Prophylactic efficacy of an intranasal spray with 2 synergetic antibodies neutralizing Omicron
Xinghai Zhang, Feiyang Luo, Huajun Zhang, Hangtian Guo, Junhui Zhou, Tingting Li, Shaohong Chen, Shuyi Song, Meiying Shen, Yan Wu, Yan Gao, Xiaojian Han, Yingming Wang, Chao Hu, Xiaodong Zhao, Huilin Guo, Dazhi Zhang, Yuchi Lu, Wei Wang, Kai Wang, Ni Tang, Tengchuan Jin, Menglu Ding, Shuhui Luo, Cuicui Lin, Tingting Lu, Bingxia Lu, Yang Tian, Chengyong Yang, Guofeng Cheng, Haitao Yang, Aishun Jin, Xiaoyun Ji, Rui Gong, Sandra Chiu, Ailong Huang
Xinghai Zhang, Feiyang Luo, Huajun Zhang, Hangtian Guo, Junhui Zhou, Tingting Li, Shaohong Chen, Shuyi Song, Meiying Shen, Yan Wu, Yan Gao, Xiaojian Han, Yingming Wang, Chao Hu, Xiaodong Zhao, Huilin Guo, Dazhi Zhang, Yuchi Lu, Wei Wang, Kai Wang, Ni Tang, Tengchuan Jin, Menglu Ding, Shuhui Luo, Cuicui Lin, Tingting Lu, Bingxia Lu, Yang Tian, Chengyong Yang, Guofeng Cheng, Haitao Yang, Aishun Jin, Xiaoyun Ji, Rui Gong, Sandra Chiu, Ailong Huang
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Clinical Research and Public Health COVID-19 Immunology

Prophylactic efficacy of an intranasal spray with 2 synergetic antibodies neutralizing Omicron

Abstract

BACKGROUND As Omicron is prompted to replicate in the upper airway, neutralizing antibodies (NAbs) delivered through inhalation might inhibit early-stage infection in the respiratory tract. Thus, elucidating the prophylactic efficacy of NAbs via nasal spray addresses an important clinical need.METHODS The applicable potential of a nasal spray cocktail containing 2 NAbs was characterized by testing its neutralizing potency, synergetic neutralizing mechanism, emergency protective and therapeutic efficacy in a hamster model, and pharmacokinetics/pharmacodynamic (PK/PD) in human nasal cavity.RESULTS The 2 NAbs displayed broad neutralizing efficacy against Omicron, and they could structurally compensate each other in blocking the Spike-ACE2 interaction. When administrated through the intranasal mucosal route, this cocktail demonstrated profound efficacy in the emergency prevention in hamsters challenged with authentic Omicron BA.1. The investigator-initiated trial in healthy volunteers confirmed the safety and the PK/PD of the NAb cocktail delivered via nasal spray. Nasal samples from the participants receiving 4 administrations over a course of 16 hours demonstrated potent neutralization against Omicron BA.5 in an ex vivo pseudovirus neutralization assay.CONCLUSION These results demonstrate that the NAb cocktail nasal spray provides a good basis for clinical prophylactic efficacy against Omicron infections.TRIAL REGISTRATION www.chictr.org.cn, ChiCTR2200066525.FUNDING The National Science and Technology Major Project (2017ZX10202203), the National Key Research and Development Program of China (2018YFA0507100), Guangzhou National Laboratory (SRPG22-015), Lingang Laboratory (LG202101-01-07), Science and Technology Commission of Shanghai Municipality (YDZX20213100001556), and the Emergency Project from the Science & Technology Commission of Chongqing (cstc2021jscx-fyzxX0001).

Authors

Xinghai Zhang, Feiyang Luo, Huajun Zhang, Hangtian Guo, Junhui Zhou, Tingting Li, Shaohong Chen, Shuyi Song, Meiying Shen, Yan Wu, Yan Gao, Xiaojian Han, Yingming Wang, Chao Hu, Xiaodong Zhao, Huilin Guo, Dazhi Zhang, Yuchi Lu, Wei Wang, Kai Wang, Ni Tang, Tengchuan Jin, Menglu Ding, Shuhui Luo, Cuicui Lin, Tingting Lu, Bingxia Lu, Yang Tian, Chengyong Yang, Guofeng Cheng, Haitao Yang, Aishun Jin, Xiaoyun Ji, Rui Gong, Sandra Chiu, Ailong Huang

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Figure 7

Nasal samples from Cohort 1a and 1d demonstrated over 90% neutralization potency on pseudotyped Omicron BA.5.

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Nasal samples from Cohort 1a and 1d demonstrated over 90% neutralization...
Nasal swabs samples taken 4 hours after the first dosing in Cohort 1a (n = 5), together with samples taken 8 (n = 5) and 24 (n = 10) hours after the last dosing in Cohort 1d, were subjected to a pseudovirus neutralization assay against BA.5. Baseline samples were taken 24 hours prior to the first dosing in Cohort 1d (n = 10). The final neutralization activities in the original nasal samples were calculated by fitting a standard dose response curve. Data are presented in a box-and-whiskers plot with maximal and minimal data points (whiskers) and median (line). Dashed lines indicate IC90 of the pseudoviral neutralization assay of BA.5.