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AU2011218689C1 - Binding molecules capable of neutralizing rabies virus and uses thereof - Google Patents

Binding molecules capable of neutralizing rabies virus and uses thereof Download PDF

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AU2011218689C1
AU2011218689C1 AU2011218689A AU2011218689A AU2011218689C1 AU 2011218689 C1 AU2011218689 C1 AU 2011218689C1 AU 2011218689 A AU2011218689 A AU 2011218689A AU 2011218689 A AU2011218689 A AU 2011218689A AU 2011218689 C1 AU2011218689 C1 AU 2011218689C1
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rabies virus
binding
amino acid
binding molecules
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Alexander Berthold Hendrik Bakker
Cornelis Adriaan De Kruif
Robert Arjen Kramer
Willem Egbert Marissen
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Janssen Vaccines and Prevention BV
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Crucell Holand BV
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Abstract

Documen&2-30AM/201l The present invention provides binding molecules that 10 specifically bind to rabies virus and are capable of neutralizing the virus. The invention further provides nucleic acid molecules encoding the binding molecules, compositions comprising the binding molecules and methods of identifying or producing the binding molecules. The binding 15 molecules can be used in the diagnosis, prophylaxis and/or treatment of a condition resulting from rabies virus. Preferably, they can be used in the postexposure prophylaxis of rabies.

Description

Australian Patents Act 1990 - Regulation 3.2 ORIGINAL COMPLETE SPECIFICATION STANDARD PATENT Invention Title "Binding molecules capable of neutralizing rabies virus and uses thereof' The following statement is a full description of this invention, including the best method of performing it known to us: C:\NRPorbl\DCC\AMCU844291 I.DOC TITLE OF THE INVENTION Binding molecules capable of neutralizing rabies virus and uses thereof This application is a divisional of Australian Patent Application No. 2005250163, the entire contents of which is incorporated herein by reference. 5 FIELD OF THE INVENTION The invention relates to medicine. In particular the invention relates to rabies virus neutralizing binding molecules. The binding molecules are useful in the postexposure prophylaxis of rabies. 10 BACKGROUND OF THE INVENTION Rabies is a viral infection with nearly worldwide distribution that affects principally wild and domestic animals but also involves humans, resulting in a devastating, is almost invariable fatal encephalitis. Annually, more than 70,000 human fatalities are estimated, and millions of others require postexposure treatment. The rabies virus is a bullet-shaped, enveloped, single stranded RNA virus classified in the rhabdovirus family and 20 Lyssavirus genus. The genome of rabies virus codes for five viral proteins: RNA-dependent RNA polymerase (L); a nucleoprotein (N); a phosphorylated protein (P); a matrix protein (M) located on the inner side of the viral protein envelope; and an external surface glycoprotein (G) . 25 The G protein (62-67 kDa) is a type-I glycoprotein composed of 505 amino acids that has two to four potential N glycosylation sites, of which only one or two are glycosylated depending on the virus strains. The G protein forms the protrusions that cover the outer surface of the virion 30 envelope and is known to induce virus-neutralizing antibodies. Rabies can be treated or prevented by both passive and active immunizations. Rabies postexposure prophylaxis includes 2 prompt local wound care and administration of both passive (anti-rabies immunoglobulins) and active (vaccines) immunizations. Currently, the anti-rabies immunoglobulins (RIG) are 5 prepared from the serum samples of either rabies virus-immune humans (HRIG) or rabies virus-immune horses (ERIG). A disadvantage of ERIG as well as BRIG is that they are not available in sufficient amounts and, in case of HRIG, are too expensive. In addition, the use of ERIG might lead to adverse 10 reactions such as anaphylactic shock. The possibility of contamination by known or unknown pathogens is an additional concern associated with HRIG. To overcome these disadvantages it has been suggested to use monoclonal antibodies capable of neutralizing rabies virus in postexposure prophylaxis: Rabies 15 virus neutralizing murine monoclonal antibodies are known in the art (see Schumacher et al., 1989). However, the use of murine antibodies in vivo is limited due to problems associated with administration of-murine antibodies to humans, such as short serum half life, an inability to trigger certain 20 human effector functions and elicitation of an unwanted dramatic immune response against the murine antibody in a human (the "human anti-mouse antibody" (HAMA) reaction). Recently, human rabies virus-neutralizing monoclonal antibodies have been described (see Dietzschold et al., 1990, 25 Champion et al., 2000, and Hanlon et al., 2001). For human anti-rabies monoclonal antibodies to be as effective as HRIG in postexposure prophylaxis a mixture of monoclonal antibodies should be used. In such a mixture each antibody should bind to a different epitope or site on the virus to prevent the escape 30 of resistant variants of the virus. Currently, there is still a significant need for new human rabies virus-neutralizing monoclonal antibodies having 3 improved postexposure prophylactic potential, particularly antibodies having different epitope-recognition specificities. The present invention provides such human monoclonal antibodies that offer the potential to be used in mixtures 5 useful in the postexposure prophylaxis of a wide range of rabies viruses and neutralization-resistant variants thereof. DESCRIPTION OF THE FIGURES Figure 1 shows the comparison of the amino acid sequences of 10 the rabies virus strain CVS-11 and E57 escape viruses. Virus infected cells were harvested 2 days post-infection and total RNA was isolated. cDNA was generated and used for DNA sequencing. Regions containing mutations are shown and the mutations are indicated in bold. Figure 1A shows the 15 comparison of the nucleotide sequences. Numbers above amino acids indicate amino acids numbers from rabies virus glycoprotein including signal peptide. Figure 1B shows the comparison 'of- amino acid sequences. Schematic drawing of rabies virus glycoprotein is shown on top. The black box 20 indicates the signal peptide, while the gray box indicates the transmembrane domain. The sequences in Figure 1 are also represented by SEQ ID Nos:130-141. Figure 2 shows the comparison of the amino acid sequences of 25 the rabies virus strain CVS-11 and EJB escape viruses. Virus infected cells were harvested 2 days post-infection and total RNA was isolated. cDNA was generated and used for DNA sequencing. Regions containing mutations are shown and the mutations are indicated in bold. Figure 2A shows the 30 comparison of the nucleotide sequences. Numbers above amino acids indicate amino acid numbers from rabies virus glycoprotein including the signal peptide. Figure 2B shows the 4 comparison of amino acid sequences. Schematic drawing of rabies virus glycoprotein is shown on top. The black box indicates the signal peptide, while the gray box indicates the transmembrane domain. The sequences in Figure 2 are also 5 represented by SEQ ID Nos:142-151. Figure 3 shows the vector PDV-C06. Figure 4 shows a competition ELISA of anti-rabies virus scFvs 10 and the biotinylated anti-rabies virus antibody called CR-57. ELISA plates coated with purified rabies virus G protein were incubated with the respective scFvs before addition of CR 57bio (0.5 pg/ml). Subsequently, CR-57bio binding was monitored in absence and presence of scFvs. 15 Figure 5 shows a competition ELISA of anti-rabies virus scFvs and the anti-rabies virus antibody called CR-57. ELISA plates coated with purified rabies virus G protein were incubated with CR-57 (1 pg/ml) before addition of excess scFvs. 20 Subsequently, scFv binding was monitored in absence and presence of CR-57. Figure 6 shows a competition ELISA assay of anti-rabies virus G protein IgGs and the anti-rabies virus antibody called aR 25 57. G protein (ERA strain) was incubated with unlabeled IgGs (shown on the X-axis). Biotinylated CR57 (CR57bio) was added and allowed to bind to the G protein before visualization by means of streptavidin-HRP. ELISA signals are shown as percentage of CR57bio binding alone. 30 Figure 7 shows a competition FACS assay of anti-rabies virus G protein IgGs and the anti-rabies virus antibody called CR-57.
