.g., IgG1, IgG2, IgG3, IgG4, IgA1, and IgA2) of immunoglobulins or subclass.
  • type e.g., IgG, IgE, IgM, IgD, IgA, and IgY
  • class e.g., IgG1, IgG2, IgG3, IgG4, IgA1, and IgA2
  • Light chains can be classified as kappa ( ⁇ ) or lambda ( ⁇ ). Each heavy chain can be associated with a kappa or lambda light chain.
  • ⁇ kappa
  • lambda ⁇
  • Each heavy chain can be associated with a kappa or lambda light chain.
  • immunoglobulins are produced by hybridomas, B cells, or genetically engineered host cells, their light and heavy chains are joined by covalent bonds, and the "tail" portions of the two heavy chains are linked by covalent disulfide bonds or non-covalent bonding.
  • the amino acid sequence extends from the N-terminus at the forked end of the Y configuration to the C-terminus at the bottom of each chain.
  • the variable region of the immunoglobulin kappa light chain is V ⁇ ; the variable region of the immunoglobulin lambda light chain is V ⁇ .
  • Both light and heavy chains are divided into regions of structural and functional homology.
  • the terms "constant” and “variable” are used according to function.
  • the variable region of the light chain (VL) and the variable region of the heavy chain (VH) determine antigen recognition and specificity.
  • the constant regions of the light and heavy chains confer important biological properties such as secretion, transplacental movement, Fc receptor binding, complement fixation, etc. By convention, the numbering of constant regions increases as they become farther away from the antigen-binding site or amino terminus of the antibody.
  • the N-terminal portion is the variable region and the C-terminal portion is the constant region; the CH3 and CL domains actually comprise the carboxy-terminal ends of the heavy and light chains, respectively.
  • variable regions enable the antibody to selectively recognize and specifically bind epitopes on antigens.
  • a subset of the VL and VH domains or complementarity determining regions (CDRs) of an antibody combine to form variable regions that define a three-dimensional antigen-binding site.
  • This antibody quaternary structure forms the antigen binding site present at the end of each arm of the Y. More specifically, the antigen binding site is defined by three CDRs (ie, HCDR1, HCDR2, HCDR3, LCDR1, LCDR2, and LCDR3) in each of the VH and VL chains.
  • immunoglobulin molecules may consist of only heavy chains and no light chains . See, eg, Hamers-Casterman et al., Nature, 363:446-448 (1993).
  • each antigen-binding domain In naturally occurring antibodies, the six “complementarity determining regions" or “CDRs” present in each antigen-binding domain are short, A non-contiguous sequence of amino acids that specifically binds to an antigen. The remaining other amino acids in the antigen-binding domain, referred to as the "framework" regions, show less inter-molecular variability.
  • the framework regions largely adopt a ⁇ -sheet conformation, and the CDRs form loop structures attached to them, or in some cases form part of the ⁇ -sheet structure. Thus, the framework regions position the CDRs in the correct orientation by forming a scaffold through non-covalent interchain interactions.
  • the antigen-binding domain with the CDRs in specific positions forms a surface complementary to the epitope on the antigen that facilitates the non-covalent binding of the antibody to its antigenic epitope.
  • a surface complementary to the epitope on the antigen that facilitates the non-covalent binding of the antibody to its antigenic epitope.
  • those of ordinary skill in the art can identify it by known methods. Amino acids comprising CDRs and framework regions were determined (see Kabat, E., et al., USDepartment of Health and Human Services, Sequences of Proteins of Immunological Interest, (1983) and Chothia and Lesk, J. Mol. Biol., 196 :901-917(1987)).
  • CDR complementarity determining regions
  • CDRs as defined by Kabat and Chothia include overlapping or subsets of amino acid residues when compared to each other. Nevertheless, it is within the scope of the invention to use either definition to refer to the CDRs of an antibody or variant thereof.
  • the exact residue numbers comprising a particular CDR will vary depending on the sequence and size of the CDR. Those skilled in the art can generally determine which specific residues are included in the CDRs based on the amino acid sequence of the variable region of the antibody.
  • Kabat et al. also defined a numbering system applicable to the variable region sequences of any antibody.
  • One of ordinary skill in the art can apply this "Kabat numbering" system to any variable region sequence independently of other experimental data other than the sequence itself.
  • “Kabat numbering” refers to the numbering system proposed by Kabat et al., U.S. Dept. of Health and Human Services in "Sequence of Proteins of Immunological Interest” (1983).
  • Antibodies can also use the EU numbering system.
  • the antibodies or antigen-binding fragments disclosed herein may be derived from any animal, including birds and mammals.
  • the antibody is of human, murine, donkey, rabbit, goat, camel, llama, horse or chicken origin.
  • the variable regions may be of condricthoid origin (eg, from sharks).
  • a "heavy chain constant region” includes an amino acid sequence derived from an immunoglobulin heavy chain.
  • a polypeptide comprising a heavy chain constant region includes at least one of a CH1 domain, a hinge (eg, upper, middle, and/or lower hinge region) domain, a CH2 domain, a CH3 domain, or a variant or fragment.
  • the antibody or antigen-binding fragment disclosed in the present invention comprises a CH1 domain; comprises a CH1 domain, at least a part of the hinge region and a CH2 domain; comprises a CH1 domain and a CH3 domain; comprises a CH1 domain and at least a part of the hinge region and a CH3 domain; or comprising a CH1 domain, at least a portion of the hinge region, and a CH2 domain and a CH3 domain.
  • an antibody or antigen-binding fragment disclosed herein comprises a CH3 domain.
  • antibodies or antigen-binding fragments used in the present invention may lack part or all of the CH2 domain.
  • heavy chain constant regions may be modified such that the amino acid sequence of their naturally occurring immunoglobulin molecule is altered.
  • the heavy chain constant regions of antibodies can be derived from different immunoglobulin molecules.
  • the heavy chain constant region of a polypeptide can include a CH1 domain derived from an IgG 1 molecule and a hinge region derived from an IgG 3 molecule.
  • the heavy chain constant region may comprise a hinge region derived in part from an IgG 1 molecule and in part from an IgG 3 molecule.
  • part of the heavy chain may include a chimeric hinge region derived partly from an IgG 1 molecule and partly from an IgG4 molecule.
  • a “light chain constant region” includes an amino acid sequence from an antibody light chain.
  • the light chain constant region comprises at least one of a constant kappa domain or a constant lambda domain.
  • a “light chain-heavy chain pair” refers to a collection of light and heavy chains that can form dimers through disulfide bonds between the CL domain of the light chain and the CH1 domain of the heavy chain.
  • a "VH domain” includes the amino-terminal variable domain of an immunoglobulin heavy chain
  • a "CH1 domain” includes the first (mostly amino-terminal) constant region of an immunoglobulin heavy chain.
  • the CH1 domain is adjacent to the VH domain and is amino-terminal to the hinge region of an immunoglobulin heavy chain molecule.
  • the CH2 domain is not closely paired with other domains, but rather two N-linked branched carbohydrate chains are inserted between the two CH2 domains of the intact native IgG molecule.
  • the CH3 domain extends from the CH2 domain to the C-terminus of the IgG molecule and contains approximately 108 residues.
  • a "hinge region” includes part of the heavy chain region connecting the CH1 domain and the CH2 domain.
  • the hinge region comprises approximately 25 residues and is flexible, allowing the two N-terminal antigen-binding regions to move independently.
  • the hinge region can be subdivided into three distinct domains: upper, middle and lower hinge domains (Roux et al., J. Immunol 161:4083 (1998)).
  • Disulfide bond refers to a covalent bond formed between two sulfur atoms.
  • a thiol group of cysteine can form a disulfide bond or bridge with a second thiol group.
  • the CH1 and CL regions are linked by a disulfide bond, and the two heavy chains are linked by two disulfide bonds at positions 239 and 242 in the Kabat numbering system (positions 226 and 229 in the EU numbering system) connected everywhere.
  • a “chimeric antibody” refers to any antibody whose variable regions are obtained or derived from a first species and whose constant regions (which may be complete, partial or modified) are derived from a second species.
  • the variable regions are of non-human origin (eg, mouse or primate) and the constant regions are of human origin.
  • Specific binding or “specific for” generally refers to the complementary binding of an antibody or antigen-binding fragment to a specific antigen through its antigen-binding domain and epitope to form a relatively stable complex.
  • Specificity can be expressed in terms of the relative affinity with which an antibody or antigen-binding fragment binds to a particular antigen or epitope. For example, antibody “A” may be said to have a higher specificity for that antigen than antibody “B” if it has a greater relative affinity for the same antigen than antibody "B”.
  • Specific binding can be described by an equilibrium dissociation constant (KD), with a smaller KD implying a tighter binding.
  • KD equilibrium dissociation constant
  • An antibody that "specifically binds" to a spike protein includes an equilibrium dissociation constant KD less than or equal to about 100 nM, less than or equal to about 10 nM, less than or equal to about 5 nM, less than or equal to about 1 nM with the spike protein.
  • Monospecific antibodies can specifically bind one antigen or one epitope, while bispecific antibodies can specifically bind two different antigens or two different epitopes.
  • Treatment means therapeutic treatment and prophylactic or preventive measures, the purpose of which is to prevent, slow down, ameliorate or stop an undesirable physiological change or disorder, such as the progression of a disease, including but not limited to the following whether detectable or undetectable Relief of symptoms, reduction of disease extent, stabilization of disease state (i.e. not worsening), delay or slowing of disease progression, amelioration, remission, alleviation or disappearance of disease state (whether partial or total), prolongation and Expected survival without treatment, etc.
  • Those in need of treatment include those already suffering from the condition or disorder, A patient susceptible to a condition or disorder, or in need of prevention of the condition or disorder, who can or is expected to benefit from administration of an antibody or pharmaceutical composition disclosed herein for detection, diagnostic procedures and/or treatment.
  • the term "in need” means that a patient has been identified as being in need of a particular method or treatment. In some embodiments, identification may be by any diagnostic means. A patient may in need thereof during any of the methods and treatments described herein.
  • Patient refers to any mammal in need of diagnosis, prognosis, or treatment, including humans, dogs, cats, rabbits, rats, mice, horses, cattle, and the like.
  • ECMO refers to extracorporeal membrane oxygenation (Extracorporeal Membrane Oxygenation, ECMO), which is a medical emergency technical equipment, which is mainly used to provide continuous extracorporeal breathing and circulation for patients with severe cardiopulmonary failure to maintain their lives.
  • ICU refers to the intensive care unit (Intensive Care Unit), where treatment, nursing, and rehabilitation can be carried out simultaneously, providing isolation places and equipment for severe or comatose patients, providing the best nursing care, comprehensive treatment, combination of medical care and nursing care, and surgery Postoperative early rehabilitation, joint care and sports therapy and other services.
  • Intensive Care Unit intensive care unit
  • Treatment, nursing, and rehabilitation can be carried out simultaneously, providing isolation places and equipment for severe or comatose patients, providing the best nursing care, comprehensive treatment, combination of medical care and nursing care, and surgery Postoperative early rehabilitation, joint care and sports therapy and other services.
  • IMV intermittent mandatory ventilation, which implements periodic volume or pressure ventilation according to a preset time interval, ie time trigger. This period allows the patient to breathe spontaneously at any set basal pressure level during mandatory ventilation. During spontaneous breathing, the patient can breathe spontaneously with continuous airflow support, or the machine will open the valve on demand to allow spontaneous breathing. According to most ventilators can provide pressure support during spontaneous breathing.
  • HFNC High-flow nasal cannula oxygen therapy
  • High-flow nasal cannula oxygen therapy is an oxygen therapy method that directly delivers a certain oxygen concentration of air and oxygen mixed with high-flow gas to the patient through a nasal catheter without sealing.
  • a form of non-invasive respiratory support that rapidly improves oxygenation. At present, it can be applied to patients with acute hypoxic respiratory failure, patients after surgery, patients with respiratory failure without endotracheal intubation, immunosuppressed patients, patients with cardiac insufficiency, etc.
  • NMV Non-invasive Ventilation, which refers to non-invasive mechanical ventilation except tracheal intubation and tracheotomy.
  • IC50 means 50% inhibitory concentration, ie the concentration of drug or inhibitor required to inhibit a given biological process by half.
  • the "parental Fc region" in the present invention can be a naturally occurring Fc region, and the gene encoding the Fc region can be from human, mouse, rabbit, camel, monkey, preferably human and mouse; for example, the parental Fc region is SEQ ID NO:60 , the Fc region of SEQ ID NO:61 or SEQ ID NO:66.
  • the invention provides antibodies with high affinity for spike protein, including bispecific antibodies, single domain antibodies and heavy chain antibodies.
  • Bispecific antibodies, single domain antibodies, and heavy chain antibodies exhibit potent binding activity and are useful for therapeutic and diagnostic applications.
  • these antibodies can prevent the fusion of SARS-CoV-2 virus particles and cell membranes, and mediate immune cell phagocytosis and clearance of virus particles.
  • Some embodiments provide a single domain antibody, the amino acid sequence of the single domain antibody is shown in SEQ ID NO:69.
  • the diabody, single domain antibody or heavy chain antibody may also be linked with an amino acid sequence or one or more modifying groups.
  • the diabodies, single domain antibodies or heavy chain antibodies disclosed herein may contain a flexible linker sequence, or may be modified to add functional groups (eg PEG, drug, toxin or tag).
  • the bispecific antibody, single domain antibody or heavy chain antibody disclosed in the present invention also includes modified derivatives, that is, modified by covalent attachment of any type of molecule to the antibody, wherein the covalent attachment does not prevent the antibody from binding to the epitope .
  • modified derivatives that is, modified by covalent attachment of any type of molecule to the antibody, wherein the covalent attachment does not prevent the antibody from binding to the epitope .
  • antibodies may be glycosylated, acetylated, pegylated, phosphorylated, amidated, derivatized by known protecting/blocking groups, proteolytically cleaved, linked to cellular ligands, or other proteins etc. Any of the numerous chemical modifications can be performed by existing techniques, including but not limited to specific chemical cleavage, acetylation, formylation, metabolic synthesis of tunicamycin, etc.
  • a bispecific antibody, single domain antibody or heavy chain antibody can be conjugated to a therapeutic agent, prodrug, peptide, protein, enzyme, virus, lipid, biological response modifier, pharmaceutical agent, or PEG.
  • a diabody, single domain antibody or heavy chain antibody can be detectably labeled by coupling it to a chemiluminescent compound.
  • the presence of the chemiluminescently labeled antibody is then determined by detecting the luminescence that occurs during the chemical reaction.
  • chemiluminescent labeling compounds include luminol, isoluminol, aromatic acridinium esters, imidazoles, acridinium salts, and oxalate esters.
  • the present invention also discloses polynucleotides or nucleic acid molecules encoding the bispecific antibody, single domain antibody and heavy chain antibody of the present invention.
  • the polynucleotide disclosed in the present invention can encode heavy chain, light chain, heavy chain variable region, light chain variable region, Fc region, part of heavy chain variable region or part of light chain variable region, bispecific, single domain antibody or heavy chain antibody.
  • Methods of making antibodies are well known in the art and described herein.
  • both the variable and constant regions of the antibodies disclosed herein are fully human. Fully human antibodies and antigen-binding fragments can be prepared using techniques disclosed in the art and described herein.
  • Fully human antibodies to a particular antigen can be produced by administering the antigen to transgenic animals that have been modified to produce fully human antibodies in response to antigen challenge.
  • Exemplary techniques that can be used to prepare such antibodies are found in US Patent Nos. 6,458,592; 6,420,140, the entire contents of which are incorporated herein by reference.
  • antibodies are produced that do not elicit an adverse immune response in the animal (eg, human) to be treated.
  • the antibodies disclosed herein are modified using art-recognized techniques to reduce their immunogenicity.
  • antibodies can be humanized, primatized, deimmunized or chimeric antibodies can be prepared. These types of antibodies are derived from non-human antibodies, usually murine or primate antibodies, which retain or substantially retain the antigen-binding properties of the parent antibody but are less immunogenic in humans.
  • framework residues in the human framework regions will be replaced by corresponding residues from the CDR donor antibody, such as residues that improve antigen binding.
  • framework substitutions can be identified by methods known in the art, such as by modeling the interaction of CDRs and framework residues to identify framework residues important for antigen binding and by sequence alignment to identify abnormal framework residues at specific positions. (Refer to US Patent 5,585,089; the entire contents of which are incorporated herein by reference).
  • Antibodies can be humanized using a variety of techniques known in the art, such as CDR grafting (EP 239,400; WO 91/09967; US Patents 5,225,539, 5,530,101 and 5,585,089), repair or surface rearrangement (EP 592,106; EP 519,596; ), and chain rearrangements (US Patent 5,565,332), the entire contents of which are incorporated herein by reference.
  • Deimmunization can also be used to reduce the immunogenicity of antibodies.
  • the term "deimmunization” includes altering antibodies to modify T cell epitopes (see eg WO/9852976A1 and WO/0034317A2).
  • the heavy and light chain variable region sequences from a starting antibody are analyzed and a human T cell epitope "map" from each variable region is generated, showing the epitopes relative to the complementarity determining regions (CDRs) and the positions of other key residues within the sequence.
  • CDRs complementarity determining regions
  • a series of alternative heavy chain variable region sequences and light chain variable region sequences comprising combinations of amino acid substitutions are designed and these sequences are subsequently incorporated into a series of binding polypeptides.
  • Genes for the complete heavy and light chains containing the modified variable and human constant regions are then cloned into expression vectors, and the plasmids are subsequently transformed into cell lines to produce complete antibodies.
  • Antibodies are then compared using appropriate biochemical and biological assays to identify the best antibody.
  • the binding specificity of the antibodies disclosed in the present invention can be detected by in vitro experiments, such as co-immunoprecipitation, radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA).
  • in vitro experiments such as co-immunoprecipitation, radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA).
  • scFv Single-chain fusion peptides are generated by amino acid bridging of the heavy and light chain fragments of the Fv region to form single-chain units.
  • the technique of assembling functional Fv fragments in E. coli can also be used (Skerra et al., Science 242:1038-1041 (1988)).
  • Naturally occurring VHH domains directed against particular antigens or targets can be obtained from (native or immune) libraries of Camelidae VHH sequences. Such libraries and techniques are described, for example, in WO 99/37681, WO 01/90190, WO 03/025020 and WO 03/035694.
  • improved synthetic or semi-synthetic libraries derived from (native or immune) VHH libraries can be used, for example VHH libraries obtained from (native or immune) VHH libraries by techniques such as random mutagenesis and/or CDR shuffling, e.g. WO 00 /43507 described.
  • DNA encoding the desired monoclonal antibody can be isolated and sequenced using conventional methods (e.g., using oligonucleotide probes capable of binding specifically to genes encoding the heavy and light chains of murine antibodies). sequencing. Isolated and subcloned hybridoma cells can serve as a source of such DNA. Once isolated, the DNA can be placed into an expression vector and then transfected into prokaryotic or eukaryotic host cells such as E. coli cells, simian COS cells, Chinese hamster ovary (CHO) cells, or myeloma that do not produce other immunoglobulins in cells.
  • prokaryotic or eukaryotic host cells such as E. coli cells, simian COS cells, Chinese hamster ovary (CHO) cells, or myeloma that do not produce other immunoglobulins in cells.
  • Isolated DNA (which may be synthetic as described herein) can also be used to prepare sequences for the constant and variable regions of antibodies, as described in U.S. Pat. 5,658,570, the entire contents of which are incorporated herein by reference. This method extracts RNA from selected cells and converts it into cDNA, which is then amplified by PCR using Ig-specific primers. Suitable probes for this purpose are also mentioned in US Patent No. 5,658,570.
  • one or more CDRs of an antibody of the invention can be inserted into a framework region, eg, into a human framework region, to construct a humanized non-fully human antibody.
  • the framework regions may be naturally occurring or consensus framework regions, preferably human framework regions (see Chothia et al., J. Mol. Biol. 278:457-479 (1998) for a list of human framework regions).
  • Some polynucleotides may encode an antibody that specifically binds at least one epitope of an antigen of interest produced by a combination of framework regions and CDRs.
  • One or more amino acid substitutions may be made within the framework regions, and the amino acid substitutions may be selected to improve binding of the antibody to its antigen.
  • substitution or deletion of cysteine residues in one or more variable regions involved in interchain disulfide bond formation can be performed in this way, thereby producing antibody molecules lacking one or more interchain disulfide bonds.
  • Other modifications to polynucleotides within the skill of the art are also encompassed in the present invention.
  • the DNA encoding the antibody can be designed and synthesized according to the amino acid sequence of the antibody described herein according to conventional methods, placed into an expression vector, and then transfected into a host cell, and the transfected host cell is cultured in a culture medium produce antibodies.
  • the expression vector includes at least one promoter element, an antibody, antigen-binding fragment or fusion protein coding sequence, a transcription termination signal and a polyA tail.
  • Other elements include enhancers, Kozak sequences, and donor and acceptor sites for RNA splicing flanking the inserted sequence.
  • Efficient transcription can be achieved by early and late promoters of SV40, long terminal repeats from retroviruses such as RSV, HTLV1, HIVI, and early promoters of cytomegalovirus (CMV), and other cellular promoters promoters such as the actin promoter.
  • Suitable expression vectors may include pIRES1neo, pRetro-Off, pRetro-On, PLXSN, or pLNCX, pcDNA3.1(+/-), pcDNA/Zeo(+/-), pcDNA3.1/Hygro(+/-), PSVL, PMSG, pRSVcat, pSV2dhfr, pBC12MI, pCS2 or pCHO1.0 etc.
  • CHO cells Chinese hamster ovary cells (CHO cells) (e.g. CHO-K1 cells) or CHO-S, CHO-dhfr-, CHO/DG44 or ExpiCHO modified from CHO cells, NSO myeloma cells, COS cells , Cos1 cells, Cos7 cells, SP2 cells, CV1 cells, mouse L cells, human embryonic kidney cells HEK293 or HEK293T, HEK293F or HEK293E cells modified from HEK293 cells, etc.
