Structure basis for distinct protective mechanisms of IGHV3-23 antibodies targeting influenza hemagglutinin stem

Characterization of antibodies targeting the conserved stem domain of influenza hemagglutinin (HA) is critical for developing broadly protective countermeasures against influenza virus. From a phage display human antibody library, this study discovers three group 1 HA-specific stem antibodies, namely HB31, HB34, and HB315, all of which are encoded by IGHV3-23. While HB31 and HB34 have minimal neutralization activity in vitro , their Fc-mediated effector functions lead to better in vivo protection than the potently neutralizing HB315. Consistently, cryo-EM analysis suggests that HB31 and HB34 have a higher Fc accessibility than HB315, based on their epitopes and approaching angles. HB31 and HB34 engage a pocket in the upper HA stem that is rarely targeted by known HA stem antibodies, whereas the epitope of HB315 involves the lower stem. Overall, our findings provide insights not only into the structure-function relationship of HA stem antibodies, but also into the design of next-generation influenza therapeutics.