5 G protein (ERA strain) expressing PER.C6 cells were incubated with unlabeled IgGs (shown on the X-axis). Biotinylated CR57 (CR57bio) was added and allowed to bind to the G protein expressing cells before visualization by means of 5 streptavidin-PE. FACS signals are shown as percentage of CR57bio binding alone. Figure 8 shows the comparison of the amino acid sequences of CVS-11 and E98 escape viruses. Virus-infected cells were 10 harvested 2 days post-infection and total RNA was isolated. cDNA was generated and used for DNA sequencing. Region containing a point mutation is shown and the mutation is indicated in bold. Figure 8A shows the comparison of the nucleotide sequences. The number above the nucleotide 15 indicates the mutated nucleotide (indicated in bold) from rabies virus glycoprotein open reading frame without signal peptide sequence. Figure 8B shows the comparison of amino acid sequences. The number above the amino acid indicates the mutated amino acid (indicated in bold) from rabies virus 20 glycoprotein without signal peptide sequence. Figure 9 shows a phylogenetic tree of 123 rabies street viruses (123 rabies virus G glycoprotein sequences, Neighbor joining, Kimura-2-parameter method, 500 bootstraps). 25 Bold indicates viruses harboring the N>D mutation as observed in E98 escape viruses. Figure 10 shows neutralizing epitopes on rabies glycoprotein. A schematic drawing of the rabies virus glycoprotein is shown 30 depicting the antigenic sites including the novel CR57 epitope. The signal peptide (19 amino acids) and transmembrane domain are indicated by black boxes. Disulfide bridges are 6 indicated. Amino acid numbering is from the mature protein minus the signal peptide sequence. 5 DESCRIPTION OF THE INVENTION Herebelow follow definitions of teams as used in the invention. DEFINITIONS 10 Binding molecule As used herein the term "binding molecule" refers to an intact immunoglobulin including monoclonal antibodies, such as chimeric, humanized or human monoclonal antibodies, or to an antigen-binding and/or variable domain comprising fragment of 15 an immunoglobulin that competes with the intact immunoglobulin for specific binding to the binding partner of the immunoglobulin, e.g. rabies virus or a fragment thereof such as for instance the G protein. Regardless of structure, the antigen-binding fragment binds with the same antigen that is 20 recognised by the intact immunoglobulin. An antigen-binding fragment can comprise a peptide or polypeptide comprising an amino acid sequence of at least 2 contiguous amino acid residues, at least 5 contiguous amino acid residues, at least 10 contiguous amino acid residues, at least 15 contiguous 25 amino acid residues, at least 20 contiguous amino acid residues, at least 25 contiguous amino acid residues, at least 30 contiguous amino acid residues, at least 35 contiguous amino acid residues, at least 40 contiguous amino acid residues, at least 50 contiguous amino acid residues, at least 30 60 contiguous amino residues, at least 70 contiguous amino acid residues, at least contiguous 80 amino acid residues, at least contiguous 90 amino acid residues, at least contiguous 7 100 amino acid residues, at least contiguous 125 amino acid residues, at least 150 contiguous amino acid residues, at least contiguous 175 amino acid residues, at least 200 contiguous amino acid residues, or at least contiguous 250 5 amino acid residues of the amino acid sequence of the binding molecule. The term "binding molecule", as used herein includes all immunoglobulin classes and subclasses known in the art. Depending on the amino acid sequence of the constant domain of 10 their heavy chains, binding molecules can be divided into the five major classes of intact antibodies: IgA, IgD, IgE, IgG, and IgM, and several of these may be further divided into subclasses (isotypes), e.g., IgAl, IgA2, IgG1, IgG2, IgG3 and IgG4. 15 Antigen-binding fragments include, inter alia, Fab, F(ab'), F(ab')2, Fv, dAb, Fd, complementarity determining region (CDR) fragments, single-chain antibodies (scFv), bivalent single-chain antibodies, single-chain phage antibodies, diabodies, triabodies, tetrabodies, (poly)peptides 20 that contain at least a fragment of an immunoglobulin that is sufficient to confer specific antigen binding to the (poly)peptide, etc. The above fragments may be produced synthetically or by enzymatic or chemical cleavage of intact immunoglobulins or they may be genetically engineered by 25 recombinant DNA techniques. The methods of production are well known in the art and are described, for example, in Antibodies: A Laboratory Manual, Edited by: E. Harlow and D, Lane (1988), Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, which is incorporated herein by reference. A 30 binding molecule or antigen-binding fragment thereof may have one or more binding sites. If there is more than one binding 8 site, the binding sites may be identical to one another or they may be different. The binding molecule can be a naked or unconjugated binding molecule but can also be part of an immunoconjugate. A 5 naked or unconjugated binding molecule is intended to refer to a binding molecule that is not conjugated, operatively linked or otherwise physically or functionally associated with an effector moiety or tag, such as inter alia a toxic substance, a radioactive substance, a liposome, an enzyme. It will be 10 understood that naked or unconjugated binding molecules do not exclude binding molecules that have been stabilized, multimerized, humanized or in any other way manipulated, other than by the attachment of an effector moiety or tag. Accordingly, all post-translationally modified naked and 15 unconjugated binding molecules are included herewith, including where the.modifications are made in the natural binding molecule-producing cell environment, by a recombinant binding molecule-producing cell, and are introducedby the hand of man after initial binding molecule preparation. Of 20 course, the term naked or unconjugated binding molecule does not exclude the ability of the binding molecule to form functional associations with effector cells and/or molecules after administration to the body, as some of such interactions are necessary in order to exert a biological effect. The lack 25 of associated effector group or tag is therefore applied in definition to the naked or unconjugated binding molecule In vitro, not in vivo. Complementarity determining regions (CDR) 30 The term "complementarity determining regions" as used herein means sequences within the variable regions of binding molecules, such as immunoglobulins, that usually contribute to 9 a large extent to the antigen binding site which is complementary in shape and charge distribution to the epitope recognized on the antigen. The CDR regions can be specific for linear epitopes, discontinuous epitopes, or conformational 5 epitopes of proteins or protein fragments, either as present on the protein in its native conformation or, in some cases, as present on the proteins as denatured, e.g., by solubilization in SDS. Epitopes may also consist of posttranslational modifications of proteins. 10 Functional variant The term 'functional variant", as used herein, refers to a binding molecule that comprises a nucleotide and/or amino acid sequence that is altered by one or more nucleotides and/or 15 amino acids compared to the nucleotide and/or amino acid sequences of the parent binding molecule and that is -still capable of competing for binding to the binding partner, e.g. rabies virus or a fragment thereof, with the parent binding molecule. In other words, the modifications in the amino acid 20 and/or nucleotide sequence of the parent binding molecule do not significantly affect or alter the binding characteristics of the binding molecule encoded by the nucleotide sequence pr containing the amino acid sequence, i.e. the binding molecule is still able to recognize and bind its target. The functional 25 variant may have conservative sequence modifications including nucleotide and amino acid substitutions, additions and deletions. These modifications can be introduced by standard techniques known in the art, such as site-directed mutagenesis and random PCR-mediated mutagenesis, and may comprise natural 30 as well as non-natural nucleotides and amino acids. Conservative amino acid substitutions include the ones in which the amino acid residue is replaced with an amino acid 10 residue having similar structural or chemical properties. Families of amino acid residues having similar side chains have been defined in the art. These families include amino acids with basic side chains (e.g., lysine, arginine, 5 histidine), acidic side chains (e.g., aspartic acid, glutamic acid), uncharged polar side chains (e.g., asparagine, glutamine, serine, threonine, tyrosine, cysteine, tryptophan), nonpolar side chains (e.g., glycine, alanine, valine, leucine, isoleucine, proline, phenylalanine, methionine), beta-branched 10 side chains (e.g., threonine, valine, isoleucine) and aromatic side chains (e.g., tyrosine, phenylalanine, tryptophan). It will be clear to the skilled artisan that other classifications of amino acid residue families than the one used above can also be employed. Furthermore, a variant may 15 have non-conservative amino acid substitutions, e.g., replacement of an amino acid with an amino acid residue having different structural or chemical properties. Similar minor variations,.may also include amino acid deletions or , insertions, or both. Guidance in determining which amino acid 20 residues may be substituted, inserted, or deleted without abolishing immunological activity may be found using computer programs well known in the art. A mutation in a nucleotide sequence can be a single alteration made at a locus (a point mutation), such as 25 transition or transversion mutations, or alternatively, multiple nucleotides may be inserted, deleted or changed at a single locus. In addition, one or more alterations may be made at any number of loci within a nucleotide sequence. The mutations may be performed by any suitable method known in the 30 art. Host 11 The term "host", as used herein, is intended to refer to an organism or a cell into which a vector such as a cloning vector or an expression vector has been introduced. The organism or cell can be prokaryotic or eukaryotic. It should 5 be understood that this term is intended to refer not only to the particular subject organism or cell, but to the progeny of such an organism or cell as well. Because certain modifications may occur in succeeding generations due to either mutation or environmental influences, such progeny may 10 not, in fact, be identical to the parent organism or cell, but are still included within the scope of the term "host" as used herein. Human 15 The term "human", when applied to binding molecules as defined herein, refers to molecules that are either directly derived from a human or based upon a human sequence. When a binding molecule is derived from or based on a human sequence and subsequently modified, it is still to be considered human as 20 used throughout the specification. In other words, the term human, when applied to binding molecules is intended to include binding molecules having variable and constant regions derived from human germline immunoglobulin sequences based on variable or constant regions either or not occurring in a 25 human or human lymphocyte or in modified form. Thus, the human binding molecules may include amino acid residues not encoded by human germline immunoglobulin sequences, comprise substitutions and/or deletions (e.g., mutations introduced by for instance random or site-specific mutagenesis in vitro or 30 by somatic mutation in vivo). "Based on" as used herein refers to the situation that a nucleic acid sequence may be exactly copied from a template, or with minor mutations, such as by 12 error-prone PCR methods, or synthetically made matching the template exactly or with minor modifications. Semisynthetic molecules based on human sequences are also considered to be human as used herein. 5 Monoclonal antibody The term "monoclonal antibody" as used herein refers to a preparation of antibody molecules of single molecular composition, i.e. primary structure, i.e. having a single 10 amino acid sequence. A monoclonal antibody displays a single binding specificity and affinity for a particular epitope. Accordingly, the term "human monoclonal antibody" refers to an antibody displaying a single binding specificity which have variable and constant regions derived from or based on human 15 germline immunoglobulin sequences or derived from completely synthetic sequences. The method of preparing the monoclonal antibody is not relevant. Nucleic acid molecule 20 The term "nucleic acid molecule" as used in the present invention refers to a polymeric form of nucleotides and includes both sense and antisense strands of RNA, cDNA, genomic DNA, and synthetic forms and mixed polymers of the above. A nucleotide refers to a ribonucleotide, 25 deoxynucleotide or a modified form of either type of nucleotide.. The term also includes single- and double-stranded forms of DNA. In addition, a polynucleotide may include either or both naturally-occurring and modified nucleotides linked together by naturally-occurring and/or non-naturally occurring 30 nucleotide linkages. The nucleic acid molecules may be modified chemically or biochemically or may contain non natural or derivatized nucleotide bases, as will be readily 13 appreciated by those of skill in the art. Such modifications include, for example, labels, methylation, substitution of one or more of the naturally occurring nucleotides with an analog, internucleotide modifications such as uncharged linkages 5 (e.g., methyl phosphonates, phosphotriesters, phosphoramidates, carbamates, etc.), charged linkages (e.g., phosphorothioates, phosphorodithioates, etc.), pendent moieties (e.g., polypeptides), intercalators (e.g., acridine, psoralen, etc.), chelators, alkylators, and modified linkages 10 (e.g., alpha anomeric nucleic acids, etc.). The above term is also intended to include any topological conformation, including single-stranded, double-stranded, partially duplexed, triplex, hairpinned, circular and padlocked conformations. Also included are synthetic molecules that 15 mimic polynucleotides in their ability to bind to a designated sequence via hydrogen bonding and other chemical interactions. Such molecules are known in the art and include, for example, those in which peptide linkages substitute for phosphate linkages in the backbone of the molecule. A reference to a 20 nucleic acid sequence encompasses its complement unless otherwise specified. Thus, a reference to a nucleic acid molecule having a particular sequence should be understood to encompass its complementary strand, with its complementary sequence. The complementary strand is also useful, e.g., for 25 antisense therapy, hybridization probes and PCR primers. Pharmaceutically acceptable excipient By "pharmaceutically acceptable excipient" is meant any inert substance that is combined with an active molecule such as a 30 drug, agent, or binding molecule for preparing an agreeable or convenient dosage form. The "pharmaceutically acceptable excipient" is an excipient that is non-toxic, or at least of 14 which the toxicity is acceptable for its intended use, to recipients at the dosages and concentrations employed and is compatible with other ingredients of the formulation comprising the drug, agent or binding molecule. 