  • CHO cells Chinese hamster ovary cells
  • CHO-K1 cells e.g. CHO-K1 cells
  • CHO-S CHO-dhfr-
  • CHO/DG44 ExpiCHO modified from CHO cells
  • NSO myeloma cells COS cells
  • Cos1 cells Cos7 cells
  • SP2 cells CHO cells
  • CV1 cells mouse L cells
  • host cells can be co-transfected with two recombinant expression vectors, the first recombinant expression vector encodes the antibody heavy chain, and the second recombinant expression vector encodes the antibody light chain.
  • Two recombinant expression vectors may contain the same selectable marker, or they may each contain different selectable markers.
  • host cells can be transfected with recombinant expression vectors that co-encode antibody heavy and light chains.
  • Antibodies of the invention can also be produced by chemical synthesis (eg, by the method described in Solid Phase Peptide Synthesis, 2nd Ed., 1984 The Pierce Chemical Co., Rockford, Ill.). Variant antibodies can also be generated using cell-free platforms (see, e.g., Chu et al., Biochemia No. 2, 2001 (Roche Molecular Biologicals) and Murray et al., 2013, Current Opinion in Chemical Biology, 17:420-426).
  • Antibodies produced by recombinant expression can be purified by any method known in the art for the purification of immunoglobulin molecules, such as by chromatography (e.g., ion exchange, affinity chromatography, and fractional column chromatography), centrifugation, , differential solubility, or any other standard technique for purifying proteins. For example, affinity chromatography using protein A or protein G. Alternatively, the specific antigen targeted by the immunoglobulin or its epitope can be immobilized on a column to purify the immunospecific antibody by immunoaffinity chromatography. Antibodies of the invention can be fused to heterologous polypeptide sequences known in the art to facilitate purification. The purification of immunoglobulin can refer to the article of D. Wilkinson (The Philosoph, published by The Engineer, Inc., Philadelphia Pa., Vol. 14, No. 8 (April 17, 2000), pages 25-28) .
  • mutations can be introduced into the nucleotide sequence encoding the antibodies of the present invention using standard techniques known to those skilled in the art, including but not limited to site-directed mutagenesis and PCR-mediated mutations resulting in amino acid substitutions.
  • Variants include derivatives
  • mutations can be introduced randomly along all or part of the coding sequence, for example by saturation mutagenesis, and the resulting mutants can be screened for biological activity to identify mutants that retain activity.
  • substitutions may be conservative amino acid substitutions.
  • the invention also provides treatment methods and uses.
  • a method for preventing, treating or improving COVID-19 comprising administering an effective dose of an antibody (including a bispecific antibody, a single domain antibody or a heavy chain antibody) to a patient.
  • the application of the antibody (including bispecific antibody, single domain antibody or heavy chain antibody) in preventing, treating or improving COVID-19 is provided.
  • the use of the antibody (including bispecific antibody, single domain antibody or heavy chain antibody) in the preparation of a medicament for preventing, treating or improving COVID-19 is provided.
  • the patient is a patient suspected of being infected with the SARS-CoV-2 virus.
  • the patient is a patient who has been in contact with a SARS-CoV-2 virus carrier. In some embodiments, the patient is a patient confirmed to be infected with the SARS-CoV-2 virus. in some implementations In the scheme, the patient is a patient with mild symptoms. In some embodiments, the patient is a severely symptomatic patient. In some embodiments, the patient has fever, cough, hypotension, hypoxia, and/or acute respiratory distress syndrome (ARDS).
  • ARDS acute respiratory distress syndrome
  • the specific dosage and treatment regimen for any particular patient will depend on various factors, including the antibody (including bispecific, single domain, or heavy chain antibody) used, the patient's age and weight, general health, sex, and diet , as well as the timing of administration, frequency of excretion, drug combination, and severity of the particular condition being treated. These factors are in the judgment of the medical caregiver, who is within the purview of those of ordinary skill in the art.
  • the dosage will also depend on the individual patient to be treated, the route of administration, the type of formulation, the nature of the compound employed, the severity of the disease and the effect desired.
  • the dosage used can be determined by principles of pharmacology and pharmacokinetics well known in the art.
  • Methods of administration of antibodies include, but are not limited to, intradermal, intramuscular, intraperitoneal, intravenous, subcutaneous, nasal, epidural, and oral injections.
  • the pharmaceutical compositions may be administered by any convenient route, such as by infusion or bolus injection, absorbed through the epithelium or mucous membranes (eg, oral mucosa, rectal and intestinal mucosa, etc.), and may be co-administered with other biologically active agents.
  • compositions containing an antibody of the invention can be administered orally, rectally, parenterally, intracisternally, intravaginally, intraperitoneally, topically (e.g., by powder, ointment, drops, etc.) or transdermal patch), orally, or by oral or nasal spray.
  • parenteral refers to modes of administration including intravenous, intramuscular, intranasal, intraperitoneal, intrasternal, subcutaneous and intraarticular injection and infusion.
  • the mode of administration can be systemic administration or local administration.
  • compositions of the invention comprise nucleic acids or polynucleotides encoding proteins, which can be administered in vivo to promote expression of the encoded proteins by constructing them as part of a suitable nucleic acid expression vector,
  • the above-mentioned part of the vector is then administered to become an intracellular part, for example by using a retroviral vector (see US Pat. No. 4,980,286), or by direct injection, or by using particle bombardment (for example, a gene gun; Biolistic, Dupont) , or coated with liposomes or cell surface receptors or transfection reagents, or administered via linkage to homeobox peptides known to enter the nucleus (see e.g.
  • nucleic acid can be introduced into the cell by homologous recombination and integrated into the host cell DNA for expression.
  • Various known delivery systems can be used to administer the bispecific antibody, single domain antibody or heavy chain antibody of the present invention or its encoding Polynucleotides, e.g. encapsulated in liposomes, microparticles, microcapsules, recombinant cells capable of expressing said compounds, receptor-mediated endocytosis (see e.g. Wu and Wu, 1987, J. Biol. Chem. 262 :4429-4432), construction of nucleic acids as part of retroviruses or other vectors, etc.
  • Polynucleotides e.g. encapsulated in liposomes, microparticles, microcapsules, recombinant cells capable of expressing said compounds, receptor-mediated endocytosis (see e.g. Wu and Wu, 1987, J. Biol. Chem. 262 :4429-4432), construction of nucleic acids as part of retroviruses or other vectors, etc.
  • antibodies of the invention may be combined with other therapeutic or prophylactic regimens, including administration of one or more antibodies of the invention and one or more other therapeutic agents or methods used together or in combination.
  • antibodies of the invention may be administered simultaneously or separately with other therapeutic agents.
  • an antibody of the invention may be administered before or after another other therapeutic agent is administered.
  • adalimumab such as and its biosimilars, such as Abrilada TM (adalimumab-afzb), Amjevita (adalimumab-att), Cyltezo TM (adalimumab-adbm), Hyrimoz TM (adalimumab-adaz), Hulio TM , ( BAT1406)) or tocilizumab (tochilizumab, e.g.
  • the patient treated by this method is confirmed to be infected with novel coronavirus and has one or more cytokines (including tumor necrosis factor alpha (TNF- ⁇ ), IFN- ⁇ , IL-1 ⁇ , IL-2, IL -4, IL-7, IL-8, IL-10, IL-12p70, IL-13, granulocyte colony-stimulating factor (GSCF), interferon-inducible protein-10 (IP-10), monocyte chemoattractant protein -1 (MCP1), macrophage inflammatory protein 1 ⁇ (MIP1A)) increased.
  • TNF- ⁇ tumor necrosis factor alpha
  • IFN- ⁇ IFN- ⁇
  • IL-1 ⁇ interferon-inducible protein-10
  • MCP1A monocyte chemoattractant protein -1
  • MIP1A macrophage inflammatory protein 1 ⁇
  • the subject treated by the present methods has elevated TNF-alpha.
  • one or more cytokines are at least 50% above normal levels. In some embodiments, the one or more cytokines are at least 2-fold, 3-fold, or 4-fold the normal level.
  • the patient has fever, hypotension, hypoxia, and/or acute respiratory distress syndrome (ARDS) prior to treatment by the method.
  • ARDS acute respiratory distress syndrome
  • the patient has lungs filled with inflammatory fluid (so-called "white lung") prior to treatment by the method.
  • the patient has Cytokine Release Syndrome (CRS) caused by cytokine storm before treatment with the method.
  • CRS Cytokine Release Syndrome
  • antibodies of the invention are used in conjunction with ICU therapy. In some embodiments, antibodies of the invention are combined with ECMO and/or IMV therapy in vitro. In some embodiments, an antibody of the invention is combined with oxygen therapy. In some embodiments, antibodies of the invention are combined with NIV/HFNC therapy. In some embodiments, after treatment, one or more cytokines in the patient is at least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 95% lower than before treatment . In some embodiments, the method heals the patient.
  • Spike protein positive is observed in some samples, or patients infected with SARS-CoV-2 virus may respond to treatment with the antibody of the present invention. Therefore, the antibodies of the invention can also be used for detection and diagnosis.
  • a sample can be obtained from a patient. Following optional pretreatment of the sample, the sample can be incubated with an antibody of the invention under conditions that allow the antibody to interact with spike proteins that may be present in the sample. Antibodies can be used to detect the presence of spike proteins in a sample using methods such as ELISA.
  • the presence (eg, amount or concentration) of a spike protein in a sample can be used to diagnose a relevant disease, as an indication that a patient is suitable for antibody therapy, or as an indication that a patient has (or has not) responded to treatment for a disorder.
  • a prognostic approach one, two or more tests can be performed at a particular stage when starting treatment for the disease to indicate the progress of the treatment.
  • compositions comprise the antibodies described herein together with pharmaceutically acceptable excipients.
  • the term "pharmaceutically acceptable” refers to a substance approved by a governmental regulatory agency or listed in other recognized pharmacopoeias for use in animals, particularly in humans.
  • pharmaceutically acceptable excipients generally refer to any type of non-toxic solid, semi-solid or liquid fillers, diluents, encapsulating materials or formulation aids, etc.
  • Suitable pharmaceutical excipients include starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glyceryl monostearate, talc, sodium chloride, skim milk powder, glycerol, Propylene, ethylene glycol, water, ethanol, etc.
  • the pharmaceutical composition if desired, can also contain minor amounts of wetting agents, emulsifying agents, or pH buffering agents such as acetates, citrates or phosphates.
  • Antibacterial agents such as benzyl alcohol or methylparaben, antioxidants such as ascorbic acid or sodium bisulfite, chelating agents such as ethylenediaminetetraacetic acid, and tonicity adjusting agents such as sodium chloride or dextrose are also contemplated.
  • These pharmaceutical compositions may take the form of solutions, suspensions, emulsions, tablets, pills, capsules, powders, sustained release formulations and the like.
  • the pharmaceutical composition can be formulated as a suppository, with traditional binders and carriers such as triglycerides.
  • Oral formulations can include standard carriers such as pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, and the like.
  • compositions will contain a clinically effective dose of the antibody or antigen-binding fragment, preferably in purified form, together with an appropriate amount of carrier to provide a form suitable for administration to the patient.
  • the formulation should be suitable for the mode of administration.
  • the preparation can be enclosed in ampoules, disposable syringes or multiple dose vials made of glass or plastic.
  • the composition is formulated into a pharmaceutical composition suitable for intravenous injection to human body according to conventional procedures.
  • Compositions for intravenous administration are generally solutions in sterile isotonic aqueous buffer.
  • the pharmaceutical composition may also contain a solubilizer and a local anesthetic such as lidocaine to relieve pain at the injection site.
  • the active ingredients are supplied alone or in admixture in unit dosage form, such as a dry lyophilized powder or anhydrous concentrate in a hermetically sealed container (such as an ampoule, vial, or sachet) indicating the quantity of active agent. )middle.
  • the composition can be dispensed with an infusion bottle or bag containing sterile pharmaceutical grade water, physiological saline or glucose injection.
  • sterile pharmaceutical grade water physiological saline or glucose injection.
  • the compounds of the present invention can be formulated as neutral or salt forms.
  • Pharmaceutically acceptable salts include those derived from, for example, salts formed with anions of hydrochloric acid, phosphoric acid, acetic acid, oxalic acid, tartaric acid, etc. - Salts of cations such as ethylaminoethanol, histidine, procaine and the like.
  • Antibodies can be prepared by the following method or other known methods: sequence optimization is performed according to the CHO codon preference characteristics of the host cell, and the DNA sequence is obtained from the amino acid sequence.
  • sequence optimization is performed according to the CHO codon preference characteristics of the host cell, and the DNA sequence is obtained from the amino acid sequence.
  • the optimized and synthesized sequences were cloned into vectors, and then a large number of plasmids were extracted to construct stable expression cell lines: the linearized expression vector was mixed with CHO cells and then added to a 0.4cm electroporation cup for electroporation; after electroporation was completed, press 1,200 cells per well are plated in 96-well cell culture plates, and after about 2-3 weeks, select the mother clones with high expression levels to carry out cell expansion culture and expression level detection from 96-well to 24-well to 6-well to shake flasks, and shake flasks are selected Clones with high expression levels were subcloned, subclones were expanded and cultured and expressed to identify the
  • variable region composition of exemplary antibodies 1-24 and 2F8 is shown in Table 1, the framework region and CDR region of the heavy chain variable region and the light chain variable region composition are shown in Table 2, VH and CH (as set forth in SEQ ID NO:61 shown) constitutes the heavy chain of the antibody, and VL and CL (as shown in SEQ ID NO: 62) constitute the light chain of the antibody; the sequences of bispecific antibodies, single domain antibodies, heavy chain antibodies, and monospecific antibodies are shown in Table 3-Table 8 ; Wherein, antibody 2F8 (monospecific antibody) contains two identical heavy chains (as shown in SEQ ID NO:72) and two identical light chains (as shown in SEQ ID NO:74); single domain antibody The amino acid sequence of VHH18 is shown in SEQ ID NO:69; the heavy chain antibody VHH18-Fc contains two heavy chains with the same sequence (as shown in SEQ ID NO:79), and the heavy chain is composed of single domain antibody, linker and Fc ; The bispecific antibody 2F8-VH-VHH
  • the sequence of the purified antibody was confirmed by sequencing as described above.
  • variable region composition of table 1 anti-spike protein antibody (monospecific antibody)
  • Elisa detection was carried out for the above antibodies.
  • the detection method was as follows: a 96-well plate (Corning, 9018) was coated with spike-RBD-mFC (sino biologicals), sealed with tape and stored; the plate was washed in washing buffer PBST (containing 0.05% Tween 20 in PBS) for 3 washes, then add blocking solution (200 ⁇ L of 10 mg/ml BSA per well, the solvent is wash buffer); after incubation (1 hour (h), 37°C), wash the plate with wash buffer Wash 3 times, then add 100 ⁇ L of serially diluted samples to each well; after incubation (1.5h, 37°C), wash the plate with washing buffer, and then add anti-human ⁇ light chain antibody-peroxidase conjugate ( Diluted to 1:2000 in blocking solution, 100 ⁇ L/well); the plate was washed with washing buffer, and the test samples were incubated (1h, 37° C.); after 10 minutes of color development, 100 ⁇ L/well of 0.1 M
  • ACE2 angiotensin-converting enzyme 2
  • the detection method is as follows: a 96-well plate (Corning, 9018) is coated with spike-RBD-mFC (sino biologicals), sealed with tape and stored at 4°C overnight; the plate is washed in a washing buffer (PBS containing 0.05% Tween 20) Wash 3 times in washing buffer, then add blocking solution (200 ⁇ L of 10 mg/ml BSA per well, the solvent is washing buffer); after incubation (2h, 37°C), wash the plate 3 times in washing buffer, add different concentrations of Antibody samples were then added with biotinylated angiotensin-converting enzyme 2 (50ng/ml); after incubation (1h, 37°C), the plate was washed 3 times with wash buffer, and then 100 ⁇ L streptavidin was added per well Peroxidase conjugate (diluted 1:10,000 in blocking solution), after incubation (1h
  • SPR Surface Plasmon Resonance
  • antibodies 2F8 and 2F8-VH-VHH18 can block the binding of ACE2 to spike RBD, and antibody VHH18-Fc can partially block the binding of ACE2 to RBD.
  • BiaCore T200 (GE Healthcare) (Biomolecular Interaction Analysis) is detected at 25°C: ProteinA chip is used for detection, and the antibody is diluted with 1 ⁇ HBS EP+ (0.1M HEPES, 1.5M NaCl, 0.03M EDTA, supplemented with 0.005% Surfactant P20) was captured through the experimental flow path (Fc2, Fc4) at a flow rate of 10 ⁇ l/min; then the flow rate was adjusted to 30 ⁇ l/min, and the dilutions of different concentrations of Spike S1 RBD and mutants (0nM, 3.125 nM, 6.25nM, 12.5nM, 25nM and 50nM, diluted with 1 ⁇ HBS EP+), flow through the surface of the experimental flow path (Fc2, Fc4) and reference flow path (Fc1, Fc3) at the same time, carry out binding, dissociation, and finally Enter pH 1.5 Glycine buffer to regenerate the chip and enter the next cycle.
  • 1 ⁇ HBS EP+ 0.1M HEPES
  • the kinetic constant spike trimer (Acrobiosystems, SPN-C52H8) was calculated using the 1:1 Langmuir binding model on BiaCore Data Analysis software (ka is the binding rate, kd is the dissociation rate, and kD is the binding-dissociation equilibrium constant).
  • antibodies 2F8, 2F8-VL-VHH18, 2F8-VH-VHH18 and VHH18-Fc bound well to Spike S1 RBD and its mutants.
  • antibodies VHH18-Fc and 2F8-VH-VHH18 can bind spike RBD protein and mutant protein; the results show that the EC 50 value of antibody 2F8-VH-VHH18 binding to spike RBD is about 10 ng/ml.
  • the main principle is: use ACE2 + 293F cells as susceptible cells, and incubate different concentrations of antibodies with the SARS-CoV-2-Fluc pseudovirus system; when the antibody is combined with the pseudovirus, it will block the virus from entering ACE2 + 293 cells; the pseudovirus cannot effectively infect the cells, and the luciferase reporter gene on its genome cannot be expressed in the cells and generate a fluorescent signal; since the signal value of the fluorescent signal is negatively correlated with the concentration of the added antibody, the antibody can be detected Ability to inhibit virus infection in vitro.
  • the article number of the wild-type pseudovirus strain WT is GM-0220PV07 (Jiman Bio)
  • the article number of the mutant strain 1 (E484K) is GM-0220PV35 (Jiman Bio)
  • the article number of the mutant strain 2 (W436R) is GM-0220PV26 (Jiman Biological)
  • GM-0220PV33 of Mutant 3 (B.1.1.7/VUI-202012/01 del 145Y) (Jiman Biological)
  • Mutant 4 (B.1.1.7/VUI-202012/01 del 144Y/145Y) is GM-0220PV34 (Jiman Biology)
  • the article number of mutant strain 5 (B.1.351/501Y.V2, Beta) is GM-0220PV32-96T (Jiman Biology)
  • mutant 6 (D614G)
  • the article number of the product is GM-0220PV14 (Jiman Biological), mutant strain 7 (D614G,
  • HEK293 cells (ACS-4500TM, ATCC) were cultured in DMEM complete medium containing 10% FBS, and the ACE2 expression plasmid (Yiqiao Shenzhou , HG10108-M) transfection, followed by hygromycin (200 ⁇ g/ml) pressure selection and flow sorting (using 10 ⁇ g/ml anti-ACE2 and PE-coupled Anti-Human IgG-Fc), the cells Continue to amplify and select single clones with PE positive rate>90% for the next step of amplifying, and screen out HEK293 cells expressing ACE2, that is, ACE2 + 293 cells.
  • ACE2 + 293 cells were cultured to a confluence of about 90%, digested and centrifuged to remove the supernatant, resuspended, and then counted cells. Dilute the cells to 4 ⁇ 10 5 cells/mL with dilution medium, and take out the 96 wells after incubation for 1 hour
  • Inhibition rate [1-(sample group-CC control group)/(VC control group-CC control group)] ⁇ 100%.
  • the antibody 2F8-VH-VHH18 can not only effectively inhibit the wild type (Wildtype), Omicron BA.1 and BA.2.76, but also effectively inhibit the current epidemic strains Pseudoviruses, such as: Omicron BA.4/5, BF.7, BQ.1.1.
  • test antibody was serially diluted (initial concentration was 60nM, 3-fold serial dilution), and the antibody dilution was mixed with 200 PFU of SARS-CoV-2 wild-type new coronavirus particles (virus strain number: 2019-nCoV/ IQTC01/human/2020/Guangzhou, GenBank is MT123290.1) or SARS-CoV-2 delta (from the Guangdong Provincial Center for Disease Control and Prevention) were mixed in equal volumes, and a virus-free control group and a virus-free cell control group were set up at the same time ;Set up 3 duplicate wells for each experimental group, and let stand at 37°C for 1h; For the supernatant of Vero E6 cells (ATCC CRL-1587), a vero monkey kidney cell line, take 50 ⁇ l of the incubated virus-antibody mixture and transfer it to a Vero E6 cell plate, place it in a cell culture incubator at 37°C, and incubate for 1 hour; Discard the supernatant of Vero E
  • mice in each group On the third day after infection with the new coronavirus, the lung tissues of 4 mice in each group were homogenized, and the live virus titer in the lungs of the mice was detected by the FRNT method. The body weight of mice in each group was detected every day after virus infection and antibody injection for a total of 14 days.
  • G2 group, G3 group and G4 group can all block the infection of lung tissue by the new coronavirus.
  • the neutralization level of 2F8-VH-VHH18 to SARS-CoV-2 wild strain, Alpha, Beta, Gamma, Delta and Omicron mutant strain was determined by microdilution neutralization method.
  • Embodiment 10 pharmacokinetic research
  • 2F8-VH-VHH18 Since the target of 2F8-VH-VHH18 is the RBD domain of the spike protein of the SARS-CoV-2 new coronavirus, there is no related species of animals, so the 2F8-VH-VHH18 project chose to carry out single administration in SD rats pharmacokinetic test.
  • Embodiment 12 clinical trials
  • This study is a single-center, open, dose-escalation trial evaluating the pharmacokinetics, safety, tolerability and pharmacodynamics of 2F8-VH-VHH18 in healthy subjects.
