Target-agnostic identification of human antibodies to Plasmodium falciparum sexual forms reveals cross stage recognition of glutamate-rich repeats

Reviewer #1 (Public Review):

Summary:

In this paper, the authors used target agnostic MBC sorting and activation methods to identify B cells and antibodies against sexual stages of Plasmodium falciparum. While they isolated some Mabs against PFs48/45 and PFs230, two well-known candidates for "transmission blocking" vaccines, these antibodies' efficacies, as measured by TRA, did not perform as well as other known antibodies. They also isolated one cross-reactive mAb to proteins containing glutamic acid-rich repetitive elements, that express at different stages of the parasite life cycle. They then determined the structure of the Fab with the highest protein binder they could determine through protein microarray, RESA, and observed homotypic interactions.

Strengths:

- Target agnostic B cell isolation (although not a novel methodology).
- New cross-reactive antibody and mechanism (homotypic interactions) as demonstrated by structural data and other biophysical data.

Weaknesses:

The paper lacks clarity at times and could benefit from more transparency (showing all the data) and explanations.
In particular:
-define SIFA
-define TRAbs
-it is not possible to read the Supplementary Figure 6B and C panels.

Reviewer #2 (Public Review):

This manuscript by Amen, Yoo, Fabra-Garcia et al describes a human monoclonal antibody B1E11K, targeting EENV repeats which are present in parasite antigens such as Pfs230, RESAs, and 11.1. The authors isolated B1E11K using an initial target agnostic approach for antibodies that would bind gamete/gametocyte lysate which they made 14 mAbs. Following a suite of highly appropriate characterization methods from Western blotting of recombinant proteins to native parasite material, use of knockout lines to validate specificity, ITC, peptide mapping, SEC-MALS, negative stain EM, and crystallography, the authors have built a compelling case that B1E11K does indeed bind EENV repeats. In addition, using X-ray crystallography they show that two B1E11K Fabs bind to a 16 aa RESA repeat in a head-to-head conformation using homotypic interactions and provide a separate example from CSP, of affinity-matured homotypic interactions.

There are some minor comments and considerations identified by this reviewer, These include that one of the main conclusions in the paper is the binding of B1E11K to RESAs which are blood stage antigens that are exported to the infected parasite surface. It would have been interesting if immunofluorescence assays with B1E11K mAb were performed with blood-stage parasites to understand its cellular localization in those stages.

Reviewer #3 (Public Review):

The manuscript from Amen et al reports the isolation and characterization of human antibodies that recognize proteins expressed at different sexual stages of Plasmodium falciparum. The isolation approach was antigen agnostic and based on the sorting, activation, and screening of memory B cells from a donor whose serum displays high transmission-reducing activity. From this effort, 14 antibodies were produced and further characterized. The antibodies displayed a range of transmission-reducing activities and recognized different Pf sexual stage proteins. However, none of these antibodies had higher TRA than previously described antibodies.

The authors then performed further characterization of antibody B1E11K, which was unique in that it recognized multiple proteins expressed during sexual and asexual stages. Using protein microarrays, B1E11K was shown to recognize glutamate-rich repeats, following an EE-XX-EE pattern. An impressive set of biophysical experiments was performed to extensively characterize the interactions of B1E11K with various repeat motifs and lengths. Ultimately, the authors succeeded in determining a 2.6 A resolution crystal structure of B1E11K bound to a 16AA repeat-containing peptide. Excitingly, the structure revealed that two Fabs bound simultaneously to the peptide and made homotypic antibody-antibody contacts. This had only previously been observed with antibodies directed against CSP repeats.

Overall I found the manuscript to be very well written, although there are some sections that are heavy on field-specific jargon and abbreviations that make reading unnecessarily difficult. For instance, 'SIFA' is never defined. Strengths of the manuscript include the target-agnostic screening approach and the thorough characterization of antibodies. The demonstration that B1E11K is cross-reactive to multiple proteins containing glutamate-rich repeats, and that the antibody recognizes the repeats via homotypic interactions, similar to what has been observed for CSP repeat-directed antibodies, should be of interest to many in the field.