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The SARS-CoV-2 spike protein receptor-binding domain (RBD) conserved non-receptor-binding motif (non-RBM) epitope is a highly stable antigenic region on the viral spike protein that is distinct from the ACE2-interacting surface [1]. While the receptor-binding motif (RBM) is subject to intense selective pressure and frequent mutation, these non-RBM epitopes are often conserved across the Sarbecovirus subgenus due to structural or functional constraints [2][3]. These sites are typically targeted by Class 3 and Class 4 neutralizing antibodies, which bind to the side or inner faces of the RBD, respectively [2]. Therapeutic monoclonal antibodies, such as Sotrovimab, target these conserved regions to maintain neutralizing activity against variants of concern that have evolved to escape RBM-targeting antibodies [4]. The primary mechanism of action involves sterically hindering the conformational changes required for viral-host membrane fusion or facilitating the clearance of infected cells through Fc-mediated effector functions [4]. As such, these epitopes are primary targets for the development of broadly neutralizing therapeutics and next-generation vaccines aimed at providing variant-proof immunity [5]. Clinical monitoring of mutations within these epitopes is essential to ensure the continued efficacy of monoclonal antibody therapies.
Neutralization of viral entry by sterically hindering conformational changes of the spike protein or blocking membrane fusion, often maintaining activity across variants due to epitope conservation [1][4].
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