RT Journal Article SR Electronic T1 Highly potent anti-SARS-CoV-2 multi-DARPin therapeutic candidates JF bioRxiv FD Cold Spring Harbor Laboratory SP 2020.08.25.256339 DO 10.1101/2020.08.25.256339 A1 Marcel Walser A1 Sylvia Rothenberger A1 Daniel L. Hurdiss A1 Anja Schlegel A1 Valérie Calabro A1 Simon Fontaine A1 Denis Villemagne A1 Maria Paladino A1 Tanja Hospodarsch A1 Alexandra Neculcea A1 Andreas Cornelius A1 Patricia Schildknecht A1 Mirela Matzner A1 Martin Hänggi A1 Marco Franchini A1 Yvonne Kaufmann A1 Iris Schlegel A1 Chloe Iss A1 Thamar Loser A1 Susanne Mangold A1 Christel Herzog A1 Dieter Schiegg A1 Christian Reichen A1 Filip Radom A1 Andreas Bosshart A1 Andreas Lehmann A1 Micha A. Haeuptle A1 Alexander Zürcher A1 Toni Vagt A1 Gabriel Sigrist A1 Marcel Straumann A1 Karl Proba A1 Niina Veitonmäki A1 Keith M. Dawson A1 Christof Zitt A1 Jennifer Mayor A1 Sarah Ryter A1 Heyrhyoung Lyoo A1 Chunyan Wang A1 Wentao Li A1 Ieva Drulyte A1 H. Kaspar Binz A1 Leon de Waal A1 Koert J. Stittelaar A1 Seth Lewis A1 Daniel Steiner A1 Frank J.M. van Kuppeveld A1 Olivier Engler A1 Berend-Jan Bosch A1 Michael T. Stumpp A1 Patrick Amstutz YR 2020 UL http://biorxiv.org/content/early/2020/08/26/2020.08.25.256339.abstract AB Globally accessible preventive and therapeutic molecules against SARS-CoV-2 are urgently needed. DARPin molecules are an emerging class of novel therapeutics based on naturally occurring repeat proteins (∼15 kDa in size) and can be rapidly produced in bacteria in large quantities. Here, we report the identification of 380 DARPin molecules specifically targeting the SARS-CoV-2 spike protein selected from a naïve library of 1012 DARPin molecules. Using extensive biophysical and biochemical characterization, (pseudo)virus neutralization assays and cryo-EM analysis, 11 mono-DARPin molecules targeting either the receptor binding domain (RBD), the S1 N-terminal-domain (NTD) or the S2 domain of the SARS-CoV-2 spike protein were chosen. Based on these 11 mono-DARPin molecules, 31 anti-SARS-CoV-2 multi-DARPin molecules were constructed which can broadly be grouped into 2 types; multi-paratopic RBD-neutralizing DARPin molecules and multi-mode DARPin molecules targeting simultaneously RBD, NTD and the S2 domain. Each of these multi-DARPin molecules acts by binding with 3 DARPin modules to the SARS-CoV-2 spike protein, leading to potent inhibition of SARS-CoV-2 infection down to 1 ng/ml (12 pM) and potentially providing protection against viral escape mutations. Additionally, 2 DARPin modules binding serum albumin, conferring an expected half-life of about 3 weeks in humans, were included in the multi-DARPin molecules. The protective efficacy of one multi-DARPin molecule was studied in a Golden Syrian hamster SARS-CoV-2 infection model, resulting in a significant reduction in viral load and pathogenesis. In conclusion, the multi-DARPin molecules reported here display very high antiviral potency, high-production yield, and a long systemic half-life, and thereby have the potential for single-dose use for prevention and treatment of COVID-19.Competing Interest StatementMolecular Partners authors own performance share units and/or stock of the company. HKB owns stock of the company.