5 Post exposure prophylaxis "Post exposure prophylaxis" (PEP) is indicated for persons possibly exposed to a rabid animal. Possible exposures include bite exposure (i.e. any penetration of the skin by teeth) 10 including animal bites, and non-bite exposure. Non-bite exposures include exposure to large amounts of aerosolized rabies virus in laboratories or caves and surgical recipients of corneas transplanted from patients who died of rabies. The contamination of open wounds, abrasions, mucous membranes, or 15 theoretically, scratches, with saliva or other potentially infectious material (such as neural tissue) from a rabid animal also constitutes a non-bite exposure. Other contact by itself, such as petting a rabid animal and contact with blood, urine, or feces of a rabid animal, does not constitute an 20 exposure and is not an indication for prophylaxis. PEP should begin as soon as possible after an exposure. If no exposure has occurred post exposure prophylaxis is not necessary. In all post exposure prophylaxis regimens, except for persons previously immunized, active and passive immunizations should 25 be used concurrently. Specifically Binding The term "specifically binding", as used herein, in reference to the interaction of a binding molecule, e.g. an antibody, 30 and its binding partner, e.g. an antigen, means that the interaction is dependent upon the presence of a particular structure, e.g. an antigenic determinant or epitope, on the 15 binding partner. In other words, the antibody preferentially binds or recognizes the binding partner even when the binding partner is present in a mixture of other molecules or organisms. The binding may be mediated by covalent or non 5 covalent interactions or a combination of both. In yet other words, the term "specifically binding" means immunospecifically binding to an antigen or a fragment thereof and not immunospecifically binding to other antigens. A binding molecule that inmunospecifically binds to an antigen 10 may bind to other peptides or polypeptides with lower affinity as determined by, e.g., radioimmunoas says (RIA), enzyme-linked immunosorbent assays (ELISA), BIACORE, or other assays known in the art. Binding molecules or fragments thereof that immunospecifically bind to an antigen may be cross-reactive 15 with related antigens. Preferably, binding molecules or fragments thereof that immunospecifically bind to an antigen do not cross-react with other antigens. Therapeutically effective amount 20 The term "therapeutically effective amount" refers to an amount of the binding molecule as defined herein that is effective for post-exposure prophylaxis of rabies. Vector 25 The term "vector" denotes a nucleic acid molecule into which a second nucleic acid molecule can be inserted for introduction into a host where it will be replicated, and in some cases expressed. In other words, a vector is capable of transporting a nucleic acid molecule to which it has been linked. Cloning 30 as well as expression vectors are contemplated by the term "vector", as used herein. Vectors include, but are not limited to, plasmids, cosmids, bacterial artificial chromosomes (BAC) 16 and yeast artificial chromosomes (YAC) and vectors derived from bacteriophages or plant or animal includingg human) viruses. Vectors comprise an origin of replication recognized by the proposed host and in case of expression vectors, 5 promoter and other regulatory regions recognized by the host. A vector containing a second nucleic acid molecule is introduced into a cell for example by transformation, transfection, or by making use of bacterial or viral entry mechanisms. Other ways of introducing nucleic acid into cells 10 are known, such as electroporation or particle bombardment often used with plant cells, and the like. The method of introducing nucleic acid into cells depends among other things on the type of cells, and so forth. This is not critical to the invention. Certain vectors are capable of autonomous 15 replication in a host into which they are introduced (e.g., vectors having a bacterial origin of replication can replicate in bacteria) - Other vectors can be integrated into the genome of a host upon introduction into the host, and thereby are replicated along with the host genome. 20 SUMDARY OF THE INVENTION The invention provides binding molecules capable of specifically binding to and neutralizing babies virus. Furthermore, the invention pertains to nucleic acid molecules 25 encoding at least the binding region of these binding molecules. The invention further provides for the use of the binding molecules of the invention in the post exposure prophylaxis of a subject at risk of developing a condition resulting from rabies virus. 30 C$NRonbhDCCilhUJ)WI63_.DOCal/U22I20I2 16a In one embodiment, the invention provides a pharmaceutical composition comprising at least two rabies virus neutralizing monoclonal antibodies or antigen-binding fragments thereof that are capable of reacting with different, non-competing epitopes of the rabies virus, wherein a first rabies virus neutralizing monoclonal antibody or antigen-binding fragment thereof is capable of reacting with an epitope located in antigenic site I wherein the epitope comprises amino acids 226-231 of the rabies virus G protein and a second rabies virus neutralizing monoclonal antibody or antigen-binding fragment thereof is capable of reacting with an epitope located in antigenic site III of the rabies virus G protein. In a further embodiment, the invention provides a pharmaceutical composition comprising two rabies virus neutralizing binding molecules that are capable of binding to different, non-competing epitopes of the rabies virus, the composition comprising: a first rabies virus neutralizing binding molecule capable of binding to an epitope located in antigenic site I of the rabies virus G protein, said first rabies virus neutralizing antibody comprising: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 273 or a sequence that is at least 80% homologous thereto, and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 275 or a sequence that is at least 80% homologous thereto, and a second rabies virus neutralizing binding molecule capable of binding to an epitope located in antigenic site I of the rabies virus G protein. In another embodiment, the invention provides a pharmaceutical composition comprising at least two rabies virus neutralizing monoclonal antibodies or antigen-binding fragments thereof, that are capable of reacting with different, non-competing epitopes of the rabies virus, wherein a first rabies virus neutralizing monoclonal antibody or antigen-binding fragment thereof is capable of reacting with an epitope located in antigenic site 1, wherein the epitope comprises amino acids 226-231 of the rabies virus G protein, and a second rabies virus neutralizing monoclonal antibody or antigen-binding fragment thereof is capable of reacting with an epitope located in antigenic site III of the rabies virus G protein, wherein said rabies virus neutralizing antibodies or antigen-binding fragments are human antibodies. DETAILED DESCRIPTION OF THE INVENTION 17 In a first aspect the present invention encompasses binding molecules capable of specifically binding to rabies virus. Preferably, the binding molecules of the invention also have rabies virus-neutralizing activity. Preferably, the 5 binding molecules of the invention are human binding molecules. Alternatively, they may also be binding molecules of other animals. Rabies virus is part of the Lyssavirus genus. In total, the Lyssavirus genus includes eleven genotypes: rabies virus (genotype 1), Lagos bat virus 10 (genotype 2), Mokola virus (genotype 3), Duvenhage virus (genotype 4), European bat lyssavirus 1 (genotype 5), European bat lyssavirus 2 (genotype 6), Australian bat lyssavirus (genotype 7), Aravan virus (genotype 8), Khujand virus (genotype 9), Irkut virus (genotype 10) and West Caucasian 15 virus (genotype 11). Besides binding to rabies virus, the binding molecules of the invention may also be capable of binding to other genotypes of the Lyssavirus genus. Preferably, the binding molecules may also be capable of neutralizing other genotypes of the Lyssavirus genus. 20 Furthermore, the binding molecules of the invention may even be capable of binding to and/or neutralizing viruses, other than Lyssaviruses, of the rhabdovirus family. This family includes the genera cytorhabdovirus, ephemerovirus, lyssavirus, nucleorhabdovirus, rhabdovirus and vesiculovirus. 25 The binding molecules may be capable of specifically binding to rabies virus in its natural form or in its inactivated/attenuated form. Inactivation of rabies virus may be performed by treatment with inter alia beta-propiolactone (BPL) (White and Chappel, 1982), heating at 56*C for more than 30 30 minutes, gamma irradiation, treatment with acetylethylenimine or ethylenimine or treatment with ascorbic acid and copper sulfate for 72 hours (Madhusudana et al., 18 2004). General viral inactivation methods well known to the skilled artisan such as Inter alla pasteurization (wet heat), dry heat treatment, vapor heat treatment, treatment with low pH, treatment with organic solvent/detergent, nanofiltration; 5 UV light irradiation may also be used. Preferably, the inactivation is performed by treatment with beta-propiolactone (BPL). Methods to test if rabies virus is still infective or partly or completely inactivated are well known to the person skilled in the art and can among others be found in Laboratory 10 techniques in rabies, Edited by: F.-X Meslin, M.M. Kaplan and H. Koprowski (1996), 4th edition, Chapter 36, World Health Organization, Geneva. The binding molecules may also be capable of specifically binding to one or more fragments of the rabies virus such as 15 inter alia a preparation of one or more proteins and/or (poly)peptides derived from rabies virus or a cell transfected with a rabies virus protein and/or (poly)peptide. For methods of treatment and/or prevention such as methods for post exposure prophylaxis of rabies virus the binding molecules are 20 preferably capable of specifically binding to surface accessible proteins of rabies virus such as the M (see Ameyama et al. 2003) or G protein. For diagnostical purposes the human binding molecules may also be capable of specifically binding to proteins not present on the surface of rabies virus. The 25 amino acid sequence of surface accessible and internal proteins of various known strains of rabies virus can be found in the EMBL-database and/or other databases. Preferably, the fragment at least comprises an antigenic determinant recognized by the human binding molecules of the 30 invention. An "antigenic determinant" as used herein is a moiety, such as a rabies virus (poly)peptide, (glyco)protein, or analog or fragment thereof, that is capable of binding to a 19 human binding molecule of the invention with sufficiently high affinity to form a detectable antigen-binding molecule complex. The binding molecules according to the invention can be 5 intact immunoglobulin molecules such as polyclonal or monoclonal antibodies, in particular human monoclonal antibodies, or the binding molecules can be antigen-binding fragments including, but not limited to, Fab, F(ab'), F(ab')2, Fv, dAb, Fd, complementarity determining region (CDR) 10 fragments, single-chain antibodies (scFv), bivalent single chain antibodies, single-chain phage antibodies, diabodies, triabodies, tetrabodies, and (poly)peptides that contain at least a fragment of an immunoglobulin that is sufficient to confer specific antigen binding to the rabies virus or 15 fragment thereof. The binding molecules of the invention can be used in non-isolated or isolated form. Furthermore, the binding molecules of the invention can be used alone or in a - mixture comprising at least one human binding molecule (or variant or fragment thereof). In other words, the binding 20 molecules can be used in combination, e.g., as a pharmaceutical composition comprising two or more binding molecules, variants or fragments thereof. For example, binding molecules having rabies virus-neutralizing activity can be combined in a single therapy to achieve a desired 25 prophylactic, therapeutic or diagnostic effect. RNA viruses such as rabies virus make use of their own RNA polymerase during virus replication. These RNA polymerases tend to be error-prone. This leads to the formation of so called quasi-species during a viral infection. Each quasi 30 species has a unique RNA genome, which could result in differences in amino acid composition of viral proteins. If such mutations occur in structural viral proteins, the virus 20 could potentially escape from the host's immune system due to a change in T or B cell epitopes. The likelihood of this to happen is higher when individuals are treated with a mixture of two binding molecules, such as human monoclonal antibodies, 5 than with a polyclonal antibody mixture (HRIG). Therefore, a prerequisite for a mixture of two human monoclonal antibodies for treatment of rabies is that the two antibodies