Dual blockages of a broad and potent neutralizing IgM antibody targeting GH Loop of EV-As.

The reported EVA71 vaccines and immunoglobin G (IgG) antibodies have no cross-antiviral efficacy against other enterovirus A(EV-A) which caused hand, foot and mouth disease (HFMD). Here we constructed an IgM antibody (20-IgM) based on our previous discovery to address the resistance encountered by IgG-based immunotherapy. Although binding to the same conserved neutralizing epitope within the GH loop of EV-As VP1, the antiviral breath and potency of 20-IgM are still higher than its parental 20-IgG1. 20-IgM blocks the interaction between the EV-As and its receptors, scavenger receptor class B, member 2(SCARB2) and Kringle-containing transmembrane protein 1(KREMEN1) of the host cell. 20-IgM also neutralizes the EV-As at the post-attachment stages, including postattachment neutralization, uncoating and RNA release inhibition after internalization. Mechanistically, the dual blockage effect of 20-IgM is dependent on both a conserved site targeting and high affinity binding. Meanwhile, 20-IgM provides cross-antiviral efficacy in EV-As orally infected neonatal ICR mice. Collectively, 20-IgM and its property exhibit excellent antiviral activity with a dual-blockage inhibitory effect at both the pre- and post-attachment stages. The finding enhances our understanding of IgM-mediated immunity and highlights the potential of IgM subtype antibodies against enterovirus infections. This article is protected by copyright. All rights reserved.