  • Each group plans to recruit 8 healthy subjects, 2 of whom use placebo, and are randomly assigned to receive a single intravenous injection of 2F8-VH-VHH18 injection or 5% glucose injection at a ratio of 3:1. Each group will be dosed by sentinel dosing.
  • the first administration of each group is carried out at the same time when 2 subjects are observed for 24 hours, and 1 placebo subject shall be included. tester. After the first 2, dosing can proceed to the remaining 6 subjects in the group.
  • the pharmacokinetic characteristics, safety, tolerability and pharmacodynamic activity of the research drug are analyzed.
  • the pharmacodynamic activity test will use the SARS-CoV-2 pseudovirus neutralization test method to determine the neutralization ability of the subject's blood against the new coronavirus (key mutant pseudovirus).
  • HEK293F cells overexpressing ACE2 were infected with a new coronavirus carrying a luciferase reporter system, and its ability to block the virus was quantified by detecting the signal intensity of luciferase.
  • Dose group escalation carried out 100mg, 300mg, 1000mg and 1500mg four groups of dose escalation, after the 1500mg group, the safety discussion of the drug was carried out to decide whether to continue to climb.
  • the subjects need to take PK blood samples at fixed time points to detect the concentration of the drug in the serum to study the pharmacokinetics of the drug: before the administration of the study drug (predose); at the end of the administration of the study drug, 0.5 h, 2h, 8h, 12h, 24h, 36h, 48h, 72h, 96h, day 7, day 9, day 12, day 15, day 18, day 22, day 28, day 42, day 56.
  • ADA samples were collected on the 7th, 15th, 28th, 42th, and 56th days; before the study drug administration (predose), 12h and 24h after the administration , 48h, 72h, 96h, 7th day, 15th day, 28th day, 56th day for PD sample collection.
  • Dosing frequency and route of administration single administration, continuous 60-minute intravenous infusion. Safety data on infusion reactions could be reviewed to determine whether the infusion time could be adjusted to 30 minutes.
  • Pharmacokinetic evaluation indicators In this study, blood samples will be collected from subjects to detect the concentration of 2F8-VH-VHH18 in their serum, which will be used to calculate pharmacokinetic parameters.
  • Safety evaluation indicators vital signs, physical examination, electrocardiogram parameters, clinical laboratory tests (blood routine, blood biochemistry, urine routine, coagulation routine), adverse events, injection site reactions.
  • Immunogenicity evaluation indicators anti-drug antibody (ADA) positive rate, ADA titer and ADA neutralizing activity.
  • This study is a single-center, randomized, double-blind, placebo-controlled, dose-escalation evaluation of the pharmacokinetics, safety, tolerability, and immunogenicity of the injectable antibody 2F8-VH-VHH18 in healthy subjects and pharmacodynamics of clinical trials.
  • the main purpose of this study is to evaluate the safety and tolerability of antibody 2F8-VH-VHH18 in healthy people.
  • Each group plans to enroll 8 healthy subjects, 6 of whom will be given the study drug and 2 will be given a placebo. See Table 17 for the test group, dose escalation ratio, and number of subjects. Set up 4 fixed dose groups, namely 100mg, 300mg, 1000mg and 1500mg dose groups. The dose-limiting toxicity (DLT) observation period was 7 days after administration. The first batch of each dose group will select 2 subjects, including 1 placebo subject. After completing the observation of the first two subjects in this dose group, the subsequent administration and observation of the remaining 6 subjects in this group can be completed.
  • DLT dose-limiting toxicity
  • Treatment Emergent Adverse Events observed in this clinical study were grade 1 and grade 2 in severity, and no TEAEs above grade 3 occurred, no serious adverse events occurred, and no TEAEs occurred. TEAEs leading to discontinuation or death, no dose-limiting toxicity (DLT) events occurred. From the perspective of safety, the safety and tolerability of 100mg, 300mg, 1000mg and 1500mg of antibody 2F8-VH-VHH18 injected in healthy subjects were good.
  • the antibody 2F8-VH-VHH18 was absorbed quickly in the body after a single dose of 100-1500 mg in the ascending dose, and the detailed pharmacokinetic results are shown in Table 18.
  • the serum of the subjects was obtained at different time points, and the neutralizing ability (IC 50 ) of the antibody 2F8-VH-VHH18 against the Omicron BA.1 pseudovirus was detected.
  • the pharmacodynamic results are shown in Table 19.
  • the average IC 50 value of the antibody 2F8-VH-VHH18 inhibiting the SARS-CoV-2 pseudovirus was 16.850-20.510 ng/mL.
  • the results showed that the antibody 2F8-VH- VHH18 can effectively neutralize key mutant strains of SARS-CoV-2 pseudovirus.
  • 100mg, 300mg, 1000mg and 1500mg of the antibody 2F8-VH-VHH18 injected in healthy subjects is safe and well tolerated, and the antibody 2F8-VH-VHH18 can effectively neutralize the SARS-CoV-2 pseudovirus Key mutant strains.

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Abstract

一种靶向冠状病毒的抗体或抗原结合片段在预防、治疗或改善COVID-19中的应用，治疗方法包括向有需要的患者给药有效量的靶向冠状病毒的抗体或抗原结合片段。

Description

靶向冠状病毒的抗体在预防、治疗或改善COVID-19中的应用 技术领域
本发明属于生物技术领域，尤其涉及靶向冠状病毒的抗体在预防、治疗或改善COVID-19中的应用。
背景技术
冠状病毒为不分节段的单股正链RNA病毒，根据血清型和基因组特点冠状病毒亚科被分为α、β、γ和δ四个属，由于病毒包膜上有向四周伸出的突起，形如花冠而得名。2019年发现的新型冠状病毒(SARS-CoV-2或2019-nCoV)属于β属的新型冠状病毒，有包膜，颗粒呈圆形或椭圆形，常为多形性，直径60-140nm。
新型冠状病毒肺炎COVID-19主要通过呼吸道传染，其也可能通过接触传播。人群普遍易感，老年人及有基础疾病者感染后病情较重，儿童及婴幼儿也有发病。基于目前的流行病学调查，新型冠状病毒的潜伏期一般为1-14天，大多数在3-7天。感染者的主要临床症状是发热、乏力、干咳，而鼻塞、流涕等上呼吸道症状少见。在发病早期，患者的白细胞总数正常或降低，或淋巴细胞数目减少，部分患者出现肝酶、肌酶和肌红蛋白增高的现象。胸部影像显示患者早期呈现多发小斑片影及间质改变，以肺外带明显；进而发展为双肺多发磨玻璃影、浸润影，严重者可出现肺实变，并逐渐出现呼吸困难，严重者发生急性呼吸窘迫综合征(ARDS)、休克以及肺组织、心脏、肾脏多种组织损伤和功能障碍。多数轻度感染患者预后良好，重度患者病情常常危重，甚至死亡。
发明内容
本发明提供了靶向冠状病毒的抗体用于预防、治疗或改善由新型冠状病毒引发的疾病(COVID-19)的方法或用途。一些实施方案中，所述靶向冠状病毒的抗体为对SARS-CoV-2的spike蛋白具有高亲和力的抗体。一些实施方案中，所述靶向冠状病毒的抗体为双特异抗体、单域抗体或重链抗体或抗原结合片段。
本发明提供对SARS-CoV-2的spike蛋白具有高亲和力的双特异抗体或抗原结合片段。双特异抗体或抗原结合片段可以结合spike蛋白，阻止病毒颗粒和细胞结合以及可以介导免疫细胞吞噬、清除病毒颗粒。双特异抗体或抗原结合片段可用于预防、治疗或改善COVID-19如新型冠状病毒肺炎，也可以用于诊断COVID-19。
通过其表面的spike蛋白(S蛋白或棘突蛋白)与肺上皮细胞表面的一种称为血管紧张素转化酶2(ACE2)进行结合，SARS-CoV-2进入细胞内，并利用细胞为其合成新的病毒颗粒；新的病毒颗粒释放到细胞外，再利用同样的方式，病毒感染周围正常 的细胞。靶向spike蛋白的双特异抗体或抗原结合片段能阻断spike蛋白与ACE2的结合，进而阻断了病毒进入细胞，发挥抗病毒作用。本发明双特异抗体或抗原结合片段还可介导免疫细胞吞噬和清除病毒。
一些实施方案提供了靶向冠状病毒的双特异抗体，所述双特异抗体包含通过连接子L1连接的结合spike蛋白的第一结合部分以及结合spike蛋白的第二结合部分。
结合spike蛋白的第一结合部分
一些实施方案中，所述结合spike蛋白的第一结合部分包含：
(a)HCDR1，其包含如SEQ ID NO:1或2所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:3或4所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；和/或(c)HCDR3，其包含如SEQ ID NO:5-42中任一项所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体。
一些实施方案中，所述第一结合部分包含：
(a)HCDR1，其包含如SEQ ID NO:1或2所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:3或4所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；和(c)HCDR3，其包含如SEQ ID NO:5-42中任一项所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体。
一些实施方案中，所述第一结合部分包含：
(a)HCDR1，其包含如SEQ ID NO:1或2所示的氨基酸序列；(b)HCDR2，其包含如SEQ ID NO:3或4所示的氨基酸序列；和(c)HCDR3，其包含如SEQ ID NO:5-42中任一项所示的氨基酸序列。
一些实施方案中，所述第一结合部分包含：
(a)HCDR1，其包含如SEQ ID NO:1或2所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:3或4所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(c)HCDR3，其包含如SEQ ID NO:5-42中任一项所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(d)LCDR1，其包含如SEQ ID NO:43或44所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(e)LCDR2，其包含如SEQ ID NO:45或46所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；和/或(f)LCDR3，其包含如SEQ ID NO:47或48所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体。
在一些实施方案中，所述第一结合部分包含：
(a)HCDR1，其包含如SEQ ID NO:1或2所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:3或4所示的氨 基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(c)HCDR3，其包含如SEQ ID NO:5-42中任一项所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(d)LCDR1，其包含如SEQ ID NO:43或44所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(e)LCDR2，其包含如SEQ ID NO:45或46所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；和(f)LCDR3，其包含如SEQ ID NO:47或48所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体。
在一些实施方案中，所述取代变体为保守氨基酸取代变体。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1或2所示的HCDR1、如SEQ ID NO:3或4所示的HCDR2、如SEQ ID NO:5-42中任一项所示的HCDR3、如SEQ ID NO:43或44所示的LCDR1、如SEQ ID NO:45或46所示的LCDR2和如SEQ ID NO:47或48所示的LCDR3中的一个、两个、三个、四个、五个或全部。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:5所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:6所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:7所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:8所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:9所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:10所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:11所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:12所示的HCDR3、如SEQ ID NO:43所 示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:13所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:14所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:15所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:16所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:17所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:18所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:19所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:20所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:21所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:22所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:23所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如 SEQ ID NO:3所示的HCDR2、如SEQ ID NO:24所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:25所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:26所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:27所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:28所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:29所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:30所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:31所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:32所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:33所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:34所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:35所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:36所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:37所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:38所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:39所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:40所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:41所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3。
在一些实施方案中，所述第一结合部分包含如SEQ ID NO:2所示的HCDR1、如SEQ ID NO:4所示的HCDR2、如SEQ ID NO:42所示的HCDR3、如SEQ ID NO:44所示的LCDR1、如SEQ ID NO:46所示的LCDR2和如SEQ ID NO:48所示的LCDR3。
在一些实施方案中，所述第一结合部分包含重链可变区和/或轻链可变区。
在一些实施方案中，所述第一结合部分重链可变区的框架区包含重链FR1、重链FR2、重链FR3和重链FR4；所述重链FR1包含SEQ ID NO:49或50所示的序列，或与SEQ ID NO:49或50所示序列具有至少90％同一性的序列，或与SEQ ID NO:49或50所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述重链FR2包含SEQ ID NO:51或52所示的序列，或与SEQ ID NO:51或52所示序列具有至少90％同一性的序列，或与SEQ ID NO:51或52所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述重链FR3包含SEQ ID NO:53或54所示的序列，或与SEQ ID NO:53或54所示序列具有至少90％同一性的序列，或与SEQ ID NO:53或54所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述重链FR4包含SEQ ID NO:55所示的序列，或与SEQ ID NO:55所示序列具有至少90％同一性的序列，或与SEQ ID NO:55所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述重链FR1包含SEQ ID NO:49或50所示的序列，或与SEQ ID NO:49或50所示序列具有至少90％同一性的序列，或与SEQ ID NO:49或50所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；所述重链FR2包含SEQ ID NO:51或52所示的序列，或与SEQ ID NO:51或52所示序列具有至少90％同一性的序列，或与SEQ ID NO:51或52所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；所述重链FR3包含SEQ ID NO:53或54所示的序列，或与SEQ ID NO:53或54所示序列具有至少90％同一性的序列，或与SEQ ID NO:53或54所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；所述重链FR4包含SEQ ID NO:55所示的序列，或与SEQ ID NO:55所示序列具有至少90％同一性的序列，或与SEQ ID NO:55所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。在一些实施方案中，一或多个保守氨基酸取代为约1个、约2个或约3个保守氨基酸取代。
在一些实施方案中，所述重链FR1包含SEQ ID NO:49所示的序列，所述重链FR2包含SEQ ID NO:51所示的序列，所述重链FR3包含SEQ ID NO:53所示的序列，所述重链FR4包含SEQ ID NO:55所示的序列。在一些实施方案中，所述重链FR1包含SEQ ID NO:50所示的序列，所述重链FR2包含SEQ ID NO:52所示的序列，所述重链FR3包含SEQ ID NO:54所示的序列，所述重链FR4包含SEQ ID NO:55所示的序列。在一些实施方案中，所述重链可变区包含结构FR1-HCDR1-FR2-HCDR2-FR3-HCDR3-FR4。
在一些实施方案中，所述第一结合部分重链可变区包含如SEQ ID NO:49所示的FR1、如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:51所示的FR2、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:53所示的FR3、如SEQ ID NO:5-41中任一项所示的HCDR3和如SEQ ID NO:55所示的FR4。