recognize non-overlapping, non-competing epitopes on their target antigen, i.e. rabies virus glycoprotein. The chance of the 10 occurrence of rabies escape viruses is thereby minimized. As a consequence thereof, the binding molecules of the invention preferably are capable of reacting with different, non overlapping, non-competing epitopes of the rabies virus, such as epitopes on the rabies virus G protein. The mixture of 15 binding molecules may further comprise at least one other therapeutic agent such as a medicament suitable for the post exposure prophylaxis of rabies. Typically, binding molecules according to the invention can bind to their binding partners, i.e. rabies virus or 20 fragments thereof such as rabies virus proteins, with an affinity constant (K-value) that is lower than 0.2*10~4 M, 1.0*10-5 M, 1.0*10-6 M, 1.0*10 7 * M, preferably lower than 1.0*10~ a M, more preferably lower than 1.0*10-9 M, more preferably lower than 1.0*10-10 M, even more preferably lower than 1.0*10~ 25 1 M, and in particular lower than 1.0*10~" M. The affinity constants can vary for antibody isotypes. For example, affinity binding for an IgM isotype refers to a binding affinity of at least about 1.0*10-7 M. Affinity constants can for instance be measured using surface plasmon resonance, i.e. 30 an optical phenomenon that allows for the analysis of real time biospecific interactions by detection of alterations in protein concentrations within a biosensor matrix, for example 21 using the BIACORE system (Pharmacia Biosensor AB, Uppsala, Sweden). The binding molecules according to the invention may bind to rabies virus in purified/isolated or non-purified/non 5 isolated form. The binding molecules may bind to rabies virus in soluble form such as for instance in a sample or may bind ..to rabies virus bound or attached to a carrier or substrate, e.g., microtiter plates, membranes and beads, etc. Carriers or substrates may be made of glass, plastic (e.g., polystyrene), 10 polysaccharides, nylon, nitrocellulose, or teflon, etc. The surface of such supports may be solid or porous and of any convenient shape. Alternatively, the binding molecules may also bind to fragments of rabies virus such as proteins or (poly)peptides of the rabies virus. In an embodiment the 15 binding molecules are capable of specifically binding to the rabies virus G protein or fragment thereof. The rabies virus proteins or (poly)peptides may either be in soluble form or may bind to rabies virus bound or attached to a carrier or substrate as described above. In another embodiment cells 20 tranfected with the G protein may be used as binding partner for the binding molecules. In a preferred embodiment of the invention, the binding molecules of the invention neutralize rabies virus infectivity. This may be achieved by preventing the attachment 25 of rabies virus to its receptors on host cells, such as inter alia the murine p75 neurotrophin receptor, the neural cell adhesion molecule (CD56) and the acetylcholine receptor, or inhibition of the release of RNA into the cytoplasm of the cell or prevention of RNA transcription or translation. In a 30 specific embodiment, the binding molecules of the invention prevent rabies virus from infecting host cells by at least 99%, at least 95%, at least 90%, at least 85%, at least 80%, 22 at least 75%, at least 70%, at least 60%, at least 50%, at least 45%, at least 40%, at least 45%, at least 35%, at least 30%, at least 25%, at least 20%, or at least 10% relative to infection of host cells by rabies virus in the absence of said 5 binding molecules. Neutralization can for instance be measured as described in Laboratory techniques in rabies, Edited by: F.-X Meslin, M.M. Kaplan and H. Koprowski (1996), 4th edition, Chapters 15-17, World Health Organization, Geneva. Furthermore, the human binding molecules of the invention may 10 be complement fixing binding molecules capable of assisting in the lysis of enveloped rabies virus. The human binding molecules of the invention might also act as opsonins and augment phagocytosis of rabies virus either by promoting its uptake via Fc or C3b receptors or by agglutinating rabies 15 virus to make it more easily phagocytosed. In a preferred embodiment, the binding molecules according to the invention comprise at least a CDR3 region comprising the amino acid sequence selected from the group consisting of SEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:3, SEQ ID 20 NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, SEQ ID NO:8, SEQ ID NO:9, SEQ ID NO:10, SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:18, SEQ ID NO:19, SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23 and SEQ ID NO:24. In an embodiment the 25 CDR3 region is a heavy chain CDR3 region. In yet another embodiment, the binding molecules according to the invention comprise a variable heavy chain comprising essentially an amino acid sequence selected from the group consisting of SEQ ID NO:26, SEQ ID NO:27, SEQ ID 30 NO:28, SEQ ID NO:29, SEQ ID NO:30, SEQ ID NO:31, SEQ ID NO:32, SEQ ID NO:33, SEQ ID NO:34, SEQ ID NO:35, SEQ ID NO:36, SEQ ID NO:37, SEQ ID NO:38, SEQ ID NO:39, SEQ ID NO:40, SEQ ID NO:41, 23 SEQ ID NO:42, SEQ ID NO:43, SEQ ID NO:44, SEQ ID NO:45, SEQ ID NO:46, SEQ ID NO:47, SEQ ID NO:48 and SEQ ID NO:49. In a preferred embodiment the binding molecules according to the invention comprise a variable heavy chain comprising 5 essentially an amino acid sequence comprising amino acids 1 119 of SEQ ID NO:335. In a further embodiment, the binding molecules according to the invention comprise a variable heavy chain comprising the amino acid sequence of SEQ ID NO:26 and a variable light 10 chain comprising the amino acid sequence of SEQ ID NO:50, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:27 and a variable light chain comprising the amino acid sequence of SEQ ID NO:51, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:28 and a variable light 15 chain comprising the amino acid sequence of SEQ ID NO:52, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:29 and a variable light chain comprising the amino acid sequence of S#Q ID NO:53, a variable heavy chain comprising, the amino acid sequence of SEQ ID NO:30 and a variable light 20 chain comprising the amino acid sequence of SEQ ID NO:54, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:31 and a variable light chain comprising the amino acid sequence of SEQ ID NO:55, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:32 and a variable light 25 chain comprising the amino acid sequence of SEQ ID NO:56, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:33 and a variable light chain comprising the amino acid sequence of SEQ ID NO:57, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:34 and a variable light 30 chain comprising the amino acid sequence of SEQ ID NO:58, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:35 and a variable light chain comprising the amino acid 24 sequence of SEQ ID NO:59, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:36 and a variable light chain comprising the amino acid sequence of SEQ ID NO:60, a variable heavy chain comprising the amino acid sequence of SEQ 5 ID NO:37 and a variable light chain comprising the amino acid sequence of SEQ ID NO:61, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:38 and a variable light chain comprising the amino acid sequence of SEQ ID NO:62, a variable heavy chain comprising the amino acid sequence of SEQ 10 ID NO:39 and a variable light chain comprising the amino acid sequence of SEQ ID NO:63, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:40 and a variable light chain comprising the amino acid sequence of SEQ ID NO:64, a variable heavy chain comprising the amino acid sequence of SEQ 15 ID NO:41 and a variable light chain comprising the amino acid sequence of SEQ ID NO:65, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:42 and a variable light chain comprising the amino acid sequence of SEQ ID NO:46, a variable heavy chain comprising the amino acid sequence of SEQ 20 ID NO:43 and a variable light chain comprising the amino acid sequence of SEQ ID NO:67, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:44 and a variable light chain comprising the amino acid sequence of SEQ ID NO:68, a variable heavy chain comprising the amino acid sequence of SEQ 25 ID NO:45 and a variable light chain comprising the amino acid sequence of SEQ ID NO:69, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:46 and a variable light chain comprising the amino acid sequence of SEQ ID NO:70, a variable heavy chain comprising the amino acid sequence of SEQ 30 ID NO:47 and a variable light chain comprising the amino acid sequence of SEQ ID NO:71, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:48 and a variable light 25 chain comprising the amino acid sequence of SEQ ID NO:72, a variable heavy chain comprising the amino acid sequence of SEQ ID NO:49 and a variable light chain comprising the amino acid sequence of SEQ ID NO:73. In a preferred embodiment the human 5 binding molecules according to the invention comprise a variable heavy chain comprising the amino acid sequence comprising amino acids 1-119 of SEQ ID NO:335 and a variable light chain comprising the amino acid sequence comprising amino acids 1-107 of SEQ ID NO:337. 10 In a preferred embodiment the binding molecules having rabies virus neutralizing activity of the invention are administered in IgG format, preferably IgG1 format. Another aspect of the invention includes functional variants of binding molecules as defined herein. Molecules are 15 considered to be functional variants of a binding molecule according to the invention, if the variants are capable of competing for specifically binding to rabies virus or a fragment thereof with the parent binding molecules. In other words, when the functional variants are still capable of 20 binding to rabies virus or a fragment thereof. The functional variants should also still have rabies virus neutralizing activity. Functional variants include, but are not limited to, derivatives that are substantially similar in primary structural sequence, but which contain e.g. in vitro or in 25 vivo modifications, chemical and/or biochemical, that are not found in the parent binding molecule. Such modifications include inter alla acetylation, acylation, ADP-ribosylation, amidation, covalent attachment of flavin, covalent attachment of a heme moiety, covalent attachment of a nucleotide or 30 nucleotide derivative, covalent attachment of a lipid or lipid derivative, covalent attachment of phosphotidylinositol, cross-linking, cyclization, disulfide bond formation, 26 demethylation, formation of covalent cross-links, formation of cystine, formation of pyroglutamate, formylation, gamma carboxylation, glycosylation, GPI-anchor formation, hydroxylation, iodination, methylation, myristoylation, 5 oxidation, pegylation, proteolytic processing, phosphorylation, prenylation, racemization, selenoylation, sulfation, transfer-RNA mediated addition of amino acids to proteins such as arginylation, ubiquitination, and the like. Alternatively, functional variants can be binding 10 molecules as defined in the present invention comprising an amino acid sequence containing substitutions, insertions, deletions or combinations thereof of one or more amino acids compared to the amino acid sequences of the parent binding molecules. Furthermore, functional variants can comprise 15 truncations of the amino acid sequence at either or both the amino or carboxy termini. Functional variants according to the invention may have the same or different, either higher or lower, binding affinities compared to the parent binding, molecule but are still capable of binding to rabies virus or a 20 fragment thereof and are still capable of neutralizing rabies virus. For instance, functional variants according to the invention may have increased or decreased binding affinities for rabies virus or a fragment thereof compared to the parent binding molecules or may have a higher or lower rabies virus 25 neutralizing activity. Preferably, the amino acid sequences of the variable regions, including, but not limited to, framework regions, hypervariable regions, in particular the CDR3 regions, are modified. Generally, the light chain and the heavy chain variable regions comprise three hypervariable 30 regions, comprising three CDRs, and more conserved regions, the so-called framework regions (FRs). The hypervariable regions comprise amino acid residues from CDRs and amino acid 27 residues from hypervariable loops. Functional-variants intended to fall within the scope of the present invention have at least about 50% to about 99%, preferably at least about 60% to about 99%, more preferably at least about 70% to 5 about 99%, even more preferably at least about 80% to about 99%, most preferably at least about 90% to about 99%, in particular at least about 95% to about 99%, and in particular at least about 97% to about 99% amino acid sequence homology with the parent binding molecules as defined herein. Computer 10 algorithms such as inter alia Gap or Bestfit known to a person skilled in the art can be used to optimally align amino acid sequences to be compared and to define similar or identical amino acid residues. In another embodiment, functional variants may be 15 produced when the parent binding molecule comprises a glycosylation site in its sequence that results in glycosylation of the binding molecule upon expression in eukaryotic cells and hence might abrogate the binding to the antigen. The functional variant produced no longer contains 20 the glycosylation site, but will be capable of binding to rabies virus and still have neutralizing activity. Functional variants can be obtained by altering the parent binding molecules or parts thereof by general molecular biology methods known in the art including, but not limited 25 to, error-prone PCR, oligonucleotide-directed mutagenesis and site-directed mutagenesis. Furthermore, the functional variants may have complement fixing activity, be capable of assisting in the lysis of enveloped rabies virus and/or act as opsonins and augment phagocytosis of rabies virus either by 30 promoting its uptake via Fc or C3b receptors or by agglutinating rabies virus to make it more easily phagocytosed.
