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A foldon-free prefusion F trimer vaccine for respiratory syncytial virus to reduce off-target immune responses

  • Mark J. G. Bakkers,
  • Freek Cox,
  • Annemart Koornneef,
  • Xiaodi Yu,
  • Daan van Overveld,
  • Lam Le,
  • Ward van den Hoogen,
  • Joost Vaneman,
  • Anne Thoma,
  • Richard Voorzaat,
  • Lisanne Tettero,
  • Jarek Juraszek,
  • Leslie van der Fits,
  • Roland Zahn,
  • Johannes P. M. Langedijk

摘要

Respiratory syncytial virus (RSV) is a major cause of severe respiratory disease in infants and older people. Current RSV subunit vaccines are based on a fusion protein that is stabilized in the prefusion conformation and linked to a heterologous foldon trimerization domain to obtain a prefusion F (preF) trimer. Here we show that current RSV vaccines induce undesirable anti-foldon antibodies in non-human primates, mice and humans. To overcome this, we designed a foldon-free RSV preF trimer by elucidating the structural basis of trimerization-induced preF destabilization through molecular dynamics simulations and by introducing amino acid substitutions that negate hotspots of charge repulsion. The highly stable prefusion conformation was validated using antigenic and cryo-electron microscopy analysis. The preF is immunogenic and protective in naive mouse models and boosts neutralizing antibody titres in RSV-pre-exposed mice and non-human primates, while achieving similar titres to approved RSV vaccines in mice. This stable preF design is a promising option as a foldon-independent candidate for a next-generation RSV vaccine immunogen.