在一些实施方案中，所述第一结合部分重链可变区包含如SEQ ID NO:50所示的FR1、如SEQ ID NO:2所示的HCDR1、如SEQ ID NO:52所示的FR2、如SEQ ID NO:4所示的HCDR2、如SEQ ID NO:54所示的FR3、如SEQ ID NO:42所示的HCDR3和如SEQ ID NO:55所示的FR4。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:56、57、83-105任一项所示的序列，与SEQ ID NO:56、57、83-105任一项所示序列具有至少80％同一性的序列，或与SEQ ID NO:56、57、83-105任一项所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分轻链可变区包含SEQ ID NO:58或59所示的序列，与SEQ ID NO:58或59所示序列具有至少80％同一性的序列，或与SEQ ID NO:58或59所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:56所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:57所示的序 列，所述第一结合部分轻链可变区包含SEQ ID NO:59所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:83所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:84所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:85所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:86所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:87所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:88所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:89所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:90所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:91所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:92所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:93所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:94所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:95所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:96所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:97所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:98所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:99所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:100所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:101所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:102所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:103所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:104所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:105所示的序列，所述第一结合部分轻链可变区包含SEQ ID NO:58所示的序列。
在一些实施方案中，所述第一结合部分还包含重链恒定区、轻链恒定区、Fc区或其组合。在一些实施方案中，轻链恒定区是κ或λ链恒定区。在一些实施方案中，第一结合部分是IgG、IgM、IgA、IgE或IgD其中一种同种型，或其片段。在一些实施方案中，同种型是IgG1、IgG2、IgG3或IgG4，或其片段。在一些实施方案中，第一结合部分中重链恒定区的C-末端被截短。在一些实施方案中，IgG1或IgG4型的第一结合部分中重链恒定区的C-末端缺少氨基酸残基G和K。没有限制地，所述第一结合部分是嵌合抗体、人源化抗体或是全人源抗体。在某一方面，所述第一结合部分是全人源化抗体。
在一些实施方案中，Fc是变体Fc区。在一些实施方案中，相对于亲本Fc区，变体Fc区具有一个或多个氨基酸修饰，如取代、缺失或插入。在一些实施方案中，相对于亲本Fc区活性，Fc区的氨基酸修饰改变了效应功能活性。在一些实施方案中，变体Fc区可以具有改变的(即，增加的或降低的)抗体依赖性细胞毒性(ADCC)、补体介导的细胞毒性(CDC)、吞噬作用、调理作用或细胞结合。在一些实施方案中，相对于亲本Fc区，Fc区氨基酸修饰可以改变变体Fc区对FcγR(Fcγ受体)的亲和力。在一些实施方案中，所述Fc区来源于IgG1或IgG4。在一些实施方案中，Fc区突变是N297A。在一些实施方案中，Fc区突变是N297A、L234A或L235A(Eu编号)。在一些实施方案中，Fc区突变是E345R或S440Y(Eu编号)。
在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:60或61所示的序列，与SEQ ID NO:60或61所示序列具有至少80％同一性的序列，或与SEQ ID NO:60或61所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列，与SEQ ID NO:62所示序列具有至少80％同一性的序列，或与SEQ ID NO:62所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:60或61所示的序列，和/或所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:60所示的序列，所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:61所示的序列，所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。
在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示的序列，或与SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列，或与SEQ ID NO:62所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:62所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:60中第1位氨基酸至第328位氨基酸所示的序列，所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。在一些实施方案中，所述重链恒定区包含氨基酸序列如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的序列，所述轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。
在一些实施方案中，所述第一结合部分包含重链和/或轻链。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:56、57、83-105任一项所示的重链可变区和如SEQ ID NO:60或61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58或59所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:83所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:84所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:85所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:86所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID  NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:87所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:88所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:89所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:90所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:91所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:92所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:93所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:94所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:95所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:96所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:97所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:98所示的重链可 变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:99所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:100所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:101所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:102所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:103所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:104所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:105所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:56所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:57所示的重链可变区和如SEQ ID NO:61所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:59所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:56、57、83-105任一项所示的重链可变区和如SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58或59所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:83所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述 第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:84所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:85所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:86所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:87所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:88所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:89所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:90所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:91所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:92所示的重链可 变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:93所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:94所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:95所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:96所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:97所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:98所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:99所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:100所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:101所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:102所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:103所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:104所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:105所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:56所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:58所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述第一结合部分重链包含如SEQ ID NO:57所示的重链可变区和如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的重链恒定区；所述第一结合部分轻链包含如SEQ ID NO:59所示的轻链可变区和如SEQ ID NO:62所示的轻链恒定区。
在一些实施方案中，所述重链包含氨基酸序列如SEQ ID NO:71或72所示的序列，与SEQ ID NO:71或72所示序列具有至少80％同一性的序列，或与SEQ ID NO:71或72所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述轻链包含氨基酸序列如SEQ ID NO:73或74所示的序列，与SEQ ID NO:73或74所示序列具有至少80％同一性的序列，或与SEQ ID NO:73或74所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:71 或72所示的序列，和/或所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:73或74所示的序列。
在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:71所示的序列，所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:73所示的序列。在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:72所示的序列，所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:74所示的序列。
在一些实施方案中，所述重链包含氨基酸序列如SEQ ID NO:71中第1位氨基酸至第450位氨基酸或SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示的序列，与SEQ ID NO:71中第1位氨基酸至第450位氨基酸或SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示序列具有至少80％同一性的序列，或与SEQ ID NO:71中第1位氨基酸至第450位氨基酸或SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述轻链包含氨基酸序列如SEQ ID NO:73或74所示的序列，与SEQ ID NO:73或74所示序列具有至少80％同一性的序列，或与SEQ ID NO:73或74所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:71中第1位氨基酸至第450位氨基酸或SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示的序列，和/或所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:73或74所示的序列。
在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:71中第1位氨基酸至第450位氨基酸所示的序列，所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:73所示的序列。在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示的序列，所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:74所示的序列。
在一些实施方案中，所述第一结合部分包含2条序列相同的重链和2条序列相同的轻链。
连接子L1
在一些实施方案中，所述连接子L1为包含甘氨酸和丝氨酸的多肽。
在一些实施方案中，所述连接子L1的序列为(GmS)n，其中每个m独立为2、3、4或5，n独立为1、2、3、4或5。在一些实施方案中，所述连接子L1的序列为(GGGGS)n，所述n独立为1、2、3、4或5。在一些实施方案中，所述连接子L1为GGGGS。在一些实施方案中，所述连接子L1为(GGGGS)2，如SEQ ID NO:65所示。在一些实施方案中，所述连接子L1为(GGGGS)3。在一些实施方案中，所述连接子L1为(GGGGS)4，如SEQ ID NO:63所示。在一些实施方案中，所述连接子L1为(GGGGS)5，如SEQ ID NO:64所示。
结合spike蛋白的第二结合部分
在一些实施方案中，所述第二结合部分为单域抗体。在一些实施方案中，所述单域抗体为VHH。
在一些实施方案中，所述第二结合部分为单域抗体，且包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；和/或(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体。
在一些实施方案中，所述第二结合部分为单域抗体，且包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体；和(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列，或其有单一或多个位点取代、缺失或插入的变体。
在一些实施方案中，所述第二结合部分为单域抗体，且包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列；和(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列。
在一些实施方案中，所述第二结合部分为单域抗体，且包含如SEQ ID NO:69所示的氨基酸序列。
双特异抗体
在一些实施方案中，所述双特异抗体包含上述结合spike蛋白的第一结合部分以及结合spike蛋白的第二结合部分，通过上述连接子L1连接。
在一些实施方案中，所述双特异抗体包含以下特征：
所述第一结合部分至少包含如SEQ ID NO:2所示的HCDR1、如SEQ ID NO:4所示的HCDR2、如SEQ ID NO:42所示的HCDR3、如SEQ ID NO:44所示的LCDR1、如SEQ ID NO:46所示的LCDR2和如SEQ ID NO:48所示的LCDR3中的一个、两个、三个、四个、五个或全部；和/或
所述第二结合部分为VHH，所述第二结合部分至少包含SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2、如SEQ ID NO:68所示的HCDR3中的一个、两个或三个；和/或
所述第一结合部分的C-末端通过连接子L1与第二结合部分的N-末端进行连接，所述第一结合部分的C-末端为第一结合部分中重链的C-末端或轻链的C-末端；和/或
所述连接子L1的氨基酸序列为(GGGGS)n，所述n独立为1、2、3、4或5。
在一些实施方案中，所述双特异抗体包含结合spike蛋白的第一结合部分以及结合spike蛋白的第二结合部分，所述双特异抗体包含以下特征：
所述第一结合部分包含如SEQ ID NO:2所示的HCDR1、如SEQ ID NO:4所示的HCDR2、如SEQ ID NO:42所示的HCDR3、如SEQ ID NO:44所示的LCDR1、如SEQ ID NO:46所示的LCDR2和如SEQ ID NO:48所示的LCDR3；和/或
所述第二结合部分为VHH，所述第二结合部分包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2、如SEQ ID NO:68所示的HCDR3；和/或
所述第一结合部分的C-末端通过连接子L1与第二结合部分的N-末端进行连接，所述第一结合部分的C-末端为第一结合部分中重链的C-末端或轻链的C-末端；和/或
所述连接子L1的序列为(GGGGS)n，所述n独立为1、2、3、4或5。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:57所示的序列，与SEQ ID NO:57所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:57所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分轻链可变区包含SEQ ID NO:59所示的序列，与SEQ ID NO:59所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:59所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分重链可变区包含SEQ ID NO:57所示的氨基酸序列，所述第一结合部分轻链可变区包含SEQ ID NO:59所示的氨基酸序列。
在一些实施方案中，第一结合部分包含重链恒定区、轻链恒定区、Fc区或其组合。在一些实施方案中，轻链恒定区是κ或λ链恒定区。在一些实施方案中，第一结合部分是IgG、IgM、IgA、IgE或IgD型，或其片段。在一些实施方案中，第一结合部分是IgG1、IgG2、IgG3或IgG4型，或其片段。在一些实施方案中，第一结合部分中重链恒定区的C-末端被截短。在一些实施方案中，IgG1或IgG4型的第一结合部分中重链恒定区的C-末端缺少氨基酸残基G和K。在一些实施方案中，Fc是变体Fc区。在一些实施方案中，相对于亲本Fc区，变体Fc区具有一个或多个氨基酸修饰，如取代、缺失或插入。在一些实施方案中，所述第一结合部分为scFV、Fab、Fab’、F(ab)2或F(ab)2’。
在一些实施方案中，所述第一结合部分和/或第二结合部分是嵌合抗体、人源化抗体或全人源抗体。
在一些实施方案中，所述第一结合部分重链恒定区包含氨基酸序列如SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示的序列，或与SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:60或61中第1位氨基酸至第328位氨基酸所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述第一结合部分轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列，或与SEQ ID NO:62所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:62所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分的重链恒定区包含氨基酸序列如SEQ ID  NO:60中第1位氨基酸至第328位氨基酸所示的序列，所述第一结合部分的轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。在一些实施方案中，所述第一结合部分的重链恒定区包含氨基酸序列如SEQ ID NO:61中第1位氨基酸至第328位氨基酸所示的序列，所述第一结合部分的轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列。
在一些实施方案中，所述第一结合部分重链恒定区包含氨基酸序列如SEQ ID NO:60或61所示的序列，或与SEQ ID NO:60或61所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:60或61所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述第一结合部分轻链恒定区包含氨基酸序列如SEQ ID NO:62所示的序列，与SEQ ID NO:62所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:62所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述第一结合部分重链恒定区包含如SEQ ID NO:60所示的氨基酸序列，所述第一结合部分轻链恒定区包含如SEQ ID NO:62所示的氨基酸序列。在一些实施方案中，所述第一结合部分重链恒定区包含如SEQ ID NO:61所示的氨基酸序列，所述第一结合部分轻链恒定区包含如SEQ ID NO:62所示的氨基酸序列。
在一些实施方案中，所述第二结合部分为VHH。在一些实施方案中，所述第二结合部分包含如SEQ ID NO:69所示的序列，或与SEQ ID NO:69所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:69所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