28 In yet a further aspect, the invention includes immunoconjugates, i.e. molecules comprising at least one binding molecule or functional variant thereof as defined herein and further comprising at least one tag, such as inter 5 alia a detectable moiety/agent. Also contemplated in the present invention are mixtures of immunoconjugates according to the invention or mixtures of at least one immunoconjugate according to the invention and another molecule, such as a therapeutic agent or another binding molecule or 10 immunoconjugate. In a further embodiment, the immunoconjugates of the invention may comprise one or more tags. These tags can be the same or distinct from each other and can be joined/conjugated non-covalently to the binding molecules. The tag(s) can also be joined/conjugated directly to the binding 15 molecules through covalent bonding, including, but not limited to, disulfide bonding, hydrogen bonding, electrostatic bonding, recombinant fusion and conformational bonding. Alternatively, the tag(s) can be joined/conjugated to the binding molecules by means of one or more linking compounds. 20 Techniques for conjugating tags to binding molecules are well known to the skilled artisan. The tags of the immunoconjugates of the present invention may be therapeutic agents, but preferably they are detectable moieties/agents. Immunoconjugates comprising a detectable 25 agent can be used diagnostically to, for example, assess if a subject has been infected with rabies virus or monitor the development or progression of a rabies virus infection as part of a clinical testing procedure to, e.g., determine the efficacy of a given treatment regimen. However, they may also 30 be used for other detection and/or analytical and/or diagnostic purposes. Detectable moieties/agents include, but are not limited to, enzymes, prosthetic groups, fluorescent 29 materials, luminescent materials, bioluminescent materials, radioactive materials, positron emitting metals, and nonradioactive paramagnetic metal ions. The tags used to label the binding molecules for 5 detection and/or analytical and/or diagnostic purposes depend on the specific detection/analysis/diagnosis techniques and/or methods used such as inter alia immunohistochemical staining of (tissue) samples, flow cytometric detection, scanning laser cytometric detection, fluorescent immunoassays, enzyme-linked 10 immunosorbent assays (ELISA's), radioimmunoassays (RIA's), bioassays (e.g., neutralization assays), Western blotting applications, etc. For immunohistochemical staining of tissue samples preferred labels are enzymes that catalyze production and local deposition of a detectable product. Enzymes 15 typically conjugated to binding molecules to permit their immunohistochemical visualization are well-known and include, but are not limited to, acetylcholinesterase, alkaline phosphatase, beta-galactosidase, glucose oxidase, horseradish peroxidase, and urease. Typical substrates for production and 20 deposition of visually detectable products are also well known to the skilled person in the art. Next to that, imunoconjugates of the invention can be labeled using colloidal gold or they can be labeled with radioisotopes, such as 33P, 32 P, 35s, 3 H, and 1251. Binding molecules of the invention 25 can be attached to radionuclides directly or indirectly via a chelating agent by methods well known in the art. When the binding molecules of the present invention are used for flow cytometric detections, scanning laser cytometric detections, or fluorescent immunoassays, they can usefully be 30 labeled with fluorophores. A wide variety of fluorophores useful for fluorescently labeling the binding molecules of the present invention are known to the skilled artisan. When the 30 binding molecules of the present invention are used for secondary detection using labeled avidin, streptavidin, captavidin or neutravidin, the binding molecules may be labeled with biotin to form suitable prosthetic group 5 complexes. When the immunoconjugates of the invention are used for in vivo diagnostic use, the binding molecules can also be made detectable by conjugation to e.g. magnetic resonance imaging (MRI) contrast agents, such as gadolinium 10 diethylenetriaminepentaacetic acid, to ultrasound contrast agents or to X-ray contrast agents, or by radioisotopic labeling. Furthermore, the binding molecules, functional variants thereof or immunoconjugates of the invention can also be 15 attached to solid supports, which are particularly useful for in vitro immunoassays or purification of rabies virus or a fragment thereof. Such solid supports might be porous or nonporous, planar or nonplanar and include,.-but are not limited to, glass, cellulose, polyacrylamide, nylon, 20 polystyrene, polyvinyl chloride or polypropylene supports. The human binding molecules can also for example usefully be conjugated to filtration media, such as NHS-activated Sepharose or CNBr-activated Sepharose for purposes of immunoaffinity chromatography. They can also usefully be 25 attached to paramagnetic microspheres, typically by biotin streptavidin interaction. The microspheres can be used for isolation of rabies virus or a fragment thereof from a sample containing rabies virus or a fragment thereof. As another example, the human binding molecules of the present invention 30 can usefully be attached to the surface of a microtiter plate for ELISA.
31 The binding molecules of the present invention or functional variants thereof can be fused to marker sequences, such as a peptide to facilitate purification. Examples include, but are not limited to, the hexa-histidine tag, the 5 hemagglutinin (HA) tag, the myc tag or the flag tag. Alternatively, an antibody can be conjugated to a second antibody to form an antibody heteroconjugate. In another aspect the human binding molecules of the invention may be conjugated/attached to one or more antigens. Preferably, these 10 antigens are antigens which are recognized by the immune system of a subject to which the binding molecule-antigen conjugate is administered. The antigens may be identical but may also differ from each other. Conjugation methods for attaching the antigens and binding molecules are well known in 15 the art and include, but are not limited to, the use of cross linking agents. The human binding molecules will bind to rabies virus and the antigens attached to the human binding molecules will initiate a.powerful T-cell attack on the conjugate which will eventually lead to the destruction of the 20 rabies virus. Next to producing immunoconjugates chemically by conjugating, directly or indirectly via for instance a linker, the immunoconjugates can be produced as fusion proteins comprising the human binding molecules of the invention and a 25 suitable tag. Fusion proteins can be produced by methods known in the art such as, e.g., recombinantly by constructing nucleic acid molecules comprising nucleotide sequences encoding the human binding molecules in frame with nucleotide sequences encoding the suitable tag(s) and then expressing the 30 nucleic'acid molecules. It is another aspect of the present invention to provide a nucleic acid molecule encoding at least a binding molecule 32 or functional variant thereof according to the invention. Such nucleic acid molecules can be used as intermediates for cloning purposes, e.g. in the process of affinity maturation described above. In a preferred embodiment, the nucleic acid 5 molecules are isolated or purified. The skilled man will appreciate that functional variants of these nucleic acid molecules are also intended to be a part of the present invention. Functional variants are nucleic acid sequences that can be directly translated, using the standard 10 genetic code, to provide an amino acid sequence identical to that translated from the parent nucleic acid molecules. Preferably, the nucleic acid molecules encode binding molecules comprising a CDR3 region, preferably a heavy chain CDR3 region, comprising an amino acid sequence selected from 15 the group consisting of SEQ ID NO:l, SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, SEQ ID NO:8, SEQ ID NO:9, SEQ ID NO:10, SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13,SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEO.ID NO:17, SEQ ID NO:18, SEQ ID NO:19, SEQ ID NO:20, SEQ ID NO:.21, 20 SEQ ID NO:22, SEQ ID NO:23 and SEQ ID NO:24. Even more preferably, the nucleic acid molecules encode human binding molecules comprising a variable heavy chain comprising essentially an amino acid sequence selected from the group consisting of SEQ ID NO:26, SEQ ID NO:27, SEQ ID 25 NO:28, SEQ ID NO:29, SEQ ID NO:30, SEQ ID NO:31, SEQ ID NO:32, SEQ ID NO:33, SEQ ID NO:34, SEQ ID NO:35, SEQ ID NO:36, SEQ ID NO:37, SEQ ID NO:38, SEQ ID NO:39, SEQ ID NO:40, SEQ ID NO:41, SEQ ID NO:42, SEQ ID NO:43, SEQ ID NO:44, SEQ ID NO:45, SEQ ID NO:46, SEQ ID NO:47, SEQ ID NO:48 and SEQ ID NO:49. In a 30 particularly preferred embodiment the nucleic acid molecules encode binding molecules comprising a variable heavy chain 33 comprising essentially an amino acid sequence comprising amino acids 1-119 of SEQ ID NO:335. In yet another embodiment, the nucleic acid molecules encode binding molecules comprising a variable heavy chain 5 comprising the amino acid sequence of SEQ ID NO:26 and a variable light chain comprising the amino acid sequence of SEQ ID NO:50, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:27 and a variable light chain comprising the amino acid sequence of SEQ ID NO:51, or they 10 encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:28 and a variable light chain comprising the amino acid sequence of SEQ ID NO:52, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:29 and a variable light chain comprising the amino acid 15 sequence of SEQ ID NO:53, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:30 and a variable light chain comprising the amino acid sequence of SEQ ID NO:54,..or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:31 and a variable light chain 20 comprising the amino acid sequence of SEQ ID NO:55, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:32 and a variable light chain comprising the amino acid sequence of SEQ ID NO:56, or they encode a variable heavy chain comprising the amino acid sequence of SEQ 25 ID NO:33 and a variable light chain comprising the amino acid sequence of SEQ ID NO:57, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:34 and a variable light chain comprising the amino acid sequence of SEQ ID NO:58, or they encode a variable heavy chain comprising the 30 amino acid sequence of SEQ ID NO:35 and a variable light chain comprising the amino acid sequence of SEQ ID NO:59, or they encode a variable heavy chain comprising the amino acid 34 sequence of SEQ ID NO:36 and a variable light chain comprising the amino acid sequence of SEQ ID NO:60, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:37 and a variable light chain comprising the amino acid 5 sequence of SEQ ID NO:61, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:38 and a variable light chain comprising the amino acid sequence of SEQ ID NO:62, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:39 and a variable light chain 10 comprising the amino acid sequence of SEQ ID NO:63, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:40 and a variable light chain comprising the amino acid sequence of SEQ ID NO:64, or they encode a variable heavy chain comprising the amino acid sequence of SEQ 15 ID NO:41 and a variable light chain comprising the amino acid sequence of SEQ ID NO:65, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:42 and a variable light chain comprising the amino acid sequence of SEQ ID NO:66, or they encode a variable heavy chain comprising the 20 amino acid sequence of SEQ ID NO:43 and a variable light chain comprising the