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ALX-0171 is about 6,000 to 10,000 times more potent than Nb017 in neutralization tests with strains of hRSV antigenic groups A and B. To explore the effect of this enhanced neutralization on escape mutant selection, viruses resistant to either ALX-0171 or Nb017 were isolated after serial passage of the hRSV Long strain in the presence of suboptimal concentrations of the respective Nanobodies. Resistant viruses emerged notably faster with Nb017 than with ALX-0171 and in both cases contained amino acid changes in antigenic site II of hRSV F. Detailed binding and neutralization analyses of these escape mutants as well as previously described mutants resistant to certain monoclonal antibodies (MAbs) offered a comprehensive description of site II mutations which are relevant for neutralization by MAbs and Nanobodies. Notably, ALX-0171 showed a sizeable neutralization potency with most escape mutants, even with some of those selected with the Nanobody, and these findings make ALX-0171 an attractive antiviral for treatment of hRSV infections.<\/jats:p>","DOI":"10.1128\/aac.00842-16","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T02:18:28Z","timestamp":1471918708000},"page":"6498-6509","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":36,"title":["Trivalency of a Nanobody Specific for the Human Respiratory Syncytial Virus Fusion Glycoprotein Drastically Enhances Virus Neutralization and Impacts Escape Mutant Selection"],"prefix":"10.1128","volume":"60","author":[{"given":"Concepci\u00f3n","family":"Palomo","sequence":"first","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda and CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Mas","sequence":"additional","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda and CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Detalle","sequence":"additional","affiliation":[{"name":"Ablynx NV, Zwijnaarde, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Depla","sequence":"additional","affiliation":[{"name":"Ablynx NV, Zwijnaarde, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Cano","sequence":"additional","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda and CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda and CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catelijne","family":"Stortelers","sequence":"additional","affiliation":[{"name":"Ablynx NV, Zwijnaarde, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Melero","sequence":"additional","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda and CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804877"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60206-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/174.3.456"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043951"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198607103150201"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-016-2880-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1099\/0022-1317-68-9-2521"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.47.1.171-177.1983"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.virusres.2011.09.020"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1006\/viro.1993.1561"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0503989102"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.65.3.1634-1637.1991"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.61.12.3855-3861.1987"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/155.6.1198"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199308000-00013"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0168-1702(85)90045-0"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/163.4.693"},{"key":"e_1_3_2_19_2","first-page":"543","article-title":"Risk of primary infection and reinfection with respiratory syncytial virus","volume":"140","author":"Glezen WP","year":"1986","unstructured":"Glezen WP, Taber LH, Frank AL, Kasel JA. 1986. 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