一些实施方案中提供了一种双特异抗体，所述双特异抗体包含第一结合部分和单域抗体，且包含以下特征：
所述第一结合部分包含重链和轻链；所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示的序列，或与SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示的序列相比具有至少80％同一性的序列，或与SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:74所示的序列，与SEQ ID NO:74所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:74所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述第一结合部分的重链的C-末端通过如SEQ ID NO:63所示连接子L1与单域抗体进行共价连接；和/或
所述单域抗体包含如SEQ ID NO:69所示的序列，或与SEQ ID NO:69所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:69所示序列相比具有一或多个保守氨基酸取代的的氨基酸序列。
在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:72中第1位氨基酸至第451位氨基酸所示的序列，所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:74所示的序列；第一结合部分的重链的C-末端(即CH3末端)通过如SEQ ID NO:63所示连接子L1与单域抗体进行共价连接，所述单域抗体包含如SEQ ID NO:69所示的序列。
一些实施方案中提供了双特异抗体，所述双特异抗体包含第一结合部分和单域抗体，且包含以下特征：
所述第一结合部分包含重链和轻链；所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:72所示的序列，或与SEQ ID NO:72所示的序列相比具有至少80％同一性的序列，或与SEQ ID NO:72所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:74所示的序列，或与SEQ ID NO:74所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:74所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
所述第一结合部分的轻链的C-末端通过如SEQ ID NO:64所示连接子L1与单域抗体进行共价连接；和/或
所述单域抗体包含如SEQ ID NO:69所示的序列，或与SEQ ID NO:69所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:69所示序列相比具有一或多个保守氨基酸取代的的氨基酸序列。
在一些实施方案中，所述第一结合部分的重链包含氨基酸序列如SEQ ID NO:72所示的序列，所述第一结合部分的轻链包含氨基酸序列如SEQ ID NO:74所示的序列；第一结合部分的轻链的C-末端(即CL末端)通过如SEQ ID NO:64所示连接子L1与单域抗体进行共价连接，所述单域抗体包含如SEQ ID NO:69所示的序列。
在一些实施方案中，双特异抗体包含第一多肽和第二多肽。在一些实施方案中，双特异抗体包含2条序列相同的第一多肽和2条序列相同的第二多肽。
在一些实施方案中，所述第一多肽从N-端至C-端依次包含第一结合部分的重链、连接子L1、单域抗体，或由其组成；所述第二多肽包含轻链，或由其组成。
在一些实施方案中，所述第一多肽包含氨基酸序列如SEQ ID NO:77所示的序列，或与SEQ ID NO:77所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:77所示序列相比具有一或多个保守氨基酸取代的的氨基酸序列，或由其组成；和/或
所述第二多肽包含氨基酸序列如SEQ ID NO:74所示的序列，或与SEQ ID NO:74所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:74所示序列相比具有一或多个保守氨基酸取代的的氨基酸序列，或由其组成。
在一些实施方案中，所述第一多肽包含氨基酸序列如SEQ ID NO:77所示的序列，所述第二多肽包含氨基酸序列如SEQ ID NO:74所示的序列。
在一些实施方案中，所述第一多肽包含重链，或由其组成；所述第二多肽从N-端至C-端依次包含第一结合部分的轻链、连接子L1、单域抗体，或由其组成。
在一些实施方案中，所述第一多肽包含氨基酸序列如SEQ ID NO:72所示的序列，或与SEQ ID NO:72示序列相比具有至少80％同一性的序列，或与SEQ ID NO:72示序列相比具有一或多个保守氨基酸取代的的氨基酸序列，或由其组成；和/或
所述第二多肽包含氨基酸序列如SEQ ID NO:78所示的序列，或与SEQ ID NO:78示序列相比具有至少80％同一性的序列，或与SEQ ID NO:78示序列相比具有一或多个保守氨基酸取代的的氨基酸序列，或由其组成。
在一些实施方案中，所述第一多肽包含氨基酸序列如SEQ ID NO:72所示的序列，所述第二多肽包含氨基酸序列如SEQ ID NO:78所示的序列。
在一些实施方案中，所述双特异抗体为分离的双特异抗体。在一些实施方案中，所述双特异抗体为双特异单克隆抗体。在一些实施方案中，分离的双特异抗体为单克隆抗体。
在一些实施方案中，所述双特异抗体第一结合部分特异性结合spike蛋白。在一些实施方案中，所述双特异抗体第二结合部分特异性结合spike蛋白。
单域抗体
本发明还提供对SARS-CoV-2的spike蛋白具有高亲和力的单域抗体。单域抗体可以结合spike蛋白，阻止病毒颗粒和细胞结合以及可以介导免疫细胞吞噬、清除病毒颗粒。单域抗体可用于预防、治疗或改善COVID-19，也可以用于诊断COVID-19。
一些实施方案提供了靶向冠状病毒的单域抗体，所述单域抗体包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；和/或(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体。
在一些实施方案中，所述单域抗体包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；和(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体。
在一些实施方案中，所述单域抗体包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2和如SEQ ID NO:68所示的HCDR3。
在一些实施方案中，所述单域抗体为VHH。在一些实施方案中，所述单域抗体包含如SEQ ID NO:69所示的序列，或与SEQ ID NO:69所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:69所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，所述单域抗体包含如SEQ ID NO:69所示的序列，或由其组成。
在一些实施方案中，单域抗体为分离的抗体。在一些实施方案中，单域抗体为分离的单克隆抗体。
重链抗体
本发明还提供重链抗体，其包含可以结合spike蛋白的单域抗体，如本文所述的单域抗体。重链抗体阻止病毒颗粒和细胞结合，以及可以介导免疫细胞吞噬、清除病毒颗粒。重链抗体可用于预防、治疗或改善COVID-19，也可以用于诊断COVID-19。
一些实施方案提供了靶向冠状病毒的重链抗体，重链抗体的可变区包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；和/或(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体。
在一些实施方案中，所述重链抗体包含：
(a)HCDR1，其包含如SEQ ID NO:66所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；(b)HCDR2，其包含如SEQ ID NO:67所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体；和(c)HCDR3，其包含如SEQ ID NO:68所示的氨基酸序列，或其有单一位点取代、缺失或插入的变体。
在一些实施方案中，所述重链抗体的可变区包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2和如SEQ ID NO:68所示的HCDR3。
在一些实施方案中，所述重链抗体的可变区包含如SEQ ID NO:69所示的序列，或与SEQ ID NO:69所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:69所示序列相比具有一或多个保守氨基酸取代的氨基酸序列，或由其组成。
在一些实施方案中，所述重链抗体的可变区包含如SEQ ID NO:69所示的序列，或由其组成。
在一些实施方案中，重链抗体包含可变区、连接子L2和Fc区。
在一些实施方案中，所述连接子L2为包含甘氨酸和丝氨酸的多肽。在一些实施方案中，所述连接子L2的序列为(GmS)n，其中每个m独立为2、3、4或5，n独立为1、2、3、4或5。在一些实施方案中，所述连接子L2的序列为(GGGGS)n，所述n独立为1、2、3、4或5。在一些实施方案中，所述连接子L2为GGGGS。在一些实施方案中，所述连接子L2为(GGGGS)2，如SEQ ID NO:65所示。在一些实施方案中，所述连接子L2为(GGGGS)3。在一些实施方案中，所述连接子L2为(GGGGS)4，如SEQ ID NO:63所示。在一些实施方案中，所述连接子L2为(GGGGS)5，如SEQ ID NO:64所示。
在一些实施方案中，Fc区包含氨基酸序列如SEQ ID NO:70所示的序列，或与SEQ ID NO:70所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:70所示序列相 比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，重链抗体包含氨基酸序列如SEQ ID NO:79所示的序列，或与SEQ ID NO:79所示序列相比具有至少80％同一性的序列，或与SEQ ID NO:79所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
在一些实施方案中，重链抗体包含氨基酸序列如SEQ ID NO:79所示的序列。
在一些实施方案中，所述抗体特异性结合spike蛋白。
在一些实施方案中，所述抗体或其抗原结合片段为分离的抗体或抗原结合片段。
表达抗体的核酸及细胞
本发明还提供了编码所述的抗体(包括双特异抗体、单域抗体和重链抗体)的核酸。在一些实施方案中，所述核酸为分离的核酸。在一些实施方案中，所述核酸如表5和表7所示。
本发明还提供了包含所述的核酸的载体。在一些实施方案中，所述载体为分离的载体。在一些实施方案中，包含所述核酸的载体为核酸片段、质粒、噬菌体或病毒。在一些实施方案中，所述载体为分离的质粒。
本发明还提供了包含所述核酸或所述载体的宿主细胞。在一些实施方案中，所述宿主细胞为分离的宿主细胞。在一些实施方案中，所述宿主细胞为CHO细胞、HEK293细胞、Cos1细胞、Cos7细胞、CV1细胞和鼠L细胞。
应用
在一些实施方案中，本发明提供了所述抗体(例如双特异抗体、单域抗体、重链抗体等)或抗原结合片段或包含其的药物组合物在预防、治疗或改善COVID-19中的应用。
在一些实施方案中，本发明提供了一种预防、治疗或改善COVID-19的方法，其包括向有需要的患者给药有效量为约10mg至2000mg的本文所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段。在一些实施方案中，所述患者患有由新型冠状病毒引发的疾病。在一些实施方案中，所述患者为新型冠状病毒肺炎轻度型、中度型、重型或危重型感染者。在一些实施方案中，本方法治疗前患者需进入ICU治疗。在一些实施方案中，本方法治疗前患者需要体外ECMO和/或IMV治疗。在一些实施方案中，本方法治疗前患者需要氧疗。在一些实施方案中，本方法治疗前患者需要NIV/HFNC治疗。在一些实施方案中，本方法使患者状态评分降低至少1级。在一些实施方案中，本方法使患者状态评分降低至少2级。在一些实施方案中，本方法使患者痊愈。
在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约1mg/kg至35mg/kg。在一些实施方案中，剂量时间表和给药方式取决于某些患者群中的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)的获益风险评估和一般临床实践指南。在一些实施方案中，所述抗 体为抗体1-23中的任意一个或多个的组合。在一些实施方案中，所述抗体为抗体2F8。在一些实施方案中，所述抗体为单域抗体VHH18。在一些实施方案中，所述抗体为重链抗体VHH18-Fc。在一些实施方案中，所述抗体为双特异抗体2F8-VH-VHH18或2F8-VL-VHH18。
在一些实施方案中，可以将抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段配制成药物组合物，并以适合于所选给药途径的多种形式向患者给药，给药途径例如口服给药、直肠给药、肠胃外给药、脑池内给药、阴道内给药、腹腔内给药、外敷(如通过粉末，软膏，滴剂或透皮贴剂)、口腔给药或通过口服或鼻腔喷雾给药。在一些实施方案中，可以将抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段静脉输注或皮下注射给药或肌肉注射。
在一些实施方案中，向有需要的患者给药约1mg/kg至35mg/kg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约1mg/kg、约1.5mg/kg、约2mg/kg、约3mg/kg、约5mg/kg、约6mg/kg、约7mg/kg、约8mg/kg、约9mg/kg、约10mg/kg、约11mg/kg、约13mg/kg、约15mg/kg、约17mg/kg、约21mg/kg、约23mg/kg、约25mg/kg、约27mg/kg、约28mg/kg、约29mg/kg、约30mg/kg、约35mg/kg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约100mg至1500mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约100mg、约200mg、约300mg、约400mg、约500mg、约600mg、约700mg、约800mg、约900mg、约1000mg、约1100mg、约1200mg，约1500mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约100mg至1000mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约100mg、约200mg、约300mg、约400mg、约500mg、约600mg、约700mg、约800mg、约900mg、约 1000mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约100mg至600mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约100mg、约200mg、约300mg、约400mg、约500mg、约600mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约100mg至300mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约100mg、约200mg、约300mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约300mg至1500mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约300mg、约400mg、约500mg、约600mg、约700mg、约800mg、约900mg、约1000mg、约1200mg、约1300mg、约1500mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约300mg至1000mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约300mg、约400mg、约500mg、约600mg、约700mg、约800mg、约900mg、约1000mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗 体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约300mg至600mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约300mg、约400mg、约500mg、约600mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约600mg至1000mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约600mg、约700mg、约800mg、约900mg、约1000mg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，向有需要的患者给药约80mg至150mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂；比如向有需要的患者单次给药约100mg。在一些实施方案中，向有需要的患者单次给药约100mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。
在一些实施方案中，向有需要的患者给药约180mg至320mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂；比如向有需要的患者单次给药约300mg。在一些实施方案中，向有需要的患者单次给药约300mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。
在一些实施方案中，向有需要的患者给药约580mg至620mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂；比如向有需要的患者单次给药约600mg。在一些实施方案中，向有需要的患者单次给药约600mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单 域抗体或重链抗体)或抗原结合片段的制剂。
在一些实施方案中，向有需要的患者给药约980mg至1200mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂；比如向有需要的患者单次给药约1000mg。在一些实施方案中，向有需要的患者单次给药约1000mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。
在一些实施方案中，向有需要的患者给药约1450mg至1550mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂；比如向有需要的患者单次给药约1500mg。在一些实施方案中，向有需要的患者单次给药约1500mg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。
在一些实施方案中，向有需要的患者给药约1mg/kg至35mg/kg的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约1mg/kg至25mg/kg、约1.7mg/kg至25mg/kg、约1.7mg/kg至16.7mg/kg、约1.7mg/kg至5mg/kg、约5mg/kg至25mg/kg、约5mg/kg至16.7mg/kg、约16.7mg/kg至25mg/kg、约1.4mg/kg至21.4mg/kg、约1.4mg/kg至14.3mg/kg、约1.4mg/kg至4.3mg/kg、约4.3mg/kg至21.4mg/kg、约4.3mg/kg至14.3mg/kg、约14.3mg/kg至21.4mg/kg。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的给药量为约1mg/kg、约1.2mg/kg、约1.4mg/kg、约1.5mg/kg、约1.7mg/kg、约2mg/kg、约2.5mg/kg、约3mg/kg、约4mg/kg、约4.3mg/kg、约5mg/kg、约6mg/kg、约7mg/kg、约8mg/kg、约9mg/kg、约10mg/kg、约11mg/kg、约12mg/kg、约13mg/kg、约14mg/kg、约14.3mg/kg、约15mg/kg、约16mg/kg、约16.7mg/kg、约17mg/kg、约18mg/kg、约19mg/kg、约20mg/kg、约21mg/kg、约21.4mg/kg、约22mg/kg、约23mg/kg、约24mg/kg、约25mg/kg、约26mg/kg、约27mg/kg、约28mg/kg、约29mg/kg、约30mg/kg、约32mg/kg、约35mg/kg，或这些数值中任何两个值之间的范围(包括端值)或其中任何值，或含此剂量抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的制剂。在一些实施方案中，所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段为单次给药。
在一些实施方案中，单次给药抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段后，患者的症状得到缓解。在一些实施方案中，单次给药抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段后，患者的症状未得到预期缓解， 再对患者给药。
在一些实施方案中，所述抗体选自抗体1-24、抗体2F8。
在一些实施方案中，所述抗体为单域抗体VHH18。
在一些实施方案中，所述抗体为重链抗体VHH18-Fc。
在一些实施方案中，所述抗体为双特异抗体2F8-VH-VHH18。
在一些实施方案中，所述抗体为双特异抗体2F8-VL-VHH18。
在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)是通过皮下(s.c.)注射、腹膜内(i.p.)注射、肠胃外注射、动脉内注射、肌肉注射(IM)或静脉内(i.v.)注射等方式进行给药。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)是输液方式进行给药。在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)是推注方式进行给药。
在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)是通过静脉内(i.v.)输液方式进行给药。在一些实施方案中，静脉内输液持续时间为约20分钟、约25分钟、约30分钟、约35分钟、约45分钟、约50分钟、约55分钟、约60分钟、约65分钟、约70分钟、约75分钟、约80分钟、约85分钟、约90分钟，或这些数值中任何两个值之间的范围(包括端值)或其中任何值。在一些实施方案中，静脉输液持续时间≥60分钟。在一些实施方案中，静脉输液持续时间≤60分钟。在一些实施方案中，静脉输液持续时间≥30分钟。
在一些实施方案中，抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)与其他治疗方法联合使用用于预防、治疗或改善COVID-19，例如激素、体外ECMO、IMV、NIV、HFNC和/或氧疗。
另一方面，本发明还公开了所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段在制备用于预防、治疗或改善COVID-19的药物中的应用。在一些实施方案中，用于预防、治疗或改善COVID-19的药物包括抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段。
另一方面，本发明还公开了一种试剂盒，试剂盒包含抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)和用于指导有需要患者给药抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段(或制剂)的说明书。
本发明还提供了诊断方法和用途。在一些实施方案中，提供了检测样品中SARS-CoV-2表达的方法，使样品与本文所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段进行接触，使得所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段结合spike蛋白，并检测其结合，即样品中spike蛋白的含量。在一些实施方案中，提供了所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段在制备用于诊断COVID-19的试剂盒中的应用。在一些实施方案中，提供 了包含所述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的诊断试剂盒。
药物组合物
另一方面，本发明还公开了包含本文所述抗体或抗原结合片段以及药学上可接受的辅料的药物组合物。在一些实施方案中，所述药物组合物为适合注射用的药物组合物，如推注型药物组合物或输液(滴注)型药物组合物或喷雾型药物组合物。适于注射用途的药物组合物包括无菌水性溶液(在此是水溶性的)或分散体以及用于即时制备无菌注射液或分散体的无菌粉末。对于静脉内施用，合适的载体包括生理盐水、葡萄糖注射液、无菌水或磷酸盐缓冲盐水(PBS)、乙醇、多元醇(例如，甘油、丙二醇和液体聚乙二醇等)的溶剂或分散介质，及其适宜的混合物。在一些实施方案中，药物组合物还包括药学可接受的载体。在一些实施方案中，药学上可接受的载体可以包含抗细菌剂和/或抗真菌剂，如对羟基苯甲酸酯、氯代丁醇、苯酚、抗坏血酸、硫柳汞、苯甲醇等来实现。在一些实施方案中，药学上可接受的载体可以包含等渗剂，如糖、多元醇(诸如甘露糖醇、山梨醇)、氯化钠。在一些实施方案中，药物组合物至少包含0.1％的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段。抗体的百分比可以变化，并且为给定剂型重量的约2％至约90％之间。这种治疗上有用的药物组合物中抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段的量可以为给药的有效量。
另一方面，本发明还公开了上述药物组合物的制备方法：将本文所述的抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段与药学上可接受的载体(例如注射用水，生理盐水、葡萄糖注射液等)混合。上述抗体(例如双特异抗体、单域抗体或重链抗体)或抗原结合片段与药学上可接受的载体的混合方法是本领域通常已知的。
本发明提供了靶向冠状病毒的双特异抗体及其应用，双特异抗体中第一结合部分与第二结合部分协同阻止SARS-CoV-2病毒颗粒侵染细胞，以及介导免疫细胞吞噬、清除病毒颗粒，预防、治疗或改善COVID-19；本发明双特异抗体还可以用于诊断检测患者是否感染SARS-CoV-2。
附图说明
图1为部分本发明抗spike蛋白抗体在ELISA实验中抑制SARS-CoV-2与ACE2结合的曲线图。图1中横坐标表示浓度，纵坐标表示OD值；其中，1表示抗体1，7表示抗体7，8表示抗体8，9表示抗体9，12表示抗体12，18表示抗体18，19表示抗体19，20表示抗体20，21表示抗体21，22表示抗体22。