amino acid sequence of SEQ ID NO:67, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:44 and a variable light chain comprising the amino acid sequence of SEQ ID NO:68, or they encode a 25 variable heavy chain comprising the amino acid sequence of SEQ ID NO:45 and a variable light chain comprising the amino acid sequence of SEQ ID NO:69, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:46 and a variable light chain comprising the amino acid sequence of SEQ 30 ID NO:70, or they encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:47 and a variable light chain comprising the amino acid sequence of SEQ ID NO:71, or they 35 encode a variable heavy chain comprising the amino acid sequence of SEQ ID NO:48 and a variable light chain comprising the amino acid sequence of SEQ ID NO:72, or they encode a variable heavy chain comprising the amino acid sequence of SEQ 5 ID NO:49 and a variable light chain comprising the amino acid sequence of SEQ ID NO:73. In a preferred embodiment the nucleic acid molecules encode human binding molecules comprising a variable heavy chain comprising the amino acid sequence comprising amino acids 1-119 of SEQ ID NO:335 and a 10 variable light chain comprising the amino acid sequence comprising amino acids 1-107 of SEQ ID NO:337. In a specific embodiment of the invention the nucleic acid molecules encoding the variable heavy chain of the binding molecules of the invention comprise essentially a 15 nucleotide sequence selected from the group consisting of SEQ ID NO:74, SEQ ID NO:75, SEQ ID NO:76, SEQ ID NO:77, SEQ ID NO:78, SEQ ID NO:79, SEQ ID NO:80, SEQ ID NO:81, SEQ ID NO:82, SEQ ID NO:83, SEQ-ID NO:84, SEQ ID NO:85, SEQ ID NO:86, SEQ ID NO:87, SEQ ID NO:88, SEQ ID NO:89, SEQ ID NO:90, SEQ ID NO:91, 20 SEQ ID NO:92, SEQ ID NO:93, SEQ ID NO:94, SEQ ID NO:95, SEQ ID NO:96 and SEQ ID NO:97. Preferably, the nucleic acid molecules encoding the variable heavy chain of the binding molecules of the invention comprise essentially a nucleotide sequence comprising nucleotides 1-357 of SEQ ID NO:334. 25 In yet another specific embodiment of the present invention, the nucleic acid molecules encoding the variable light chain of the binding molecules of the invention comprise essentially a nucleotide sequence selected of the group consisting of SEQ ID NO:98, SEQ ID NO:99, SEQ ID NO:100, SEQ 30 ID NO:101, SEQ ID NO:102, SEQ ID NO:103, SEQ ID NO:104, SEQ ID NO:105, SEQ ID NO:106,.SEQ ID NO:107, SEQ ID NO:108, SEQ ID NO:109, SEQ ID NO:110, SEQ ID NO:111, SEQ ID NO:112, SEQ ID 36 NO:113, SEQ ID NO:114, SEQ ID NO:115, SEQ ID NO:116, SEQ ID NO:117, SEQ ID NO:118, SEQ ID NO:119, SEQ ID NO:120 and SEQ ID NO:121. Preferably, the nucleic acid molecules encoding the variable light chain of the human binding molecules of the 5 invention comprise essentially a nucleotide sequence comprising nucleotides 1-321 of SEQ ID NO:336. It is another aspect of the invention to provide vectors, i.e. nucleic acid constructs, comprising one or more nucleic acid molecules according to the present invention. Vectors can 10 be derived from plasmids such as inter alla F, R1, RP1, Col, pBR322, TOL, Ti, etc; cosmids; phages such as lambda, lambdoid, M13, Mu, P1, P22, Qs, T-even, T-odd, T2, T4, T7, etc; plant viruses such as inter alia alfalfa mosaic virus, bromovirus, capillovirus, carlavirus, carmovirus, caulivirus, 15 clostervirus, comovirus, cryptovirus, cucumovirus, dianthovirus, fabavirus, fijivirus, furovirus, geminivirus, hordeivirus, ilarvirus, luteovirus, machlovirus, marafivirus, .necrovirus, nepovirus, phytorepvirus, plant rhabdovirus, potexvirus, potyvirus, sobemovirus, tenuivirus, tobamovirus, 20 tobravirus, tomato spotted wilt virus, tombusvirus, tymovirus, etc; or animal viruses such as inter alia adenovirus, arenaviridae, baculoviridae, birnaviridae, bunyaviridae, calciviridae, cardioviruses, coronaviridae, corticoviridae, cystoviridae, Epstein-Barr virus, enteroviruses, filoviridae, 25 flaviviridae, Foot-and-Mouth disease virus, hepadnaviridae, hepatitis viruses, herpesviridae, immunodeficiency viruses, influenza virus, inoviridae, iridoviridae, orthomyxoviridae, papovaviruses, paramyxoviridae, parvoviridae, picornaviridae, poliovirus, polydnaviridae, poxviridae, reoviridae, 30 retroviruses, rhabdoviridae, rhinoviruses, Semliki Forest virus, tetraviridae, togaviridae, toroviridae, vaccinia virus, vescular stomatitis virus, etc. Vectors can be used for 37 cloning and/or for expression of the human binding molecules of the invention and might even be used for gene therapy purposes. Vectors comprising one or more nucleic acid molecules according to the invention operably linked to one or 5 more expression-regulating nucleic acid molecules are also covered by the present invention. The choice of the vector is dependent on the recombinant procedures followed and the host used. Introduction of vectors in host cells can be effected by inter alla calcium phosphate transfection, virus infection, 10 DEAE-dextran mediated transfection, lipofectamin transfection or electroporation. Vectors may be autonomously replicating or may replicate together with the chromosome into which they have been integrated. Preferably, the vectors contain one or more selection markers. The choice of the markers may depend 15 on the host cells of choice, although this is not critical to the invention as is well known to persons skilled in the art. They include, but-are not limited to, kanamycin, neomycin, puromycin, hygromycin, zeocin, thymidine kinase gene from Herpes simplex virus (HSV-TK), dihydrofolate reductase gene 20 from mouse (dhfr). Vectors comprising one or more nucleic acid molecules encoding the human binding molecules as described above operably linked to one or more nucleic acid molecules encoding proteins or peptides that can be used to isolate the binding molecules are also covered by the invention. These 25 proteins or peptides include, but are not limited to, glutathione-S-transferase, maltose binding protein, metal binding polyhistidine, green fluorescent protein, luciferase and beta-galactosidase. Hosts containing one or more copies of the vectors 30 mentioned above are an additional subject of the present invention. Preferably, the hosts are host cells. Host cells include, but are not limited to, cells of mammalian, plant, 38 insect, fungal or bacterial origin..Bacterial cells include, but are not limited to, cells from Gram positive bacteria such as several species of the genera Bacillus, Streptomyces and Staphylococcus or cells of Gram negative bacteria such as 5 several species of the genera Escherichia, such as E. coli, and Pseudomonas. In the group of fungal cells preferably yeast cells are used. Expression in yeast can be achieved by using yeast strains such as inter alIa Picbia pastoris, Saccharomyces cerevisiae and Hansenula polymorpba. 10 Furthermore, insect cells such as cells from Drosophila and Sf9 can be used as host cells. Besides that, the host cells can be plant cells. Transformed (transgenic) plants or plant cells are produced by known methods, for example, Agrobacterium-mediated gene transfer, transformation of leaf 15 discs, protoplast transformation by polyethylene glycol induced DNA transfer, electroporation, sonication, microinjection or bolistic gene transfer. Additionally, a suitable expression system can be a baculovirus system. Expression systems using mammalian cells such as Chinese 20 Hamster Ovary (CHO) cells, COS cells, BHK cells or Bowes melanoma cells are preferred in the present invention. Mammalian cells provide expressed proteins with posttranslational modifications that are most similar to natural molecules of mammalian origin. Since the present 25 invention deals with molecules that may have to be administered to humans, a completely human expression system would be particularly preferred. Therefore, even more preferably, the host cells are human cells. Examples of human cells are inter alla HeLa, 911, AT1080, A549, 293 and HEK293T 30 cells. Preferred mammalian cells are human retina cells such as 911 cells or the cell line deposited at the European Collection of Cell Cultures (ECACC), CAMR, Salisbury, 39 Wiltshire SP4 OJG, Great Britain on 29 February 1996 under number 96022940 and marketed under the trademark PER.C60 (PER.C6 is a registered trademark of Crucell Holland B.V.). For the purposes of this application "PER.C6" refers to cells 5 deposited under number 96022940 or ancestors, passages up stream or downstream as well as descendants from ancestors of deposited cells, as well as derivatives of any of the foregoing. In preferred embodiments, the human producer cells 10 comprise at least a functional part of a nucleic acid sequence encoding an adenovirus El region in expressible format. In even more preferred embodiments, said host cells are derived from a human retina and immortalised with nucleic acids comprising adenoviral El sequences,; such as the cell line 15 deposited at the European Collection of Cell Cultures (ECACC), CAMR, Salisbury, Wiltshire SP4 OJG, Great Britain on 29 February 1996 under number 96022940 and marketed under the trademark PER.C6. Production of recombinant proteins in host cells can be performed according to methods well known in the 20 art. The use of the cells marketed under the trademark PER.C60 as a production platform for proteins of interest has been described in WO 00/63403 the disclosure of which is incorporated herein by reference in its entirety. A method of producing a binding molecule or a functional 25 variant according to the invention is an additional part of the invention. The method comprises the steps of a) culturing a host according to the invention under conditions conducive to the expression of the binding molecule or functional variant thereof, and b) optionally, recovering the expressed 30 binding molecule or functional variant thereof. The expressed binding molecules or functional variants thereof can be recovered from the cell free extract, but preferably they are 40 recovered from the culture medium. Methods to recover proteins, such as binding molecules, from cell free extracts or culture medium are well known to the man skilled in the art. Binding molecules or functional variants thereof as 5 obtainable by the above described method are also a part of the present invention. Alternatively, next to the expression in hosts, such as host cells, the binding molecules or functional variants thereof of the invention can be produced synthetically by 10 conventional peptide synthesizers or in cell-free translation systems using RNA nucleic acid derived from DNA molecules according to the invention. Binding molecule or functional variants thereof as obtainable by the above described synthetic production methods or cell-free translation systems 15 are also a part of the present invention. In another embodiment binding molecules or functional variants thereof according to the present invention may be generated by transgenic non-human mammals, such as for. instance transgenic mice or rabbits, that express human 20 immunoglobulin genes. Preferably, the transgenic non-human mammals have a genome comprising a human heavy chain transgene and a human light chain transgene encoding all or a portion of the human binding molecules as described above. The transgenic non-human mammals can be immunized with a purified or enriched 25 preparation of rabies virus or a fragment thereof. Protocols for immunizing non-human mammals are well established in the art. See Using Antibodies: A Laboratory Manual, Edited by: E. Harlow, D. Lane (1998), Cold Spring Harbor Laboratory, Cold Spring Harbor, New York and Current Protocols in Immunology, 30 Edited by: J.E. Coligan, A.M. Kruisbeek, D.H. Margulies, E.M. Shevach, W. Strober (2001), John Wiley & Sons Inc., New York, the disclosures of which are incorporated herein by reference.