图2示抗体阻断spike RBD与ACE2的结合；其中，ACE2对照组中未添加抗体。
图3示抗体2F8-VH-VHH18对新冠病毒不同毒株假病毒的抑制曲线。
图4示抗体阻断病毒侵染小鼠；图中，纵坐标表示肺部病毒滴度。
图5示抗体对小鼠体重的影响；图中，纵坐标表示小鼠体重百分含量，横坐标表示天数。
术语
除非另作说明，否则下列的每一个术语应当具有下文所述的含义。
定义
应当注意的是，术语“一种”实体是指一种或多种该实体，例如“一种抗体”应当被理解为一种或多种抗体，因此，术语“一种”(或“一个”)、“一种或多种”和“至少一种”可以在本文中互换使用。
本文所用的术语“包含”或“包括”意味着组合物和方法等包括所列举的元素，例如组份或步骤，但不排除其它。“基本上由……组成”意味着组合物和方法排除对组合的特征有根本影响的其它元素，但不排除对组合物或方法无本质上影响的元素。“由……组成”意味着排除未特别列举的元素。
术语“多肽”旨在涵盖单数的“多肽”以及复数的“多肽”，并且是指由通过酰胺键(也称为肽键)线性连接的氨基酸单体形成的分子。术语“多肽”是指含两个或更多个氨基酸的任何单条链或多条链，并且不涉及产物的特定长度。因此，“多肽”的定义中包括肽、二肽、三肽、寡肽、“蛋白质”、“氨基酸链”或用于指两个或多个氨基酸链的任何其他术语，并且术语“多肽”可以用来代替上述任何一个术语，或者与上述任何一个术语交替使用。术语“多肽”也意在指多肽表达后修饰的产物，包括但不限于糖基化、乙酰化、磷酸化、酰胺化、通过已知的保护/封闭基团衍生化、蛋白水解切割或非天然发生的氨基酸修饰。多肽可以源自天然生物来源或通过重组技术产生，但其不必从指定的核酸序列翻译所得，它可能以包括化学合成的任何方式产生。
“氨基酸”是指既含氨基又含羧基的有机化合物，比如α-氨基酸，其可直接或以前体的形式由核酸编码。单个氨基酸由三个核苷酸(所谓的密码子或碱基三联体)组成的核酸编码。每一个氨基酸由至少一个密码子编码。相同氨基酸由不同密码子编码称为“遗传密码的简并性”。氨基酸包括天然氨基酸和非天然氨基酸。天然氨基酸包括丙氨酸(三字母代码：ala，一字母代码：A)、精氨酸(arg，R)、天冬酰胺(asn，N)、天冬氨酸(asp，D)、半胱氨酸(cys，C)、谷氨酰胺(gln，Q)、谷氨酸(glu，E)、甘氨酸(gly，G)、组氨酸(his，H)、异亮氨酸(ile，I)、亮氨酸(leu，L)、赖氨酸(lys，K)、甲硫氨酸(met，M)、苯丙氨酸(phe，F)、脯氨酸(pro，P)、丝氨酸(ser，S)、苏氨酸(thr，T)、色氨酸(trp，W)、酪氨酸(tyr，Y)和缬氨酸(val，V)。
“保守氨基酸取代”是指一个氨基酸残基被另一个含有化学性质(例如电荷或疏水性)相似的侧链(R基团)的氨基酸残基所取代。一般而言，保守氨基酸取代不大会在实质上改变蛋白质的功能性质。含有化学性质相似侧链的氨基酸类别的实例包括：1)脂族侧链：甘氨酸、丙氨酸、缬氨酸、亮氨酸和异亮氨酸；2)脂族羟基侧链：丝氨酸和苏氨酸；3)含酰胺的侧链：天冬酰胺和谷氨酰胺；4)芳族侧链：苯丙氨酸、 酪氨酸和色氨酸；5)碱性侧链：赖氨酸、精氨酸和组氨酸；6)酸性侧链：天冬氨酸和谷氨酸。
“VL、VH、VHH的保守氨基酸取代”的氨基酸数目为约1个、约2个、约3个、约4个、约5个、约6个、约8个、约9个、约10个、约11个、约13个、约14个、约15个保守氨基酸取代，或这些数值中的任何两个值之间的范围(包括端点)或其中任何值。“重链恒定区、轻链恒定区、重链或轻链、融合蛋白第一多肽或第二多肽的保守氨基酸取代”的氨基酸数目为约1个、约2个、约3个、约4个、约5个、约6个、约8个、约9个、约10个、约11个、约13个、约14个、约15个、约18个、约19个、约22个、约24个、约25个、约29个、约31个、约35个、约38个、约41个、约45个保守氨基酸取代，或这些数值中的任何两个值之间的范围(包括端点)或其中任何值。
本发明中关于细胞、核酸、多肽、抗体等所使用的术语“分离的”，例如“分离的”DNA、RNA、多肽、抗体是指分别于细胞天然环境中的其它组分如DNA或RNA中的一种或多种所分离的分子。本发明使用的术语“分离的”还指当通过重组DNA技术产生时基本上不含细胞材料、病毒材料或细胞培养基的核酸或肽，或化学合成时的化学前体或其他化学品。此外，“分离的核酸”意在包括不以天然状态存在的核酸片段，并且不会以天然状态存在。术语“分离的”在本发明中也用于指从其他细胞蛋白质或组织分离的细胞或多肽。分离的多肽意在包括纯化的和重组的多肽。分离的多肽、抗体等通常通过至少一个纯化步骤制备。在一些实施方案中，分离的核酸、多肽、抗体等的纯度至少为约50％、约60％、约70％、约80％、约90％、约95％、约99％，或这些数值中的任何两个值之间的范围(包括终点)或其中任何值。
术语“重组”涉及多肽或多聚核苷酸，意指天然不存在的多肽或多聚核苷酸的形式，不受限制的实施例可以通过组合产生通常并不存在的多聚核苷酸或多肽。
“同源性”或“同一性”是指两个肽之间或两个核酸分子之间的序列相似性。可以通过比较每个序列中可以比对的位置来确定同源性或同一性。当被比较的序列中的位置被相同的碱基或氨基酸占据时，则分子在该位置是同源的或同一的。序列之间的同源程度是由序列共有的匹配或同源位置的数目组成的一个函数。
“至少80％同一性”为约80％同一性、约81％同一性、约82％同一性、约83％同一性、约85％同一性、约86％同一性、约87％同一性、约88％同一性、约90％同一性、约91％同一性、约92％同一性、约94％同一性、约95％同一性、约98％同一性、约99％同一性，或这些数值中的任何两个值之间的范围(包括端点)或其中任何值。
“至少90％同一性”为约90％同一性、约91％同一性、约92％同一性、约93％同一性、约94％同一性、约95％同一性、约92％同一性、约96％同一性、约99％同一性，或这些数值中的任何两个值之间的范围(包括端点)或其中任何值。核酸或多聚核苷酸序列(或多肽或抗体序列)与另一序列有具有一定百分比(例如90％、95％、98％ 或者99％)的“同一性”或“序列同一性”是指当序列比对时，所比较的两个序列中该百分比的碱基(或氨基酸)相同。可以使用目测或本领域已知的软件程序来确定该比对同一性百分比或序列同一性，比如Ausubel et al.eds.(2007)在Current Protocols in Molecular Biology中所述的软件程序。优选使用默认参数进行比对。其中一种比对程序是使用默认参数的BLAST，例如BLASTN和BLASTP，两者使用下列默认参数：Geneticcode＝standard；filter＝none；strand＝both；cutoff＝60；expect＝10；Matrix＝BLOSUM62；Descriptions＝50sequences；sortby＝HIGHSCORE；Databases＝non-redundant；GenBank+EMBL+DDBJ+PDB+GenBankCDStranslations+SwissProtein+SPupdate+PIR。生物学上等同的多聚核苷酸是具有上述指定百分比的同一性并编码具有相同或相似生物学活性的多肽的多聚核苷酸。
多聚核苷酸是由四个核苷酸碱基的特定序列组成：腺嘌呤(A)、胞嘧啶(C)、鸟嘌呤(G)、胸腺嘧啶(T)，或当多聚核苷酸是RNA时胸腺嘧啶换为尿嘧啶(U)。“多聚核苷酸序列”可以以多聚核苷酸分子的字母表示。该字母表示可以被输入到具有中央处理单元的计算机中的数据库中，并用于生物信息学应用，例如用于功能基因组学和同源性搜索。
术语“多聚核苷酸”、“核酸”和“寡核苷酸”可互换使用，是指任何长度的核苷酸的聚合形式，无论是脱氧核糖核苷酸还是核糖核苷酸或其类似物。多聚核苷酸可以具有任何三维结构并且可以执行已知或未知的任何功能。以下是不受限制的多聚核苷酸的实施例：基因或基因片段(例如探针、引物、EST或SAGE标签)、外显子、内含子、信使RNA(mRNA)、转运RNA、核糖体RNA、核糖酶、cDNA、dsRNA、siRNA、miRNA、重组多聚核苷酸、分支的多聚核苷酸、质粒、载体、任何序列的分离的DNA、任何序列的分离的RNA、核酸探针和引物。多聚核苷酸可以包含修饰的核苷酸，例如甲基化的核苷酸和核苷酸类似物。如果存在该修饰，则对核苷酸的结构修饰可以在组装多聚核苷酸之前或之后进行。核苷酸的序列可以被非核苷酸组分中断。聚合后可以进一步修饰多聚核苷酸，例如通过与标记组分缀合。这个术语也指双链和单链分子。除另有说明或要求外，本公开的任何多聚核苷酸的实施例包括双链形式和已知或预测构成双链形式的两种可互补单链形式中的每一种。
术语“编码”应用于多核苷酸时，是指被称为“编码”多肽的多核苷酸，在其天然状态或当通过本领域技术人员公知的方法操作时，经转录和/或翻译可以产生该多肽和/或其片段。
“抗体”是指特异性识别和结合抗原的多肽或多肽复合物。抗体可以是完整的抗体及其任何抗原结合片段或其单链。因此术语“抗体”包括分子中含有具有与抗原结合的生物学活性的免疫球蛋白分子的至少一部分的任何蛋白质或肽。抗体和抗原结合片段包括但不局限实施例所述的重链或轻链或其配体结合部分的互补决定区(CDR)、重链可变区(VH)、轻链可变区(VL)、重链恒定区(CH)、轻链恒定区(CL)、框架区(F R)或其任何部分，或结合蛋白的至少一部分。CDR区包括轻链的CDR区(LCDR1-3)和重链的CDR区(HCDR1-3)。可变区可包含结构FR1-CDR1-FR2-CDR2-FR3-CDR3-FR4。
术语“抗体片段”或“抗原结合片段”指抗体的一部分，例如F(ab’)2、F(ab)2、Fab'、Fab、Fv、scFv等。不管其结构如何，抗体片段与被完整抗体识别的同一抗原结合。术语“抗体片段”包括适体、镜像异构体和双价抗体。术语“抗原结合片段”还包括通过与特定抗原结合形成复合物起抗体作用的任何合成或基因工程蛋白质。
“单链可变片段”或“scFv”是指免疫球蛋白的重链(VH)和轻链(VL)的可变区的融合蛋白。在一些方面，这些区域与10个至约25个氨基酸的短接头肽连接。接头可以富含甘氨酸以增加柔韧性，以及富含丝氨酸或苏氨酸以增加溶解性，并且可以连接VH的N端和VL的C端，反之亦然。尽管该蛋白质被除去了恒定区和引入了接头，但其保留了原始免疫球蛋白的特异性。ScFv分子通常是本领域中已知的，例如在美国专利5,892,019中有相关描述。
术语“单域抗体”或“sdAb”是指具有三个互补决定区(CDR)的单一抗原结合多肽。单独的sdAb能够与抗原结合，但不与相应的含CDR多肽配对。在一些情况下，sdAb从骆驼HCAb工程化，并且其重链可变结构域在本文中称为“VHH”。骆驼sdAb是最小的已知抗原结合抗体片段之一(参见，例如，Hamers-Casterman等人，Nature 363:446-8(1993)；Greenberg等人，Nature 374:168-73(1995)；Hassanzadeh-Ghassabeh等人，Nanomedicine(Lond),8:1013-26(2013))。
术语“重链抗体”或“HcAb”是指功能性抗体，其包含重链(VHH、CH2和CH3)，但缺少通常存在于抗体中的轻链。已知骆驼科动物(例如骆驼、美洲驼或羊驼)产生HcAb。
在一些实施方案中，双特异抗体中第一结合部分为靶向spike蛋白的抗体，为完整抗体或抗原结合片段。在一些实施方案中，第一结合部分为IgG型抗体。在一些实施方案中，第一结合部分为IgG型抗体，且其重链的C-末端被截短。
在一些实施方案中，双特异抗体中第二结合部分为靶向spike蛋白的抗体，为完整抗体或抗原结合片段。在一些实施方案中，双特异抗体中第二结合部分为单域抗体。
术语“抗体”包括可以在生物化学上区分的各种广泛种类的多肽。本领域技术人员将会理解，重链的类别包括gamma、mu、alpha、delta或epsilon(γ、μ、α、δ、ε)，其中还有一些亚类(例如γ1-γ4)。该链的性质决定了抗体的“种类”分别为IgG、IgM、IgA、IgG或IgE。免疫球蛋白亚类(同种型)，例如IgG1、IgG2、IgG3、IgG4、IgG5等已被充分表征并且赋予的功能特异性也已知。所有的免疫球蛋白种类都在本发明公开的保护范围内。在一些实施方案中，免疫球蛋白分子为IgG种类。IgG通常包含分子量约23,000道尔顿的两条相同的轻链多肽和分子量约为53,000-70,000的两条相同的重链多肽。这四条链通过二硫键以“Y”构型连接，其中轻链从“Y”口开始并延续通过可 变区包围重链。
本发明公开的抗体、抗原结合片段、或衍生物包括但不限于多克隆、单克隆、多特异性，全人源、人源化、灵长类化、嵌合抗体/单链抗体、表位结合片段例如Fab、Fab'和F(ab')2、Fd、Fvs、单链Fvs(scFv)，二硫键连接的Fvs(sdFv)，包含VK或VH结构域的片段，或由Fab表达文库产生的片段和抗独特型(抗Id)抗体。本发明公开的免疫球蛋白或抗体分子可以是免疫球蛋白的任何类型(例如IgG、IgE、IgM、IgD、IgA和IgY)或种类(例如，IgG1、IgG2、IgG3、IgG4、IgA1和IgA2)或者亚类。
轻链可以分为kappa(κ)或lambda(λ)。每个重链可以与κ或λ轻链结合。一般来说，当由杂交瘤，B细胞或基因工程宿主细胞生产免疫球蛋白时，其轻链和重链通过共价键结合，两条重链的“尾巴”部分通过共价二硫键或非共价键结合。在重链中，氨基酸序列从Y构型的叉状末端的N末端延伸至每条链底部的C末端。免疫球蛋白κ轻链可变区为Vκ；免疫球蛋白λ轻链可变区为Vλ。
轻链和重链都分成结构和功能同源性的区域。术语“恒定的”和“可变的”根据功能被使用。轻链可变区(VL)和重链可变区(VH)决定了抗原识别和特异性。轻链和重链的恒定区赋予重要的生物学性质，如分泌、经胎盘移动、Fc受体结合、补体结合等。按照惯例，恒定区的编号随着它们变得更远离抗体的抗原结合位点或氨基末端而增加。N端部分是可变区，C端部分是恒定区；CH3和CL结构域实际上分别包含重链和轻链的羧基端。
如上所述，可变区使得抗体能够选择性识别和特异性结合抗原上的表位。具体而言，抗体的VL结构域和VH结构域或互补决定区(CDR)的子集结合形成了限定三维抗原结合位点的可变区。该抗体四级结构形成存在于Y的每个臂末端的抗原结合位点。更具体地说，抗原结合位点由VH和VL链中各自的三个CDR(即HCDR1、HCDR2、HCDR3、LCDR1、LCDR2和LCDR3)定义。在某些情况下，例如某些来源于骆驼科动物的免疫球蛋白分子或基于骆驼科动物免疫球蛋白改造的免疫球蛋白分子，完整的免疫球蛋白分子可以仅由重链组成，没有轻链。例如参见Hamers-Casterman et al.，Nature，363:446-448(1993)。
在天然存在的抗体中，假设抗体在含水环境中呈现其三维构型时，存在于每个抗原结合域中的六个“互补决定区”或“CDR”是形成抗原结合结构域的短的、非连续的与抗原特异性结合的氨基酸序列。抗原结合结构域中被称为“构架”区域的剩余其它氨基酸显示出较小的分子间可变性。构架区大部分采用β-折叠构象，CDR形成与之连接的环状结构，或在某些情况下形成β折叠结构的一部分。因此，框架区通过形成支架从而通过链间非共价相互作用使CDR定位在正确的方位上。具有特定位置的CDR的抗原结合域形成了与抗原上的表位互补的表面，该互补表面促进抗体和其抗原表位的非共价结合。对于给定的重链或轻链可变区，本领域普通技术人员都可以通过已知方法鉴 定出包含CDR和框架区的氨基酸(参见Kabat,E.,et al.,U.S.Department of Health and Human Services,Sequences of Proteins of Immunological Interest,(1983)和Chothia and Lesk,J.Mol.Biol.,196:901-917(1987))。
在本领域中使用和/或接受的术语有两个或多个定义的情况下，除非明确地对立指出，否则本文使用的术语的定义包括所有这些含义。一个具体的例子是使用“互补决定区”(“CDR”)一词来描述在重链和轻链多肽的可变区内发现的非连续的抗原结合位点。这一特定区域在Kabat et al.,U.S.Dept.of Health and Human Services,Sequences of Proteins of Immunological Interest(1983)和Chothia等在J.Mol.Biol.196:901-917(1987)有相关描述，其通过引用全部并入本文。
根据Kabat和Chothia定义的CDR包括相互比较时的氨基酸残基的重叠或子集。尽管如此，应用任一定义来指代抗体或其变体的CDR都在本发明范围内。包含特定CDR的确切残基编号将根据CDR的序列和大小而变化。本领域技术人员通常可以根据抗体的可变区氨基酸序列确定出CDR包含哪些特定的残基。
Kabat等人还定义了适用于任何抗体的可变区序列的编号系统。本领域普通技术人员可以不依赖于序列本身以外的其他实验数据将该“Kabat编号”系统应用到任何可变区序列。“Kabat编号”是指由Kabat et al.,U.S.Dept.of Health and Human Services在“Sequence of Proteins of Immunological Interest”(1983)提出的编号系统。抗体还可以用EU编号系统。
本发明公开的抗体或抗原结合片段可以来源于任何动物，包括鸟类和哺乳动物。较佳地，抗体是人源、鼠源、驴源、兔源、山羊源、骆驼源、美洲驼源、马源或鸡源抗体。在另一实施方案中，可变区可以是软骨鱼纲(condricthoid)来源(例如来自鲨鱼)。
“重链恒定区”包括来源于免疫球蛋白重链的氨基酸序列。包含重链恒定区的多肽包括CH1结构域、铰链(例如上、中和/或下铰链区)结构域、CH2结构域、CH3结构域，或变体或片段中的至少一种。例如，本发明公开的抗体或抗原结合片段包含CH1结构域；包含CH1结构域、至少一部分铰链区以及CH2结构域；包含CH1结构域和CH3结构域；包含CH1结构域以及至少一部分铰链区以及CH3结构域；或包含CH1结构域、至少一部分铰链区以及CH2结构域和CH3结构域。在另一实施方案中，本发明公开的抗体或抗原结合片段包含CH3结构域。此外，本发明中使用的抗体或抗原结合片段可能缺部分或全部CH2结构域。如上所述，本领域普通技术人员应当理解，重链恒定区可以被修饰从而使得它们天然存在的免疫球蛋白分子的氨基酸序列发生变化。
抗体的重链恒定区可以来源于不同的免疫球蛋白分子。例如，多肽的重链恒定区可以包括源自IgG1分子的CH1结构域和源自IgG3分子的铰链区。在另一实施方案中，重链恒定区可以包括部分源自IgG1分子和部分源自IgG3分子的铰链区。在另一实施方 案中，部分重链可以包括部分源自IgG1分子和部分源自IgG4分子的嵌合铰链区。
“轻链恒定区”包括来自抗体轻链的氨基酸序列。较佳地，轻链恒定区包含恒定κ结构域或恒定λ结构域中的至少一个。“轻链-重链对”是指可通过轻链的CL结构域和重链的CH1结构域之间的二硫键形成二聚体的轻链和重链的集合。
如上所述，各种免疫球蛋白种类的恒定区的亚基结构和三维构型是众所周知的。“VH结构域”包括免疫球蛋白重链的氨基末端可变结构域，“CH1结构域”包括免疫球蛋白重链的第一个(大部分氨基末端)恒定区。CH1结构域与VH结构域相邻，并且是免疫球蛋白重链分子铰链区的氨基端。CH2结构域不与其它结构域紧密配对，而是在完整的天然IgG分子的两个CH2结构域之间插入两个N-连接的分支碳水化合物链。CH3结构域从CH2结构域开始延伸到IgG分子的C-末端，大约包含108个残基。“铰链区”包括连接CH1结构域和CH2结构域的部分重链区域。所述铰链区包含约25个残基并且是有韧性的，从而使得两个N端抗原结合区能够独立移动。铰链区可以被细分为三个不同的结构域：上、中和下铰链结构域(Rouxetal.,J.Immunol 161:4083(1998))。
“二硫键”指两个硫原子之间形成的共价键。半胱氨酸的硫醇基团可以与第二个硫醇基团形成二硫键或桥接。在大多数天然存在的IgG分子中，CH1和CL区通过二硫键连接，两条重链通过两个二硫键在Kabat编号系统中对应的位置239和242(EU编号系统位置226和229)处相连接。
“嵌合抗体”指其可变区从第一个物种中获得或衍生，而其恒定区(可以是完整的、部分的或修饰过的)来源于第二个物种的任何抗体。某些实施方案中，可变区来自非人源(例如小鼠或灵长类动物)，而恒定区来自人源。
“特异性结合”或“对……具有特异性”通常是指抗体或抗原结合片段与特定抗原通过其抗原结合结构域与表位互补性结合形成相对稳定的复合物。“特异性”可以用抗体或抗原结合片段与特定抗原或表位结合的相对亲和力表达。例如，如果抗体“A”比抗体“B”与同一抗原的相对亲和力大，可以认为抗体“A”比抗体“B”对该抗原具有更高的特异性。特异性结合可以用平衡解离常数(KD)来描述，较小的KD意味着较紧密的结合。确定两个分子是否特异性结合的方法是本领域内众所周知的，并包括例如平衡透析、表面等离子共振、生物膜层光学干涉测量法等。“特异性结合”spike蛋白的抗体包括与spike蛋白平衡解离常数KD小于或等于约100nM、小于或等于约10nM、小于或等于约5nM、小于或等于约1nM。单特异抗体可特异性结合一个抗原或一个表位，而双特异抗体可特异性结合两个不同的抗原或两个不同的表位。
“治疗”是指治疗性治疗和预防性或防治性措施，其目的是预防、减缓、改善或停止不良的生理改变或紊乱，例如疾病的进程，包括但不限于以下无论是可检测还是不可检测的结果，症状的缓解、疾病程度的减小、疾病状态的稳定(即不恶化)、疾病进展的延迟或减缓、疾病状态的改善、缓和、减轻或消失(无论是部分还是全部)、延长与不接受治疗时预期的生存期限等。需要治疗的患者包括已经患有病症或紊乱的患者， 容易患有病症或紊乱的患者，或者需要预防该病症或紊乱的患者，可以或预期从施用本发明公开的抗体或药物组合物用于检测、诊断过程和/或治疗中受益的患者。
本文所用术语“给药”是指施用一种物质(例如，双特异抗体2F8-VH-VHH18)以实现治疗目的(例如，治疗COVID-19)。
如本文所用，术语“有需要”是指已将患者鉴定为需要特定方法或治疗。在一些实施例中，可以通过任何诊断方式进行识别。在本文描述的任何方法和治疗中，患者可能需要。
“有效量”是指活性化合物或药剂的量，其能引起组织、系统、动物、个体或人类的生物学或医学反应；有效量由研究人员、兽医、医生或其他临床医生寻求的。
“患者”指需要诊断、预后或治疗的任何哺乳动物，包括人类、狗、猫、兔子、大鼠、小鼠、马、牛等。
“约”指相关技术领域技术人员容易知道的相应数值的常规误差范围。在一些实施方式中，本文中提到“约”指所描述的数值以及其±10％、±5％或±1％的范围。
“ECMO”即指体外膜肺氧合(Extracorporeal Membrane Oxygenation，ECMO)，其是一种医疗急救技术设备，主要用于对重症心肺功能衰竭患者提供持续的体外呼吸与循环，以维持患者生命。
“ICU”是指重症加强护理病房(Intensive Care Unit)，治疗、护理、康复均可同步进行，为重症或昏迷患者提供隔离场所和设备，提供最佳护理、综合治疗、医养结合，以及术后早期康复、关节护理运动治疗等服务。
“IMV”即指间歇性指令通气(intermittent mandatory ventilation)，其是根据预先设置的时间间隔即时间触发，来实施周期性的容量或压力通气。这期间允许患者在指令通气期间以任何设定的基础压力水平进行自主呼吸。在自主呼吸时，患者可以在持续气流支持下自主呼吸，或者机器将按需阀门打开以允许自主呼吸。据大多数呼吸机都可以在自主呼吸时提供压力支持。
“HFNC”即经鼻高流量氧疗(High-flow nasal cannula oxygen therapy)，其是通过无需密封的鼻塞导管直接将一定氧浓度的空氧混合高流量气体输送给患者的一种氧疗方式，作为一种无创呼吸支持的形式，其能迅速地改善氧合。目前可以应用于急性低氧性呼吸衰竭患者、外科手术后患者、呼吸衰竭未行气管插管患者、免疫抑制患者、心功能不全患者等。
“NIV”即指无创通气(Non-invasine Ventilation)，是指除气管插管、气管切开以外的无创伤的机械通气。
“EC50”即半最大效应浓度(concentration for 50％of maximal effect,EC50)是指能引起50％最大效应的浓度。
“IC50”表示50％抑制浓度，即对指定的生物过程抑制一半时所需的药物或者抑制剂的浓度。
本发明中“亲本Fc区”可以为天然存在的Fc区，编码Fc区的基因可来自人、鼠、兔、骆驼、猴子，优选为人和小鼠；例如，亲本Fc区为SEQ ID NO:60、SEQ ID NO:61或SEQ ID NO:66中Fc区。
本文提及专利、出版物的相关描述均通过引用全部并入本文。
双特异抗体、单域抗体和重链抗体
本发明提供了对spike蛋白具有高亲和力的抗体，包括双特异抗体、单域抗体和重链抗体。双特异抗体、单域抗体和重链抗体表现出有效的结合活性，并可用于治疗和诊断用途。比如，这些抗体可以阻止SARS-CoV-2病毒颗粒和细胞膜融合，以及介导免疫细胞吞噬、清除病毒颗粒。
一些实施方案提供了双特异抗体，双特异抗体中第一结合部分的重链的C-末端(即CH3末端)通过连接子L1与单域抗体进行共价连接。在一些实施方案中，双特异抗体包含2条序列相同的第一多肽和2条序列相同的第二多肽；所述第一多肽的氨基酸序列如SEQ ID NO:77所示，所述第二多肽的氨基酸序列如SEQ ID NO:74所示。
一些实施方案提供了双特异抗体，双特异抗体中第一结合部分的轻链的C-末端(即CL末端)通过连接子L1与单域抗体进行共价连接。在一些实施方案中，双特异抗体包含2条序列相同的第一多肽和2条序列相同的第二多肽；所述第一多肽的氨基酸序列如SEQ ID NO:72所示，所述第二多肽的氨基酸序列如SEQ ID NO:78所示。
一些实施方案提供了单域抗体，单域抗体的氨基酸序列如SEQ ID NO:69所示。
一些实施方案提供了重链抗体，重链抗体含有2条序列相同的重链，其重链序列如SEQ ID NO:79所示。
在一些实施方案中，双特异抗体、单域抗体或重链抗体还可连接氨基酸序列或一个或多个修饰基团。例如，本发明公开的双特异抗体、单域抗体或重链抗体可以包含有韧性的接头序列，或者可以被修饰以添加功能性基团(例如PEG、药物、毒素或标签)。
本发明公开的双特异抗体、单域抗体或重链抗体还包含被修饰的衍生物，即通过任何类型的分子与抗体的共价连接进行修饰，其中共价连接不会阻止抗体与表位结合。包括但不限制以下实例，抗体可以被糖基化、乙酰化、聚乙二醇化、磷酸化、酰胺化、通过已知的保护/封闭基团衍生化、蛋白水解切割、连接至细胞配体或其他蛋白质等。众多化学修饰中的任一种修饰可以通过现有技术进行，包括但不限于特异性化学裂解、乙酰化、甲酰化、衣霉素的代谢合成等。
在一些实施方案中，双特异抗体、单域抗体或重链抗体可以与治疗剂、药物前体、肽、蛋白质、酶、病毒、脂类、生物反应调节剂、药剂或PEG进行缀合。
双特异抗体、单域抗体或重链抗体可以与治疗剂缀合或融合，所述治疗剂可包括可检测标记，如放射性标记、免疫调节剂、激素、酶、寡核苷酸、光敏治疗剂、诊断剂、细胞毒性剂、超声增强剂、非放射性标记物及其组合物，和本领域已知的其它此 类试剂。
双特异抗体、单域抗体或重链抗体可通过将其偶联至化学发光化合物来被可检测地标记。然后通过检测在化学反应过程中出现的发光从而确定化学发光标记的抗体的存在。化学发光标记化合物的实例包括鲁米诺、异鲁米诺、芳香吖啶酯、咪唑、吖啶盐和草酸酯。
本发明还公开了编码本发明所述双特异抗体、单域抗体和重链抗体的多聚核苷酸或核酸分子。本发明公开的多聚核苷酸可以编码重链、轻链、重链可变区、轻链可变区、Fc区、部分重链可变区或部分轻链可变区、双特异、单域抗体或重链抗体。制备抗体的方法是本领域公知的并且在本发明中有所描述。在某些实施方案中，本发明公开的抗体的可变区和恒定区都是全人源的。全人源抗体和抗原结合片段可以使用本领域中公开的技术和本发明所述的技术制备。例如，针对特定抗原的全人源抗体可以通过将抗原施用于转基因动物中来制备，所述转基因动物已经被改良过以响应抗原攻击而产生全人源抗体。可用于制备这种抗体的示例性技术参见美国专利6,458,592；6,420,140，其全部内容通过引用并入本文。
在某些实施方案中，制备的抗体不会在待治疗的动物(例如人类)中引起有害的免疫应答。在一实施方案中，本发明公开的抗体(包括双特异抗体、单域抗体或重链抗体)使用本领域公认的技术修饰以降低其免疫原性。例如，抗体可以被人源化、灵长类化、去免疫化或者可以制备嵌合抗体。这些类型的抗体来源于非人抗体，通常是鼠类或灵长类抗体，其保留或基本保留亲本抗体的抗原结合特性但在人体中免疫原性较低。其可以通过多种方法来实现，包括(a)将整个非人源的可变区移植到人源的恒定区以产生嵌合抗体；(b)将一个或多个非人类互补决定区(CDR)的至少一部分移植到人源的框架和恒定区中，保留或不保留关键的框架残基；或(c)移植整个非人源的可变区，但通过用类人源的部分置换表面残基从而“隐藏”它们。通常人框架区中的框架残基将被来自CDR供体抗体的相应残基取代，比如能够改善抗原结合的残基。这些框架替换可以通过本领域公知的方法鉴定，例如通过模拟CDR和框架残基的相互作用以鉴定对抗原结合起重要作用的框架残基和通过序列对比以鉴定特定位置上异常的框架残基。(参考美国专利5,585,089；其全部内容通过引用并入本文)。可以使用本领域公知的多种技术使抗体人源化，例如CDR移植(EP 239,400；WO 91/09967；美国专利5,225,539,5,530,101和5,585,089)，修复或者表面重排(EP592,106；EP519,596；)，以及链的重排(美国专利5,565,332)，其全部内容通过引用并入本文。
去免疫化也可用于降低抗体的免疫原性。在本发明中，术语“去免疫化”包括改变抗体以修饰T细胞表位(参见例如WO/9852976A1和WO/0034317A2)。例如，分析来自起始抗体的重链可变区序列和轻链可变区序列，并产生来自每个可变区的人T细胞表位“图谱”，显示表位相对于互补决定区(CDRs)和序列内其它关键残基的位置。分析来自T细胞表位图的单个T细胞表位，以鉴定具有较低改变抗体活性风险的可选择 的氨基酸取代。设计包含氨基酸取代组合的一系列可选的重链可变区序列和轻链可变区序列，随后将这些序列掺入到一系列结合多肽中。然后将包含修饰过的可变区和人类恒定区的完整重链和轻链的基因克隆到表达载体中，随后将质粒转入细胞系以产生完整的抗体。然后利用合适的生物化学和生物学实验中比较抗体，鉴定出最佳的抗体。
本发明公开的抗体的结合特异性可以通过体外实验，例如免疫共沉淀、放射免疫实验(RIA)或酶联免疫吸附实验(ELISA)来检测。
scFv的制备可参见生产单链单元的技术(美国专利4,694,778)。通过氨基酸桥接Fv区的重链和轻链片段形成单链单元，产生单链融合肽。也可以使用在大肠杆菌中组装功能性Fv片段的技术(Skerra et al.,Science 242:1038-1041(1988))。
可用于生产单链Fv(scFv)和抗体的技术的实例包括如美国专利4,946,778和5,258,498中所述。对于包括在人体内使用抗体和体外检测实验的某些用途，可以使用嵌合抗体、人源化抗体或全人源抗体。嵌合抗体是抗体的不同部分源自不同动物物种的一类分子，例如具有鼠源单克隆抗体的可变区和人源免疫球蛋白恒定区的抗体。生产嵌合抗体的方法是本领域已知的，参见美国专利5,807,715、4,816,567和4,816,397，其全部内容通过引用并入本文。
针对特定抗原或靶标的天然存在的VHH域可获自骆驼科VHH序列的(原生或免疫)文库。这样的文库和技术例如描述于WO 99/37681、WO 01/90190、WO 03/025020和WO 03/035694。或者，可使用来源于(原生或免疫)VHH文库的改进合成或半合成文库，例如通过例如随机诱变和/或CDR改组的技术获自(原生或免疫)VHH文库的VHH文库，例如WO 00/43507中所述。
此外，在Newman,Biotechnology 10:1455-1460(1992)中公开了另一种生产重组抗体的高效方法，特别地，该技术能产生含有猴可变区和人恒定区序列的灵长类抗体，该参考文献的全部内容通过引用并入本文。此外，该技术也在共同转让的美国专利5,658,570、5,693,780和5,756,096中有所提及，每个专利的全部内容通过引用并入本文。
抗体可以通过本领域已知的多种方法制备，包括使用来自免疫球蛋白序列的抗体文库进行的噬菌体展示方法。也可参考美国专利4,444,887和4,716,111，以及PCT公布文本WO 98/46645、WO 98/50433、WO 98/24893、WO 98/16654、WO 96/34096、WO 96/33735和WO 91/10741，每个专利的全部内容通过引用并入本文。
在另一实施方案中，使用常规方法(例如使用能够特异性结合编码鼠抗体重链和轻链的基因的寡核苷酸探针)，可以分离编码所需单克隆抗体的DNA并对其进行测序。分离的和亚克隆的杂交瘤细胞可以作为此类DNA的来源。一旦分离出来，DNA可以被置于表达载体中，然后被转染到原核或真核宿主细胞如大肠杆菌细胞、猿猴COS细胞、中国仓鼠卵巢(CHO)细胞或不产生其他免疫球蛋白的骨髓瘤细胞中。分离的DNA(如本文所述可以是合成的)也可用于制备抗体的恒定区和可变区的序列，如美国专 利5,658,570中所述，其全部内容通过引用并入本文。该方法从所选细胞中提取RNA并转化成cDNA，然后使用Ig特异性引物通过PCR技术进行扩增。适于此目的的合适的探针在美国专利5,658,570中也有所提及。
此外，使用常规重组DNA技术，可将本发明的抗体的一个或多个CDR插入框架区，例如插入到人类框架区以构建人源化非全人源抗体。框架区可以是天然存在的或共有的框架区，优选人类框架区(参见Chothia et al.,J.Mol.Biol.278:457-479(1998)，其列出一系列人类框架区)。一些多核苷酸可以编码框架区和CDR组合产生的与目标抗原的至少一个表位特异性结合的抗体。在框架区内可以进行一个或多个氨基酸取代，可以选择能够改善抗体与其抗原结合的氨基酸取代。另外，可用此法进行参与链间二硫键形成的一个或多个可变区中半胱氨酸残基的取代或缺失，从而产生缺少一个或多个链间二硫键的抗体分子。本领域技术范围内的对多核苷酸进行的其他改变也涵盖于本发明中。
在一些实施方案中，可以按常规方法根据本文所述抗体的氨基酸序列设计合成编码抗体的DNA，将其置入表达载体中，然后转染宿主细胞，在培养基中培养被转染的宿主细胞产生抗体。在一些实施方案中，表达载体包括至少一个启动子元件，抗体、抗原结合片段或融合蛋白编码序列，转录终止信号和polyA尾。其他元件包括增强子，Kozak序列及插入序列两侧RNA剪接的供体和受体位点。可以通过SV40的前期和后期启动子，来自逆转录病毒的长末端重复序列如RSV、HTLV1、HIVI及巨细胞病毒(CMV)的早期启动子来获得高效的转录，也可应用其它一些细胞的启动子如肌动蛋白启动子。合适的表达载体可包括pIRES1neo，pRetro-Off，pRetro-On，PLXSN，或者pLNCX，pcDNA3.1(+/-)，pcDNA/Zeo(+/-)，pcDNA3.1/Hygro(+/-)，PSVL，PMSG，pRSVcat，pSV2dhfr，pBC12MI，pCS2或pCHO1.0等。常使用的哺乳动物细胞包括中国仓鼠卵巢细胞(CHO细胞)(例如CHO-K1细胞)或从CHO细胞修饰的CHO-S、CHO-dhfr-、CHO/DG44或ExpiCHO、NSO骨髓瘤细胞、COS细胞、Cos1细胞、Cos7细胞、SP2细胞、CV1细胞、鼠L细胞、人胚肾细胞HEK293或从HEK293细胞修饰的HEK293T、HEK293F或HEK293E细胞等。
在一些实施方案中，插入基因片段需含有筛选标记，常见的筛选标记包括二氢叶酸还原酶，谷氨酰胺合成酶，新霉素抗性，潮霉素抗性等筛选基因，以便于转染成功的细胞的筛选分离。将构建好的质粒转染到无上述基因的宿主细胞，经过选择性培养基培养，转染成功的细胞大量生长，产生想要获得的目的蛋白。
通过使用本领域技术人员公知的技术可以选择、构建和培养生产抗体的细胞系。这些技术在各种实验室手册和主要出版物中均有描述，例如Recombinant DNA Technology for Production of Protein Therapeutics in Cultured Mammalian Cells，D.L.Hacker,F.M.Wurm,in Reference Module in Life Sciences,2017，其全部内容包括补充内容通过引用并入全文。
对于本发明的抗体的重组表达，可以用两种重组表达载体共转染宿主细胞，第一重组表达载体编码抗体重链，第二重组表达载体编码抗体轻链。两个重组表达载体可以含有相同的筛选标记，或者它们可以各自含有不同的筛选标记。可替代地，可以使用共编码抗体重链和轻链的重组表达载体转染宿主细胞。
本发明的抗体还可以通过化学合成(例如，通过Solid Phase Peptide Synthesis，第2版，1984 The Pierce Chemical Co.，Rockford，Ill.中描述的方法)来生产。还可以使用无细胞平台(参见例如，Chu等人，Biochemia No.2，2001(Roche Molecular Biologicals)以及Murray等人，2013，Current Opinion in Chemical Biology，17:420–426)生成变体抗体。
通过重组表达产生的抗体，可以通过本领域已知的用于纯化免疫球蛋白分子的任何方法将它纯化，例如通过层析(例如，离子交换、亲和层析和分级柱层析)、离心、差异溶解度、或纯化蛋白质的任何其它标准技术。例如利用蛋白A或蛋白G进行亲和层析。另外，可将免疫球蛋白所靶向的特异抗原或其表位固定于柱上，以通过免疫亲和色谱来纯化免疫特异性抗体。本发明的抗体可以与本领域已知的异源多肽序列融合，以促进纯化。免疫球蛋白的纯化可参考D.Wilkinson的文章(The Scientist，由The Scientist,Inc.,Philadelphia Pa.出版，第14卷，第8期(2000年4月17日)，第25-28页)。
此外，可以使用本领域技术人员已知的标准技术在编码本发明所述抗体的核苷酸序列中引入突变，包括但不限于导致氨基酸取代的定点突变和PCR介导的突变。变体(包括衍生物)编码相对于原重链可变区HCDR1、HCDR2、HCDR3和轻链可变区LCDR1、LCDR2或LCDR3来说少于50个氨基酸的取代、少于40个氨基酸的取代、少于30个氨基酸的取代、少于25个氨基酸的取代、少于20个氨基酸的取代、少于15个氨基酸的取代、少于10个氨基酸的取代、少于5个氨基酸的取代、少于4个氨基酸的取代、少于3个氨基酸的取代或少于2个氨基酸的取代。或者可以沿着全部或部分编码序列时随机引入突变，例如通过饱和突变，以及可以筛选所得突变体的生物活性以鉴定保留活性的突变体。在一些实施方案中，取代可以为保守氨基酸取代。
治疗方法
本发明还提供了治疗方法和用途。在一些实施方案中，提供了用于预防、治疗或改善COVID-19的方法，所述方法包括向患者施用有效剂量的抗体(包括双特异抗体、单域抗体或重链抗体)。在一些实施方案中，提供了所述抗体(包括双特异抗体、单域抗体或重链抗体)在预防、治疗或改善COVID-19中的应用。在一些实施方案中，提供了所述抗体(包括双特异抗体、单域抗体或重链抗体)在制备用于预防、治疗或改善COVID-19的药物中的应用。在一些实施方案中，所述患者为疑似感染SARS-CoV-2病毒的患者。在一些实施方案中，所述患者为与SARS-CoV-2病毒携带者有接触的患者。在一些实施方案中，所述患者为确诊感染SARS-CoV-2病毒的患者。在一些实施 方案中，所述患者为有轻微症状的患者。在一些实施方案中，所述患者为有严重症状的患者。在一些实施方案中，所述患者有发热，咳嗽，低血压，缺氧，和/或急性呼吸窘迫综合征(ARDS)。
对于任何特定患者的具体剂量和治疗方案将取决于各种因素，包括所使用的抗体(包括双特异抗体、单域抗体或重链抗体)、患者的年龄和体重、一般健康状况、性别和饮食，以及给药时间、排泄频率、药物组合，以及所治疗的特定疾病的严重程度。由包括在本领域普通技术人员范围内的医疗护理人员对这些因素进行判断。所述剂量还将取决于待治疗的个体患者、给药途径、制剂类型、所用化合物的特性、疾病的严重程度以及所需的效果。所用剂量可以通过本领域熟知的药理学和药代动力学原理确定。
抗体(包括双特异抗体、单域抗体或重链抗体)施用方法包括但不限于真皮内、肌肉、腹腔、静脉、皮下、鼻腔、硬脊膜外和口服注射。药物组合物可以通过任何方便的途径施用，例如通过输注或推注，通过上皮或皮肤粘膜(例如口腔粘膜、直肠和肠粘膜等)吸收，并且可以与其他生物活性剂共同施用。因此，含有本发明的抗体的药物组合物可以口服给药、直肠给药、肠胃外给药、脑池内给药、阴道内给药、腹腔内给药、外敷(如通过粉末，软膏，滴剂或透皮贴剂)、口腔给药或通过口服或鼻腔喷雾给药。
本发明使用的术语“肠胃外”是指包括静脉内、肌肉内、鼻腔内、腹腔内、胸骨内、皮下和关节内注射和输注的施用方式。施用方式可以是全身施用或局部施用。
在一些实施方案中，本发明组合物包含编码蛋白质的核酸或多聚核苷酸，可以通过将其构建为合适的核酸表达载体的一部分来体内施用所述核酸以促进其编码的蛋白质的表达，然后通过下述方式施用上述部分载体使其变为胞内部分，例如通过使用逆转录病毒载体(参见美国专利4,980,286)，或通过直接注射，或通过使用微粒轰击(例如基因枪；Biolistic，Dupont)，或用脂质体或细胞表面受体或转染试剂包被，或者通过与已知进入细胞核的同源异型盒类肽连接施用(参见例如Joliot et al.,1991,Proc.Natl.Acad.Sci.USA 88:1864-1868)等等。可选地，核酸可以通过同源重组在引入细胞内并整合至宿主细胞DNA中用于表达。
在一些实施方案中，本发明的抗体，包括双特异抗体、单域抗体或重链抗体施用于患者的剂量为10mg至2000mg，或1mg/kg至35mg/kg患者体重。给药频率可以为单次给药。或者，每次给药可相隔至少1天至3天；或至少一星期。或者，给药频率可以为每周给药2次、每周给药1次、每2周给药1次、每3周给药1次、每4周给药1次、每5周给药1次、每6周给药1次、每7周给药1次、每8周给药1次或每12周给药1次。可以通过例如脂质化等修饰来增强抗体的摄取和组织穿透能力(例如进入脑内)，从而减少本发明抗体的施用的剂量和频率。
各种已知输送系统可用于施用本发明双特异抗体、单域抗体或重链抗体或其编码 多核苷酸，例如包封于脂质体、微粒、微胶囊、能够表达所述化合物的重组细胞、受体介导的内吞作用(参见例如Wu and Wu,1987,J.Biol.Chem.262:4429-4432)、作为逆转录病毒或其它载体的一部分的核酸的构建等。
联合疗法
在一些实施方案中，本发明抗体，包括双特异抗体、单域抗体或重链抗体可以结合其它治疗或预防方案，包括施用一种或多种本发明抗体以及一种或多种其它治疗剂或方法一起使用或组合使用。对于组合治疗，本发明抗体可以与其它治疗剂可同时或分开施用。当分开施用时，可以在施用另一种其它治疗剂之前或之后施用本发明抗体。
一些新型冠状病毒肺炎重型或危重型患者存在细胞因子风暴现象，本发明抗体可与阿达木单抗(adalimumab，例如及其生物类似物，如AbriladaTM(adalimumab-afzb)，Amjevita(adalimumab-att)，CyltezoTM(adalimumab-adbm)，HyrimozTM(adalimumab-adaz)，HulioTM，(BAT1406))或托珠单抗(tochilizumab,例如及其生物类似物，如BAT1806)联合用于治疗，其可以减缓TNF-α表达上调导致的炎症反应。在一些实施方案中，本方法治疗的患者被确诊感染新型冠状病毒并且有一种或多种细胞因子(包括肿瘤坏死因子α(TNF-α)，IFN-γ、IL-1β、IL-2、IL-4、IL-7、IL-8、IL-10、IL-12p70、IL-13、粒细胞集落刺激因子(GSCF)、干扰素诱导蛋白-10(IP-10)、单核细胞趋化蛋白-1(MCP1)、巨噬细胞炎性蛋白1α(MIP1A))增高。在一些实施方案中，本方法治疗的患者有TNF-α增高。在一些实施方案中，一种或多种细胞因子高于正常水平至少50％。在一些实施方案中，一种或多种细胞因子至少为正常水平的2倍、3倍或4倍。在一些实施方案中，本方法治疗前患者有发热，低血压，缺氧，和/或急性呼吸窘迫综合征(ARDS)。在一些实施方案中，本方法治疗前患者有肺部充满炎性液体(即所谓的“白肺”)。在一些实施方案中，本方法治疗前患者有细胞因子风暴引起的细胞因子释放综合症(Cytokine Release Syndrome，CRS)。
在一些实施方案中，本发明抗体用于结合ICU治疗。在一些实施方案中，本发明抗体结合体外ECMO和/或IMV治疗。在一些实施方案中，本发明抗体结合氧疗。在一些实施方案中，本发明抗体结合NIV/HFNC治疗。在一些实施方案中，治疗后，患者的一种或多种细胞因子比治疗前至少降低20％、30％、40％、50％、60％、70％、80％、90％、或95％。在一些实施方案中，本方法使患者痊愈。
诊断方法
在某些样品中观察到spike蛋白阳性，或者被SARS-CoV-2病毒感染了的患者可能对使用本发明抗体的治疗有响应。因此，本发明抗体也可以用于检测和诊断。
样品可以从患者体内获得。在选择性地对样品进行预处理之后，可以在允许抗体与可能存在于样品中的spike蛋白相互作用的条件下，将样品与本发明抗体一起孵育。可以使用诸如ELISA的方法，利用抗体来检测样品中spike蛋白的存在。
样品中spike蛋白的存在(比如含量或浓度)可以用于诊断相关疾病，作为患者适用抗体治疗的指示，或作为患者已经(或没有)对病症治疗作出反应的指示。对于预后方法，可以在开始疾病治疗时在特定阶段进行一次、两次或更多次地检测，以指示治疗的进展。
药物组合物
本发明还提供了药物组合物。这样的组合物包含本文所述抗体以及药学上可接受的辅料。
在一些实施方案中，术语“药学上可接受的”是指由政府的监管机构批准的或其他公认的药典中列出的用于动物(特别是用于人类)的物质。此外，“药学上可接受的辅料”通常指是任何类型的无毒固体、半固体或液体填充剂、稀释剂、包封材料或制剂助剂等。
术语“辅料”是指可以与活性成分一起施用于患者的稀释剂、佐剂、赋形剂或载体。这此类药物载体可以是无菌液体，如水和油，包括石油、动植物或合成来源的油，如花生油、大豆油、矿物油、芝麻油等。当药物组合物静脉内给药时，水是优选的载体。盐水溶液和葡萄糖水溶液和甘油溶液也可用作液体载体，特别是用于注射溶液。合适的药物赋形剂包括淀粉、葡萄糖、乳糖、蔗糖、明胶、麦芽、大米、面粉、白垩、硅胶、硬脂酸钠、单硬脂酸甘油酯、滑石、氯化钠、脱脂奶粉、甘油、丙烯、乙二醇、水、乙醇等。如有需要，药物组合物还可以含有少量的润湿剂、乳化剂，或pH缓冲剂如乙酸盐、柠檬酸盐或磷酸盐。抗菌剂如苯甲醇或对羟基苯甲酸甲酯、抗氧化剂如抗坏血酸或亚硫酸氢钠、螯合剂如乙二胺四乙酸，以及调节张力的试剂如氯化钠或右旋葡萄糖也是可以预见的。这些药物组合物可以采取溶液、悬液、乳剂、片剂、丸剂、胶囊、散剂、缓释制剂等形式。该药物组合物可以用传统的粘合剂和载体如甘油三酯配制成栓剂。口服制剂可以包括标准载体，例如药物等级的甘露糖醇、乳糖、淀粉、硬脂酸镁、糖精钠、纤维素、碳酸镁等。合适的药物载体的实例在E.W.Martin的Remington's Pharmaceutical Sciences中有描述，在此通过引用并入本发明。此类组合物将含有临床有效剂量的抗体或抗原结合片段，优选以纯化后的形式，连同合适数量的载体，以提供适合于患者的给药形式。该制剂应该适用于给药模式。制剂可以封装在安瓿瓶、一次性注射器或由玻璃或塑料制成的多剂量小瓶中。
在一些实施方案中，根据常规步骤将组合物配制成适合静脉内注射于人体的药物组合物。用于静脉内给药的组合物通常是在无菌等渗水性缓冲液中的溶液。药物组合物还可包含增溶剂和局部麻醉剂如利多卡因，从而缓解注射部位的疼痛。一般而言，有效成分以单位剂量形式单独供给或混在一起供给，如以干燥的冻干粉末或无水浓缩物的形式装在可指示活性剂份量的密封容器(如安瓿瓶、西林瓶或小袋)中。在通过输注施用组合物的情况下，可以用含有无菌药用级水、生理盐水或者葡萄糖注射液的输液瓶或者输液袋来分装组合物。在通过注射施用组合物的情况下，可以使用注射用 的无菌水或生理盐水或葡萄糖注射液的安瓿瓶或者西林瓶，使得可以在施用之前混合有效成分。
本发明的化合物可以配制成中性的或盐的形式。药学上可接受的盐包括衍生自如与盐酸、磷酸、乙酸、草酸、酒石酸等的阴离子形成的盐，以及衍生自如与钠、钾、铵、钙、氢氧化铁、异丙胺、三乙胺、2-乙氨基乙醇、组氨酸、普鲁卡因等的阳离子形成的盐。
具体实施方式
以下通过具体的实施例进一步说明本发明的技术方案，具体实施例不代表对本发明保护范围的限制。其他人根据本发明理念所做出的一些非本质的修改和调整仍属于本发明的保护范围。
下述实施例中所用的材料、试剂等，如无特殊说明，均可从商业途径得到。
实施例1抗spike蛋白抗体的制备
抗体(包括单特异抗体、双特异抗体、单域抗体和重链抗体)可以通过以下方法或其他已知方法制备：依照宿主细胞CHO密码子偏好性特点进行序列优化，由氨基酸序列得到DNA序列。将优化并合成的序列分别克隆入载体，然后分别抽提大量质粒，进行稳定表达细胞株的构建：线性化的表达载体与CHO细胞混匀后加入0.4cm电转杯进行电转；电转完成后，按1200个细胞每孔铺到96孔细胞培养板，约2-3周后选择表达量高的母克隆进行96孔到24孔到6孔到摇瓶的细胞扩大培养和表达量检测，选择摇瓶表达量高的克隆进行亚克隆，亚克隆扩大培养和表达鉴定同母克隆，根据表达量水平和细胞株稳定性选择单克隆稳定细胞株，悬浮培养12天左右收获上清，进行ProteinA亲和捕获，阴离子及阳离子层析获得纯度大于95％的抗体。
示例性抗体1-24和2F8的可变区组成见表1，重链可变区的框架区和CDR区以及轻链可变区组成见表2，VH与CH(如SEQ ID NO:61所示)组成抗体的重链，VL与CL(如SEQ ID NO:62所示)组成抗体的轻链；双特异抗体、单域抗体、重链抗体、单特异抗体的序列见表3-表8；其中，抗体2F8(单特异抗体)含有两条序列相同的重链(如SEQ ID NO:72所示)和两条序列相同的轻链(如SEQ ID NO:74所示)；单域抗体VHH18的氨基酸序列如SEQ ID NO:69所示；重链抗体VHH18-Fc含有2条序列相同的重链(如SEQ ID NO:79所示)，重链由单域抗体、连接子和Fc组成；双特异抗体2F8-VH-VHH18含有两条序列相同的第一多肽(如SEQ ID NO:77所示)和两条序列相同的第二多肽(如SEQ ID NO:74所示)，第一多肽由重链、连接子和单域抗体组成，第二多肽由轻链组成；双特异抗体2F8-VL-VHH18含有2条序列相同的第一多肽(如SEQ ID NO:72所示)和2条序列相同的第二多肽(如SEQ ID NO:78所示)，第一多肽由重链组成，第二多肽由轻链、连接子和单域抗体组成。表3、表5中重链的Fc区采用下单划线标出。
纯化后的抗体经测序证实序列如上所述。
表1抗spike蛋白抗体(单特异抗体)的可变区组成
表2抗spike蛋白抗体(单特异抗体)的重链可变区和轻链可变区

表3氨基酸序列




表4单域抗体和重链抗体的氨基酸序列
表5单特异抗体的氨基酸序列

表6抗体2F8的核酸序列
表7双特异抗体、重链抗体的氨基酸序列

表8双特异抗体、重链抗体的核酸序列


实施例2抗体与SARS-CoV-2 spike蛋白结合活性的检测
针对上述抗体进行Elisa检测，检测方法为：将96孔板(Corning，9018)用spike-RBD-mFC(sino biologicals)包被，并用胶带密封并储存；将板在清洗缓冲液PBST(含0.05％Tween 20的PBS)中清洗3次，之后加入封闭溶液(每孔200μL的10mg/ml BSA，溶剂为清洗缓冲液)；孵育(1小时(h)，37℃)后，将板用清洗缓冲液洗涤3次，然后每孔添加梯度稀释好的样品100μL；孵育(1.5h，37℃)后，将板用清洗缓冲液洗涤，然后加入抗人κ轻链抗体-过氧化物酶偶联物(在封闭溶液中稀释至1:2000，100μL/孔)；将板用清洗缓冲液洗涤，在添加100μL TMB(Tetramethylbenzidine，Biopanda TMB-S-001)底物/孔之前，将测试样品孵育(1h，37℃)；显色10分钟后，加入100μL/孔0.1M H2SO4终止反应，然后在450nm的吸光度下测量96孔板。
通过吸光值计算EC50，各种单特异抗体与SARS-CoV-2 spike蛋白结合的EC50值见表9。
表9单特异抗体与SARS-CoV-2 spike蛋白结合的EC50值
实施例3抗体阻断SARS-CoV-2 spike蛋白与血管紧张素转化酶2结合
1)针对上述某些抗体进行竞争Elisa以检测其阻断spike蛋白与血管紧张素转化酶2(ACE2)结合的能力。检测方法为：将96孔板(Corning，9018)用spike-RBD-mFC(sino biologicals)包被，并用胶带密封并储存4℃过夜；将板在清洗缓冲液(含0.05％Tween 20的PBS)中清洗3次，之后加入封闭溶液(每孔200μL的10mg/ml BSA，溶剂为清洗缓冲液)；孵育(2h，37℃)后，将板在清洗缓冲液中清洗3次，加入不同浓度的抗体样品，然后加入生物素化的血管紧张素转化酶2(50ng/ml)；孵育(1h，37℃)后，将板用清洗缓冲液洗涤3次，然后每孔添加100μL链霉亲和素过氧化物酶偶联物(在封闭溶液中稀释1:10,000)，孵育(1h，37℃)后，将板用清洗缓冲液洗涤，加100μL/ 孔TMB底物；显色10分钟后，加入50μL/孔0.1M H2SO4终止反应，在450nm的吸光度下测量吸光值。
上述各种抗体阻断COVID-19 spike蛋白与ACE2结合的曲线图见图1。
2)采用SPR(表面等离子共振)技术进行检测：先将100nM biotinylated spike RBD(Acrobiosystems，SPD-C82E9)蛋白结合在streptavidin探针上，结合了biotinylated spike RBD的探针与100nM抗体溶液进行孵育，将捕获了抗体的探针与100nM ACE2(近岸生物，C419)蛋白进行孵育，以便检测已经结合了抗体的spike RBD蛋白是否还可以与溶液中的ACE2进行结合。
如图2显示，抗体2F8和2F8-VH-VHH18可阻断ACE2与spike RBD的结合，抗体VHH18-Fc可部分阻断ACE2与RBD的结合。
实施例4抗体与spike蛋白亲和力的测定
BiaCore T200(GE Healthcare)(生物分子相互作用分析)在25℃进行检测：采用ProteinA芯片进行检测，抗体使用1×HBS EP+进行稀释(0.1M HEPES，1.5M NaCl，0.03M EDTA，再补充0.005％表面活性剂P20)，以10μl/min的流速通过实验流路(Fc2、Fc4)，进行捕获；之后流速调为30μl/min，依次分析不同浓度Spike S1 RBD及突变体的稀释液(0nM、3.125nM、6.25nM、12.5nM、25nM和50nM，用1×HBS EP+稀释)，同时流经实验流路(Fc2、Fc4)和参比流路(Fc1、Fc3)表面，进行结合、解离，最后进pH 1.5 Glycine缓冲液对芯片进行再生并进入下一个循环。在BiaCore Data Analysis软件上使用1:1 Langmuir结合模型计算动力学常数spike trimer(Acrobiosystems，SPN-C52H8)(ka为结合速率，kd为解离速率，kD为结合解离平衡常数)。
如表10-12所示，抗体2F8、2F8-VL-VHH18、2F8-VH-VHH18和VHH18-Fc与Spike S1 RBD及其突变体的结合力良好。
表10抗体与Spike S1 RBD(Acrobiosystems，SPD-C52H3)的亲和力常数
表11抗体与三聚体spike trimer(Acrobiosystems，SPN-C52H8)的亲和力常数
表12抗体2F8-VH-VHH18与抗原结合的亲和力常数(NA表示非突变型，WT RBD monomer即Spike S1 RBD)
实施例5抗体的结合活性的检测
1)将spike RBD蛋白(Acrobiosytems，SPD-C52H3)，P.1.突变株S1蛋白(义翘神州，40591-V08H14)，B.1.351突变株S1蛋白(义翘神州，40591-V08H15)，B.1.617突变株(义翘神州，40592-V08H88)，B.1.1.7突变株(义翘神州，40591-V08H8)，D614G突变株(近岸生物，DRA57)，Omicron BA.1 RBD，Omicron BA.2 RBD稀释至2μg/ml，每孔100μl置于96孔板(Corning，9018)中，4℃包被过夜；将96孔板在清洗缓冲液PBST(含0.05％Tween-20的PBS缓冲液)中清洗3次，之后加入封闭溶液(每孔200μL 3mg/ml BSA，溶剂为清洗缓冲液)，37℃孵育2h；然后，将96孔板用清洗缓冲液洗涤3次，每孔添加梯度稀释的抗体溶液100μL，37℃孵育1.5h后；将96孔板用清洗缓冲液洗涤5次，加入100μL的抗人κ轻链抗体-过氧化物酶偶联物(在封闭溶 液中稀释至1:2000)，37℃孵育1h；将96孔板用清洗缓冲液洗涤8次，再添加100μL TMB(Tetramethylbenzidine，Biopanda TMB-S-001)底物进行显色；显色10-15min后，加入50μL 0.1M H2SO4终止反应，450nm的吸光度下测量96孔板的光吸收值。
如表13所示，抗体VHH18-Fc和2F8-VH-VHH18能结合spike RBD蛋白及突变株蛋白；结果显示，抗体2F8-VH-VHH18与spike RBD结合的EC50值约为10ng/ml。