41 In a further aspect, the invention provides a method of identifying binding molecules such as human monoclonal antibodies or fragments thereof according to the invention or nucleic acid molecules according to the invention capable of 5 specifically binding to rabies virus and comprises the steps of a) contacting a collection of binding molecules on the surface of replicable genetic packages with the rabies virus or a fragment thereof under conditions conducive to binding, b) selecting at least once for replicable genetic packages 10 binding to the rabies virus or the fragment thereof, and c) separating and recovering the replicable genetic packages binding to the rabies virus or the fragment thereof. The selection step may be performed in the presence of rabies virus. The rabies virus may be isolated or non 15 isolated, e.g. present in serum and/or blood of an infected individual. In another embodiment the rabies virus is inactivated. Alternatively, the selection step may be performed in the presence of a fragment.of rabies virus such as an extracellular part of the rabies virus, one or more 20 (poly)peptides derived from rabies virus such as the G protein, fusion proteins comprising these proteins or (poly)peptides, and the like. In another embodiment cells transfected with rabies virus G protein are used for selection procedures. 25 In yet a further aspect, the invention provides a method of obtaining a binding molecule or a nucleic acid molecule according to the invention, wherein the method comprises the steps of a) performing the above described method of identifying binding molecules, such as human monoclonal 30 antibodies or fragments thereof according to the invention, or nucleic acid molecules according to the invention, and b) isolating from the recovered replicable genetic packages the 42 binding molecule and/or the nucleic acid encoding the binding molecule. Once a new monoclonal antibody has been established or identified with the above mentioned method of identifying binding molecules or nucleic acid molecules encoding the 5 binding molecules, the DNA encoding the scFv or Fab can be isolated from the bacteria or replicable genetic packages and combined with standard molecular biological techniques to make constructs encoding bivalent scFvs or complete human immunoglobulins of a desired specificity (e.g. IgG, IgA or 10 IgM). These constructs can be transfected into suitable cell lines and complete human monoclonal antibodies can be produced (see Huls et al., 1999; Boel et al., 2000). A replicable genetic package as used herein can be prokaryotic or eukaryotic and includes cells, spores, 15 bacteria, viruses, (bacterio)phage and polysomes. A preferred replicable genetic package is a phage. The human binding molecules, such as for instance single chain Fv's, are displayed on the replicable genetic package, i.e. they are attached to a group or molecule located at an exterior surface 20 of the replicable genetic package. The replicable genetic package is a screenable unit comprising a human binding molecule to be screened- linked to a nucleic acid molecule encoding the binding molecule. The nucleic acid molecule should be replicable either in vivo (e.g., as a vector) or in 25 vitro (e.g., by PCR, transcription and translation). In vivo replication can be autonomous (as for a cell), with the assistance of host factors (as for a virus) or with the assistance of both host and helper virus (as for a phagemid). Replicable genetic packages displaying a collection of human 30 binding molecules are formed by introducing nucleic acid molecules encoding exogenous binding molecules to be displayed into the genomes of the replicable genetic packages to form 43 fusion proteins with endogenous proteins that are normally expressed from the outer surface of the replicable genetic packages. Expression of the fusion proteins, transport to the outer surface and assembly results in display of exogenous 5 binding molecules from the outer surface of the replicable genetic packages. In a further aspect the invention pertains to a human binding molecule capable of binding rabies virus or a fragment thereof and being obtainable by the identification method as described above. 10 In yet a further aspect the invention relates to a method of identifying a binding molecule potentially having neutralizing activity against rabies virus, wherein the method comprises the steps of (a) contacting a collection of binding molecules on the surface of replicable genetic packages with 15 the rabies virus under conditions conducive to binding, (b) separating and recovering binding molecules that bind to the rabies virus from binding molecules that do not bind, (c) isolating at least-one recovered binding molecule, (d) verifying if the binding molecule isolated has neutralizing 20 activity against the rabies virus, characterized in that the rabies virus in step a is inactivated. The inactivated rabies virus may be purified before being inactivated. Purification may be performed by means of well known purification methods suitable for viruses such as for instance centrifugation 25 through a glycerol cushion. The inactivated rabies virus in step a may be immobilized to a suitable material before use. Alternatively, the rabies virus in step a may still be active. In another alternative embodiment a fragment of a rabies virus, such as a polypeptide of a rabies virus such as the G 30 protein, is used in step a. In yet another embodiment cells transfected with rabies virus G protein are used for selecting binding molecule potentially having neutralizing activity 44 against rabies virus. As indicated herein, when cells expressing rabies virus G protein were included in the selection method the number of selected neutralizing antibodies was higher compared to selection methods wherein 5 only purified rabies virus G protein and/or inactivated rabies virus was used. In a further embodiment the method of identifying a binding molecule potentially having neutralizing activity against rabies virus as described above further comprises the 10 step of separating and recovering, and optionally isolating, human binding molecules containing a variable heavy 3-30 germline gene. A person skilled in the art can identify the specific germline gene by methods known in the art such as for instance nucleotide sequencing. The step of separating and 15 recovering binding molecules containing a variable heavy 3-30 germline gene can be performed before or after step c. As indicated below- the majority of rabies virus neutralizing human monoclonal antibodies found in the present invention comprises this specific VH germline gene. 20 Phage display methods for identifying and obtaining (neutralizing) binding molecules, e.g. antibodies, are by now well-established methods known by the person skilled in the art. They are e.g. described in US Patent Number 5,696,108; Burton and Barbas, 1994; de Kruif et al., 1995b; and Phage 25 Display: A Laboratory Manual. Edited by: CF Barbas, DR Burton, JK Scott and GJ Silverman (2001), Cold Spring Harbor Laboratory Press, Cold Spring Harbor, New York. All these references are herewith incorporated herein in their entirety. For the construction of phage display libraries, 30 collections of human monoclonal antibody heavy and light chain variable region genes are expressed on the surface of bacteriophage, preferably filamentous bacteriophage, 45 particles, in for example single-chain Fv (scFv) or in Fab format (see de Kruif et al., 1995b). Large libraries of antibody fragment-expressing phages typically contain more than 1.0*109 antibody specificities and may be assembled from 5 the immunoglobulin V regions expressed in the B lymphocytes of immunized- or non-immunized individuals. In a specific embodiment of the invention the phage library of human binding molecules, preferably scFv phage library, is prepared from RNA isolated from cells obtained from a subject that has been 10 vaccinated against rabies or exposed to a rabies virus. RNA can be isolated from inter alia bone marrow or peripheral blood, preferably peripheral blood lymphocytes. The subject can be an animal vaccinated or exposed to rabies virus, but is preferably a human subject which has been vaccinated or has 15 been exposed to rabies virus. Preferably the human subject has been vaccinated. A collection of human binding molecules on the surface of replicable genetic packages, such as a scFv phage library, as described above is another aspect of the present invention. 20 Alternatively, phage display libraries may be constructed from immunoglobulin variable regions that have been partially assembled in vitro to introduce additional antibody diversity in the library (semi-synthetic libraries). For example, in vitro assembled variable regions contain stretches of 25 synthetically produced, randomized or partially randomized DNA in those regions of the molecules that are important for antibody specificity, e.g. CDR regions. Rabies virus specific phage antibodies can be selected from the libraries by iumobilising target antigens such as antigens from rabies 30 virus on a solid phase and subsequently exposing the target antigens to a phage library to allow binding of phages expressing antibody fragments specific for the solid phase- 46 bound antigen (s). Non-bound phages are removed by washing and bound phages eluted from the solid phase for infection of Escherichia coli (E.coli) bacteria and subsequent propagation. Multiple rounds of selection and propagation are usually 5 required to sufficiently enrich for phages binding specifically to the target antigen(s). If desired, before exposing the phage library to target antigens the phage library can first be subtracted by exposing the phage library to non-target antigens bound to a solid phase. Phages may also 10 be selected for binding to complex antigens such as complex mixtures of rabies virus proteins or (poly)peptides, host cells expressing one or more rabies virus proteins or (poly)peptides of rabies virus, or (inactivated) rabies virus itself. Antigen specific phage antibodies can be selected from 15 the library by incubating a solid phase with bound thereon a preparation of inactivated rabies virus with the phage antibody library to let for example the scFv or Fab part of the phage.bind to the proteins/polypeptides of the rabies virus preparation. After incubation and several washes to 20 remove unbound and loosely attached phages, the phages that have bound with their scFv or Fab part to the preparation are eluted and used to infect Escherichia coli to allow amplification of the new specificity. Generally, one or more selection rounds are required to separate the phages of 25 interest from the large excess of non-binding phages. Alternatively, known proteins or (poly)peptides of the rabies virus can be expressed in host cells and these cells can be used for selection of phage antibodies specific for the proteins or (poly)peptides. A phage display method using these 30 host cells can be extended and improved by subtracting non relevant binders during screening by addition of an excess of host cells comprising no target molecules or non-target 47 molecules that are similar, but not identical, to the target, and thereby strongly enhance the chance of finding relevant binding molecules (This process is referred to as the MAbstract process. MAbstract" is a registered trademark of 5 Crucell Holland B.V., see also US Patent Number 6,265,150 which is incorporated herein by reference). In yet a further aspect, the invention provides compositions comprising at least one binding molecule, at least one functional variant or fragment thereof, at least one 10 immunoconjugate according to the invention or a combination thereof. The compositions may further comprise inter alla stabilising molecules, such as albumin or polyethylene glycol, or salts. Preferably, the salts used are salts that retain the desired biological activity of the human binding molecules and 15 do not impart any undesired toxicological effects. If necessary, the human binding molecules of the invention may be coated in or on a material to protect them from the action of acids or other natural or non-natural conditions that may inactivate the binding molecules. 