表13抗体的结合活性EC50(ng/ml)
“-”表示未检测。
2)采用上述方法检测抗体2F8-VH-VHH18与spike RBD或其变体的结合活性，结果如表14所示：抗体2F8-VH-VHH18能结合spike RBD蛋白及多种突变株蛋白。
表14抗体的结合活性EC50(pM)

实施例6双特异抗体和重链抗体抑制假病毒侵染ACE2+293细胞
1)本实验是从体外评估抗体抑制spike-pseudotyped假病毒(吉满生物)侵染表达ACE2细胞(即ACE2+293细胞)的能力。采用ACE2+293细胞检测抗体抑制带有荧光素酶基因的SARS-CoV-2假病毒侵染细胞的能力。其主要原理是：采用ACE2+293F细胞作为易感染细胞，将不同浓度的抗体与SARS-CoV-2-Fluc假病毒系统孵育；当抗体与假病毒孵育结合后，将阻断病毒侵染进入ACE2+293细胞；假病毒无法有效侵染细胞，其基因组上的luciferase报告基因便无法在细胞内表达且产生荧光信号；由于荧光信号的信号值与加入的抗体浓度成负相关，从而可以检测抗体的体外抑制病毒侵染的能力。其中，野生型假病毒株WT的货号为GM-0220PV07(吉满生物)，突变株1(E484K)的货号为GM-0220PV35(吉满生物)，突变株2(W436R)的货号为GM-0220PV26(吉满生物)，突变株3(B.1.1.7/VUI-202012/01 del 145Y)的GM-0220PV33(吉满生物)，突变株4(B.1.1.7/VUI-202012/01 del 144Y/145Y)的货号为GM-0220PV34(吉满生物)，突变株5(B.1.351/501Y.V2,Beta)的货号为GM-0220PV32-96T(吉满生物)，突变株6(D614G)的货号为GM-0220PV14(吉满生物)，突变株7(D614G,D936Y)(GM-0220PV19,吉满生物)，突变株8(D839Y)(GM-0220PV6,吉满生物)，突变株9(V483A)(GM-0220PV17,吉满生物)，突变株10(D614G,A831V)(GM-0220PV24,吉满生物)，突变株11(W436R)(GM-0220PV26,吉满生物)，突变株12(E484K+K417N+N501Y)(GM-0220PV31,吉满生物)，突变株13 SARS-COV-2Spike(B.1.1.529,Omicron)(GM-0220PV84，吉满生物)，突变株14(K417N)(GM-0220PV30,吉满生物)，突变株15(N501Y,D614G)(GM-0220PV29,吉满生物)，突变株16(N354D,D364Y)(GM-0220PV13,吉满生物)。
假病毒抑制能力检测方法为：抗体稀释至4μg/ml，后4倍梯度稀释，按照每孔50μl体积转移至96孔检测板中，待用；将不同突变株的假病毒原液分别用含有10％FBS的DMEM培养基进行稀释，将稀释后的假病毒溶液按照25μl每孔转移至上述含有抗体的96孔板中，混匀后室温静置1h；将ACE2+293细胞用0.25％Trypsin-EDTA(Gibco，25200-072)消化后计数，将细胞密度调至4×105cells/ml，按照每孔50μl体积将细胞 加入到上述96孔检测板中，37℃培养箱培养48h；每孔加入50μl Bio-Lite luciferase assay system(诺维赞，DD1201-03)检测试剂，静置3分钟后进行读数，并根据读数计算抑制率：抑制率＝[1-(样品组-空白对照组)/(阴性对照组-空白对照组)]×100％；其中，阴性对照组添加假病毒溶液且不添加抗体，空白对照组不添加假病毒溶液。
ACE2+293细胞的构建方法为：将HEK293细胞(ACS-4500TM，ATCC)用含10％FBS的DMEM完全培养基培养，采用lipofectamine 2000 transfection reagent(Thermo Fisher，11668019)进行ACE2表达质粒(义翘神州，HG10108-M)的转染，之后通过潮霉素(200μg/ml)的加压筛选和流式分选(采用10μg/ml anti-ACE2和PE偶联的Anti-Human IgG-Fc)，细胞继续扩增挑选出PE阳性率>90％的单克隆进行下一步扩增，筛选出表达ACE2的HEK293细胞，即ACE2+293细胞。
结果显示，抗体VHH18-Fc对突变株2的IC50为327.4ng/ml；如表15所示，2F8-VH-VHH18和2F8-VL-VHH18可有效地抑制假病毒侵染细胞。
表15抗体对假病毒的IC50(ng/ml)
“-”表示未检测。
2)采用上述方法检测抗体2F8-VH-VHH18抑制假病毒的侵染活性，结果如表16所示：2F8-VH-VHH18可有效地抑制多种假病毒侵染细胞。
表16抗体对假病毒的IC50(pM)

3)抗体2F8-VH-VHH18对假病毒侵染细胞的抑制能力
操作步骤如下：1)稀释培养基配制：取5mL热灭活FBS加入45mL DMEM Basic(1×)培养基(Thermo，货号：C11995500CP)中，混匀备用，用量根据实际需要按比例调整。2)用稀释培养基稀释抗体2F8-VH-VHH18至抗体浓度分别为1μg/mL、18μg/mL、20μg/mL，依据假病毒种类的不同进行2倍梯度稀释或3倍梯度稀释(其中野生株(吉满生物，GM-0220PV07)、Omicron BA.1(吉满生物，GM-0220PV84)和Omicron BA.2.76(南京诺唯赞生物科技有限公司，DD1782-03)对应的抗体初始浓度为1μg/mL，进行2倍梯度稀释；Omicron BF.7(南京诺唯赞生物科技有限公司，DD1789-03)和Omicron BQ.1.1(南京诺唯赞生物科技有限公司，DD1792-03)对应的抗体初始浓度为18μg/mL，进行3倍梯度稀释；Omicron BA.4/5(吉满生物，GM-0220PV90)对应的抗体初始浓度为20μg/mL，进行2倍梯度稀释)，共10个稀释梯度，然后按照50μL/孔依次加到96孔白板(Costar，货号：3917)中；3)将假病毒从-80℃冰箱取出置于冰上缓慢溶解，使用稀释培养基稀释至4×105TU/mL，于96孔白板中加入假病毒稀释液，除CC对照组外其余各25μL/孔加入病毒稀释液。将96孔白板置于培养箱中37℃孵育1h。4)ACE2+293细胞培养至汇合度90％左右，消化离心去上清后重悬后进行细胞计数，用稀释培养基将细胞稀释至4×105cells/mL，取出孵育1h后的96孔白板，以50μL/孔加入细胞悬液(2×104cells/孔)，轻轻拍打96孔白板边缘使细胞均匀分散，将96孔白板置于培养箱培养。48h后取出96孔白板，待其恢复至室温，每孔加入50μL Bio-LiteTM Luciferase Assay System溶液，室温避光反应2min后，用酶标仪Luminescence检测模块读取发光信号，并根据读数计算抑制率：抑制率＝[1-(样品组-CC对照组)/(VC对照组-CC对照组)]×100％。
中和病毒实验结果表明(见图3所示)：抗体2F8-VH-VHH18除了可以有效抑制野生株(Wildtype)、Omicron BA.1和BA.2.76外，而且还可以有效抑制当前流行的毒株假病毒，如：Omicron BA.4/5，BF.7，BQ.1.1。
实施例7抗体抑制真病毒
在BSL-3实验室将测抗体进行梯度稀释(初始浓度为60nM，3倍梯度稀释)，将抗体稀释液与200 PFU SARS-CoV-2野生型新冠病毒粒子(病毒株编号：2019-nCoV/IQTC01/human/2020/Guangzhou，GenBank为MT123290.1)或SARS-CoV-2 delta(来源于广东省疾病预防控制中心)等体积混合，同时设立无抗体的病毒对照组和无病毒的细胞对照组；每实验组设置3个复孔，37℃静置1h；吸弃96孔板中的非 洲绿猴肾细胞系Vero E6细胞(ATCC CRL-1587)的上清液，取50μl孵育后的病毒抗体混合物转移至Vero E6细胞板中，放置于细胞培养箱中37℃，孵育1小时；吸弃Vero E6细胞板中上清液，加入100μl 37℃预热的DMEM培养基(含1.6％CMC(羧甲基纤维素))，放置于37℃细胞培养箱培养24h；24h后取出细胞板，加入200μl的4％PFA(多聚甲醛溶液)，4℃过夜孵育固定灭活病毒及细胞；第二天，吸弃上清后更换新鲜4％PFA，将96孔细胞板带入BSL-2实验室进行后续实验；使用FRNT50(plaque/focus reduction neutralization test(P/FRNT))实验进行检测：破膜、封闭后分别使用SARS-CoV-2N rabbit polyclonal antibody(北京义翘神州，货号为40143-T62)和HRP goat-anti rabbit IgG(Jackson，货号为111-035-003)作为一抗和二抗，依次进行孵育；洗涤干净后使用True blue进行显色；Immuno ELISAPOT上机读取结果，Graphpad软件进行数据分析。
结果显示，抗体VHH18-Fc、2F8-VH-VHH18和2F8-VL-VHH18可有效地抑制SARS-CoV-2野生型真病毒侵染细胞：抗体VHH18-Fc对应的IC50值为23.63nM，抗体2F8-VH-VHH18对应的IC50值为0.03nM，抗体2F8-VL-VHH18对应的IC50值为0.033nM；抗体2F8-VH-VHH18可有效地抑制SARS-CoV-2delta真病毒侵染细胞，抗体2F8-VH-VHH18对应的IC50值为0.09nM。
实施例8小鼠体内阻断真病毒药效试验
在BSL-3实验室使用转染hACE2(adenovirus(Ad5-hACE2))的Balb/c雌性小鼠(湖南斯莱克景达实验动物有限公司)进行病毒侵染试验，分为5组，每组12只；G1组：小鼠滴鼻感染105个新冠病毒(病毒株编号：2019-nCoV/IQTC01/human/2020/Guangzh ou，GenBank为MT123290.1)后给药PBS作为对照；G2组：小鼠腹腔注射1mg抗体2F8-VH-VHH18，24小时(h)后进行滴鼻105个感染新冠病毒；G3组：小鼠滴鼻感染105个新冠病毒，18小时后进行腹腔注射1mg抗体2F8-VH-VHH18；G4组：小鼠滴鼻给予1mg抗体2F8-VH-VHH18，24小时后进行滴鼻感染105个新冠病毒。在感染新冠病毒后第3天，每组取4只小鼠的肺组织进行匀浆，FRNT方法检测小鼠肺部活病毒滴度。每组小鼠在感染病毒和注射抗体后每天进行体重检测，共检测14天。
1)如图4所示，G2组、G3组和G4组均能阻断新冠病毒侵染肺组织。
2)如图5所示，G2组和G4组小鼠的体重均未发生明显波动，G3组小鼠的体重在前4天发生明显下降，后恢复至正常水平。
实施例9抗体对SARS-CoV-2的中和效果
利用微量稀释中和法测定2F8-VH-VHH18对SARS-CoV-2野生株、Alpha、Beta、Gamma、Delta和Omicron突变株的中和水平。
实验结果显示，2F8-VH-VHH18对所检测的SARS-CoV-2野生株、Alpha、Beta、 Gamma、Delta和Omicron突变株共6种病毒株均有显著的中和效价。
实施例10药代动力学研究
由于2F8-VH-VHH18针对的靶点是SARS-CoV-2新冠病毒spike蛋白RBD结构域，不存在相关种属动物，故2F8-VH-VHH18项目选择在SD大鼠中开展了单次给药的药代动力学试验。
SD大鼠单次静脉输注给予2F8-VH-VHH18后，采集血样，用ELISA方法测定血样中2F8-VH-VHH18浓度，并计算主要药代动力学参数。研究中共采用30只SD大鼠(雌雄各半)，随机分为3组，每组雌性和雄性动物各5只。每组动物未禁食单次静脉推注分别给予20、50和150mg/kg 2F8-VH-VHH18。给药后血样采集至Day 14。研究结果显示，在20-150mg/kg给药剂量范围内，血清中2F8-VH-VHH18的系统暴露量无明显性别差异，并且血清中系统暴露量与给药剂量呈正相关。所有动物在整个实验期间临床详细观察未发现异常。
雄性SD大鼠单次静脉推注给予20、50、150mg/kg 2F8-VH-VHH18后，血清中2F8-VH-VHH18的t1/2分别为413.08h、244.19h和260.91h，达峰时间Tmax分别为2h、2h和3h，峰浓度Cmax分别为469754ng/mL、1306101ng/mL和3600117ng/mL，系统暴露量AUC(0-t)分别为64683258h*ng/mL、177004803h*ng/mL和495864682h*ng/mL。雌性SD大鼠单次静脉推注给予20、50、150mg/kg 2F8-VH-VHH18后，血清中2F8-VH-VHH18的t1/2分别为258.78h、277.74h和240.82h，达峰时间Tmax均为2h，峰浓度Cmax分别为518253ng/mL、1421953ng/mL和3794472ng/mL，系统暴露量AUC(0-t)分别为68764660h*ng/mL、214527346h*ng/mL和476887380h*ng/mL。
实施例11溶血试验和组织交叉反应
采用新西兰兔血红细胞进行溶血试验。当注射用2F8-VH-VHH18(50mg/mL)稀释超过10倍时，发现2F8-VH-VHH18在体外不会引起兔红细胞的溶血或凝集。
进行了2F8-VH-VHH18与3个不同个体来源的正常人及SD大鼠组织交叉反应试验，并对结果进行分析、比较，滴加2F8-VH-VHH18浓度为2和10μg/mL后，所有测试的35种人类组织和36种SD大鼠组织均未见阳性染色。
实施例12临床试验
本研究是一项单中心、开放、剂量递增评价2F8-VH-VHH18在健康人中的药代动力学、安全性、耐受性及药效学的试验。
每组计划招募8名健康受试者，其中2名使用安慰剂，按3：1比例随机分配接受单次静脉注射2F8-VH-VHH18注射液或5％葡萄糖注射液。将采用哨兵给药的方式进行每组给药。
其中每组的首次给药为2例受试者观察满24小时同时进行，需包含1名安慰剂受 试者。首2位后，可以进行该组剩余6名受试者的给药。
本试验中对健康受试者的安全性事件的分类将采用CDE 2019发布的：《预防用疫苗临床试验不良事件分级标准指导原则》。其中该标准的>＝3级的事件被定义为剂量限制性毒性(DLT)。
单一剂量组所有受试者完成给药观察7天后，经判定，如没有出现>or＝50％的本方案定义的剂量限制性毒性(DLT)，则进入下一个剂量组的给药治疗，直至探索到MTD(最大耐受剂量)或符合终止研究标准为止。根据试验收集的数据，分析研究药物的药代动力学特征、安全性、耐受性以及药效学活性。其中药效学活性检测，将利用SARS-CoV-2假病毒中和实验方法测定受试者血液对新冠假病毒(关键突变体假病毒)的中和能力。利用携带荧光素酶报告系统的新冠假病毒侵染过表达ACE2的HEK293F细胞，通过检测荧光素酶的信号强度来定衡量其对病毒的阻断能力。
剂量组爬升进行100mg，300mg，1000mg及1500mg四组剂量递增，1500mg组后进行药物的安全性讨论决定是否继续爬坡。
受试者需分别在固定时间点留取PK血样以检测血清中药物的浓度，来研究药物药代动力学：研究药物给药前(predose)；研究药物给药结束时，给药结束后0.5h、2h、8h、12h、24h、36h、48h、72h、96h、第7天、9天、12天、15天、18天、22天、28天、42天、56天。同时在研究药物给药前(predose)，第7天、15天、28天、42天、56天进行ADA样本的采集；在研究药物给药前(predose)，给药结束后第12h、24h、48h、72h、96h、第7天、15天、28天、56天进行PD样本的采集。
在整个研究期间，研究者将对生命体征、体格检查、注射部位反应、心电图、临床实验室检查、不良事件进行安全性评估。同时进行免疫原性(ADA、ADA滴度和nAb)的评估。
给药频率及给药途径：单次给药，持续60分钟静脉输注方式给药。可对输液反应的安全性数据进行审查，以确定是否可将输注时间调整为30分钟。
药代动力学评价指标：本研究将采集受试者的血样来检测其血清中2F8-VH-VHH18的浓度，用于计算药代动力学参数。
药效动力学指标：本研究将采集受试者的血样来检测其血清对SARS-CoV-2假病毒(关键突变体病毒)的中和能力。
安全性评价指标：生命体征、体格检查、心电图参数、临床实验室检查(血常规、血生化、尿常规、凝血常规)、不良事件、注射部位反应。
免疫原性评价指标：抗药物抗体(ADA)阳性率、ADA滴度和ADA的中和活性。
实施例13抗体2F8-VH-VHH18临床I期试验结果
本研究是一项单中心、随机、双盲、安慰剂对照、剂量递增评价注射用抗体2F8-VH-VHH18在健康受试者中的药代动力学、安全性、耐受性、免疫原性及药效学 的临床试验。本研究的主要目的是评价抗体2F8-VH-VHH18在健康人中的安全性与耐受性。
每组计划入组8例健康受试者，其中6例使用研究药物，2例使用安慰剂，试验组别、剂量递增比例、人数等见表17所示。设4个固定剂量组，即100mg、300mg、1000mg和1500mg剂量组。剂量限制性毒性(DLT)观察期为给药后7天。每一剂量组首批将选2例受试者，含1例安慰剂受试者。完成该剂量组首两例观察后，可完成后继该组其余6例受试者的给药和观察。
表17抗体2F8-VH-VHH18临床I期剂量递增方案设计
安全性结果：
本次临床研究中所观察到的治疗期间突发不良事件(Treatment Emergent Adverse Event,TEAE)，严重程度均为1级和2级，未发生3级以上的TEAE，未发生严重不良事件、未发生导致停药或死亡的TEAE，未发生剂量限制性毒性(DLT)事件。从安全性角度看，在健康受试者中注射抗体2F8-VH-VHH18 100mg、300mg、1000mg和1500mg安全性和耐受性均较好。
药代动力学结果：
在爬坡剂量100～1500mg，受试者单次给药后，抗体2F8-VH-VHH18在体内吸收较快，详细的药代动力学结果见表18所示。
表18药代动力学结果
备注：除Tmax为Median(Min,Max)外，其他PK参数为Geomean(％CV)
药效学结果：
依据临床方案，在不同时间点获取受试者血清，检测抗体2F8-VH-VHH18对Omicron BA.1假病毒的中和能力(IC50)。药效学结果见表19，在爬坡剂量100～1500mg，抗体2F8-VH-VHH18抑制SARS-CoV-2假病毒的IC50值均值为16.850～20.510ng/mL，结果显示抗体2F8-VH-VHH18能有效中和SARS-CoV-2假病毒关键变异型毒株。
表19药效学结果
备注：IC50值用Mean(SD)表示。
综上，在健康受试者中注射抗体2F8-VH-VHH18 100mg、300mg、1000mg和1500mg的安全性和耐受性良好，且抗体2F8-VH-VHH18能有效中和SARS-CoV-2假病毒关键变异型毒株。

Claims (10)

  1. 一种用于预防、治疗或改善COVID-19的方法，其特征在于，所述方法包括：向有需要的患者给药10mg至2000mg的抗体或抗原结合片段；
    所述抗体为靶向冠状病毒的双特异抗体，其包含结合spike蛋白的第一结合部分以及结合spike蛋白的第二结合部分，其中
    所述第一结合部分包含如SEQ ID NO:1或2所示的HCDR1、如SEQ ID NO:3或4所示的HCDR2、如SEQ ID NO:5-42中任一项所示的HCDR3、如SEQ ID NO:43或44所示的LCDR1、如SEQ ID NO:45或46所示的LCDR2和如SEQ ID NO:47或48所示的LCDR3中的一个或多个；
    所述第一结合部分的C-末端或N-末端通过连接子L1与所述第二结合部分进行连接。
  2. 如权利要求1所述的方法，其特征在于，所述连接子L1为包含甘氨酸和丝氨酸的多肽；或者，所述连接子L1的序列为(GmS)n，其中每个m独立为2、3、4或5，n独立为1、2、3、4或5；或者，所述连接子L1的序列为(GGGGS)n，所述n独立为1、2、3、4或5。
  3. 如权利要求1或2所述的方法，其特征在于，所述第一结合部分包含如SEQ ID NO:1或2所示的HCDR1、如SEQ ID NO:3或4所示的HCDR2、如SEQ ID NO:5-42中任一项所示的HCDR3、如SEQ ID NO:43或44所示的LCDR1、如SEQ ID NO:45或46所示的LCDR2和如SEQ ID NO:47或48所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:6所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:9所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:15所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:16所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的 HCDR2、如SEQ ID NO:18所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:19所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:20所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:21所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:22所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:23所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:24所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:25所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:28所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:29所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:30所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:32所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:33所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:34所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:35所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:36所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:37所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:39所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:1所示的HCDR1、如SEQ ID NO:3所示的HCDR2、如SEQ ID NO:40所示的HCDR3、如SEQ ID NO:43所示的LCDR1、如SEQ ID NO:45所示的LCDR2和如SEQ ID NO:47所示的LCDR3；或
    所述第一结合部分包含如SEQ ID NO:2所示的HCDR1、如SEQ ID NO:4所示的HCDR2、如SEQ ID NO:42所示的HCDR3、如SEQ ID NO:44所示的LCDR1、如SEQ ID NO:46所示的LCDR2和如SEQ ID NO:48所示的LCDR3。
  4. 如权利要求1-3任一项所述的方法，其特征在于，所述第一结合部分包含重链可变区和轻链可变区，所述重链可变区包含SEQ ID NO:56、57、83-105任一项所示的序列，或与SEQ ID NO:56、57、83-105任一项所示序列具有至少80％同一性的序列，或与SEQ ID NO:56、57、83-105任一项所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
    所述轻链可变区包含SEQ ID NO:58或59所示的序列，或与SEQ ID NO:58或59所示序列具有至少80％同一性的序列，或与SEQ ID NO:58或59所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
  5. 如权利要求1-4任一项所述的方法，其特征在于，所述第二结合部分包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2和如SEQ ID NO:68所示 的HCDR3中的一个、二个或三个；或者，所述第二结合部分包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2和如SEQ ID NO:68所示的HCDR3；或者，所述第二结合部分为单域抗体或重链抗体；或者，所述第二结合部分包含如SEQ ID NO:69或79所示的序列。
  6. 如权利要求1-5任一项所述的方法，其特征在于，所述双特异抗体包含第一多肽和第二多肽；其中
    所述第一多肽包含如SEQ ID NO:72或77所示的序列，或与SEQ ID NO:72或77所示序列具有至少80％同一性的序列，或与SEQ ID NO:72或77所示序列相比具有一或多个保守氨基酸取代的氨基酸序列；和/或
    所述第二多肽包含如SEQ ID NO:74或78所示的序列，或与SEQ ID NO:74或78所示序列具有至少80％同一性的序列，或与SEQ ID NO:74或78所示序列相比具有一或多个保守氨基酸取代的氨基酸序列。
  7. 一种用于预防、治疗或改善COVID-19的方法，其特征在于，所述方法包括：向有需要的患者给药10mg至2000mg的抗体或抗原结合片段；
    所述抗体或抗原结合片段包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2和如SEQ ID NO:68所示的HCDR3中的一个、二个或三个；或者，所述抗体或抗原结合片段包含如SEQ ID NO:66所示的HCDR1、如SEQ ID NO:67所示的HCDR2和如SEQ ID NO:68所示的HCDR3；或者，所述抗体或抗原结合片段为单域抗体或重链抗体；或者，所述抗体或抗原结合片段包含如SEQ ID NO:69或79所示的序列。
  8. 如权利要求1-7任一项所述的方法，其特征在于，所述患者患有由新型冠状病毒引发的疾病；或者，所述患者为新型冠状病毒肺炎轻度型、中度型、重型或危重型感染者。
  9. 如权利要求1-8任一项所述的方法，其特征在于，所述抗体或抗原结合片段的给药量为1mg/kg至35mg/kg。
  10. 如权利要求1-9任一项所述的方法，其特征在于，所述给药的给药频率为单次给药；或者给药频率为每周给药2次、每周给药1次、每2周给药1次、每3周给药1次、每4周给药1次、每5周给药1次、每6周给药1次、每7周给药1次、每8周给药1次或每12周给药1次；或者，所述给药的给药方式为注射；或者，给药方式为静脉注射、皮下注射或肌肉注射；或者，给药方式为静脉输注。
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CN113637070A (zh) * 2020-04-27 2021-11-12 百奥泰生物制药股份有限公司 抗spike蛋白的抗体或抗原结合片段及其应用
CN113637083A (zh) * 2020-04-27 2021-11-12 百奥泰生物制药股份有限公司 用于治疗冠状病毒的融合蛋白及其应用
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CN116987184A (zh) * 2023-09-26 2023-11-03 北京百普赛斯生物科技股份有限公司 新型冠状病毒bq.1.1突变株特异性抗体及其应用
CN116987184B (zh) * 2023-09-26 2024-01-12 北京百普赛斯生物科技股份有限公司 新型冠状病毒bq.1.1突变株特异性抗体及其应用

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