20 In yet a further aspect, the invention provides compositions comprising at least one nucleic acid molecule as defined in the present invention. The compositions may comprise aqueous solutions such as aqueous solutions containing salts (e.g., NaCl or salts as described above), 25 detergents (e.g., SDS) and/or other suitable components. Furthermore, the present invention pertains to pharmaceutical compositions comprising at least one n binding molecule according to the invention, at least one functional variant or fragment thereof, at least one immunoconjugate 30 according to the invention, at least one composition according to the invention, or combinations thereof. The pharmaceutical 48 composition of the invention further comprises at least one pharmaceutically acceptable excipient. In a preferred embodiment the pharmaceutical composition according to the invention comprises at least one additional 5 binding molecule, i.e. the pharmaceutical composition can be a cocktail/mixture of binding molecules. The pharmaceutical composition may comprise at least two binding molecules according to the invention or at least one binding molecule according to the invention and at least one further anti 10 rabies virus binding molecule. Said further binding molecule preferably comprises a CDR3 region comprising the amino acid sequence of SEQ ID NO:25. The binding molecule comprising the CDR3 region comprising the amino acid sequence of SEQ ID NO:25 may be a chimeric or humanized monoclonal antibody or 15 functional fragment thereof, but preferably it is a human monoclonal antibody or functional fragment thereof. In an embodiment, the binding molecule comprises a heavy chain variable region comprising the amino acid sequence SEQ ID NO:273. In another embodiment, the binding molecule comprises 20 a light chain variable region comprising the amino acid sequence SEQ ID NO:275. In yet another embodiment the binding molecule comprises a heavy and light chain comprising the amino acid sequences of SEQ ID NO:123 and SEQ ID NO:125, respectively. The binding molecules in the pharmaceutical 25 composition should be capable of reacting with different, non competing epitopes of the rabies virus. The epitopes may be present on the G protein of rabies virus and may be different, non-overlapping epitopes. The binding molecules should be of high affinity and should have a broad specificity. Preferably, 30 they neutralize as many fixed and street strains of rabies virus as possible. Even more preferably, they also exhibit neutralizing activity towards other genotypes of the 49 Lyssavirus genus or even with other viruses of the rhabdovirus family, while exhibiting no cross-reactivity with other viruses or normal cellular proteins. Preferably, the binding molecule is capable of neutralizing escape variants of the 5 other binding molecule in the cocktail. Another aspect of the present invention pertains to a pharmaceutical composition comprising at least two rabies virus neutralizing binding molecules, preferably (human) binding molecules according to the invention, characterized in 10 that the binding molecules are capable of reacting with different, non-competing epitopes of the rabies virus. In an embodiment the pharmaceutical composition comprises a first rabies virus neutralizing binding molecule which is capable of reacting with an epitope located in antigenic site I of the 15 rabies virus G protein and a second rabies virus neutralizing binding molecule which is capable of reacting with an epitope located in antigenic site III of the rabies virus G protein. -The antigenic structure of the rabies glycoprotein was initially defined by Lafon et al. (1983). The antigenic sites 20 were identified using a panel of mouse mAbs and their respective mAb resistant virus variants. Since then, the antigenic sites have been mapped by identification of the amino acid mutations in the glycoprotein of mAb resistant variants (see Seif et al., 1985; Prehaud et al., 1988; and 25 Benmansour et al., 1991). The majority of rabies neutralizing mAbs are directed against antigenic site II (see Benmansour et al., 1991), which is a discontinuous conformational epitope comprising of amino acid 34-42 and amino acid 198-200 (see Prehaud et al., 1988). Antigenic site III is a continuous 30 conformational epitope at amino acid 330-338 and harbors two charged residues, K330 and R333, that affect viral pathogenicity (see Seif et al., 1985; Coulon et al., 1998; and 50 Dietzschold et al., 1983). The conformational antigenic site I was defined by only one mAb, 509-6, and located at amino acid 231 (see Benmansour et al., 1991; and Lafon et al., 1983). Antigenic site IV is known to harbor overlapping linear 5 epitopes (see Tordo, 1996; Bunschoten et al., 1989; Luo et al., 1997; and Ni et al., 1995). Benmansour et al. (1991) also described the presence of minor site a located at position 342-343, which is distinct from antigenic site III despite its close proximity. Alignment of the CR-57 epitope with the 10 currently known linear and conformational neutralizing epitopes on rabies glycoprotein (Figure 10) revealed that the CR-57 epitope is located in the same region as the conformational antigenic site I, defined by the single mAb 509-6. Based on nucleotide and amino acid sequences of the 15 glycoprotein of the escape viruses of CR04-098, the epitope recognized by this antibody appears to be located in the same region as the continuous conformational antigenic site III. In a preferred embodiment the pharmaceutical composition comprises a first rabies virus neutralizing binding molecule 20 comprising at least a CDR3 region, preferably heavy chain CDR3 region, comprising the amino acid sequence of SEQ ID NO:25 and a second rabies virus neutralizing binding molecule comprising at least a CDR3 region, preferably heavy chain CDR3 region, comprising the amino acid sequence selected from the group 25 consisting of SEQ ID NO:4, SEQ ID NO:10, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16 and SEQ ID NO:22. More preferably, the second rabies virus neutralizing binding molecule comprises at least a CDR3 region, preferably heavy chain CDR3 region, comprising the amino acid sequence of SEQ ID NO:14. 30 Preferably, the first rabies virus neutralizing binding molecule comprises a heavy and light chain comprising the amino acid sequences of SEQ ID NO:123 and SEQ ID NO:125, 51 respectively, and the second rabies.virus neutralizing binding molecule comprises a heavy and light chain comprising the amino acid sequences of SEQ ID NO:335 and SEQ ID NO:337, respectively. Preferably, the heavy and light chain of the 5 first rabies virus neutralizing binding molecule are encoded by SEQ ID NO:122 and SEQ ID NO:124, respectively, and the heavy and light chain of the second rabies virus neutralizing binding molecule are encoded by SEQ ID NO:334 and SEQ ID NO:336, respectively. 10 A pharmaceutical composition comprising two binding molecules, wherein the pI of the binding molecules is divergent may have a problem when choosing a .suitable buffer which optimally stabilizes both binding molecules. When adjusting the pH of the buffer of the composition such that it 15 increases the stability of one binding molecule, this might decrease the stability of the other binding molecule. Decrease of stability or even instability of a binding molecule may lead to its precipitation or aggregation or to its spontaneous degradation resulting in loss of the functionality of the 20 binding molecule. Therefore, in another aspect the invention provides a pharmaceutical composition comprising at least two binding molecules, preferably human binding molecules, characterized in that the binding molecules have isoelectric points (pI) that differ less than about 1.5, 1.4, 1.3, 1.2, 25 1.1, 1.0, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, preferably less than (and including) 0.25 pI units from one another. The p1 can be measured experimentally, e.g. by means of isoelectric focusing, or be calculated based on the amino acid sequence of the binding molecules. In an embodiment the binding molecules 30 are binding molecules according to the present invention and the pharmaceutical composition is a pharmaceutical composition according to the invention. Preferably, the binding molecules 52 are monoclonal antibodies, e.g. human monoclonal antibodies such as IgG1 antibodies. Preferably, the binding molecules are capable of binding to and/or neutralizing an infectious agent, e.g. a virus, a bacterium, a yeast, a fungus or a parasite. In 5 an embodiment the binding molecules are capable of binding to and/or neutralizing a lyssavirus, e.g. rabies virus. In a specific embodiment both binding molecules have a calculated pI that is in the range between 8.0-9.5, preferably 8.1-9.2, more preferably 8.2-8.5. Preferably, the binding molecules 10 have the heavy chain CDR3 region of SEQ ID NO:14 and SEQ ID NO:25, respectively. In another embodiment the invention provides a cocktail of two or more human or other animal binding molecules, including but not limited to antibodies, wherein at least one 15 binding molecule is derived from an antibody phage or other replicable package display technique and at least one binding molecule is obtainable by a hybridoma technique. When divergent techniques being used, the selection of binding molecules having a compatible pI is also very useful in order 20 to obtain a composition wherein each binding molecule is sufficiently stable for storage, handling and subsequent use. In another embodiment the binding molecules present in the pharmaceutical composition of the invention augment each others neutralizing activity, i.e. they act synergistically 25 when combined. In other words, the pharmaceutical compositions may exhibit synergistic rabies virus, and even lyssavirus, neutralizing activity. As used herein, the term "synergistic" means that the combined effect of the binding molecules when used in combination is greater than their additive effects 30 when used individually. The ranges and ratios of the components of the pharmaceutical compositions of the invention should be determined based on their individual potencies and tested in 53 in vitro neutralization assays or animal models such as hamsters. Furthermore, the pharmaceutical composition according to the invention may comprise at least one other therapeutic, 5 prophylactic and/or diagnostic agent. Said further therapeutic and/or prophylactic agents may be anti-viral agents such as ribavirin or interferon-alpha. The binding molecules or pharmaceutical compositions of the invention can be tested in suitable animal model systems 10 prior to use in humans. Such animal model systems include, but are not limited to, mice, rats, hamsters, monkeys, etc. Typically, pharmaceutical compositions must be sterile and stable under the conditions of manufacture and storage. The human binding molecules, variant or fragments thereof, 15 immunoconjugates, nucleic acid molecules or compositions of the present invention can be in powder form for reconstitution in the appropriate pharmaceutically acceptable excipient before or at the time of delivery. In the case of sterile powders for the preparation of sterile injectable solutions, 20 the preferred methods of preparation are vacuum drying and freeze-drying lyophilizationn) that yield a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof. Alternatively, the binding molecules, variant or 25 fragments thereof, immunoconjugates, nucleic acid molecules or compositions of the present invention can be in solution and the appropriate pharmaceutically acceptable excipient can be added and/or mixed before or at the time of delivery to provide a unit dosage injectable form. Preferably, the 30 pharmaceutically acceptable excipient used in the present invention is suitable to high drug concentration, can maintain proper fluidity and, if necessary, can delay absorption.
54 The choice of the optimal route of administration of the pharmaceutical compositions will be influenced by several factors including the physico-chemical properties of the active molecules within the compositions, the urgency of the 5 clinical situation and the relationship of the plasma concentrations of the active molecules to the desired therapeutic effect. For instance, if necessary, the human binding molecules of the invention can be prepared with carriers that will protect them against rapid release, such as 10 a controlled release formulation, including implants, transdermal patches, and microencapsulated delivery systems. Biodegradable, biocompatible polymers can inter alla be used, such as ethylene vinyl acetate, poly-anhydrides, poly-glycolic acid, collagen, poly-orthoesters, and poly-lactic acid. 15 Furthermore, it may be necessary to coat the human binding molecules with, or co-administer the binding molecules with, a material or compound that prevents the inactivation of the human bingling molecules. For example, the human binding molecules may be administered to a subject in an appropriate 20 carrier, for example, liposomes, or a diluent. The routes of administration can. generally be divided into two main categories, oral and parenteral administration. The preferred administration of the human binding molecules and pharmaceutical compositions of the invention is into and 25 around the wound and intramuscularly in the gluteal region. Formulations of the human binding molecules and pharmaceutical compositions are dependent on the routes of administration. In a further aspect, the binding molecules, functional variants, immunoconjugates, compositions, or pharmaceutical 30 compositions of the invention can be used as a medicament. So, a method of treatment and/or prevention of a lyssavirus infection using the human binding molecules, functional 55 variants, immunoconjugates, compositions, or pharmaceutical compositions of the invention is another part of the present invention. The lyssavirus can be a virus from any of the known genotypes, but is preferably rabies virus. The above-mentioned 5 molecules or compositions can be used in the postexposure prophylaxis of rabies. The molecules or compositions mentioned above may be employed in conjunction with other molecules useful in diagnosis, prophylaxis and/or treatment of rabies virus. They 10 can be used in vitro, ex vivo or in vivo. For instance, the human binding molecules, functional variants, immunoconjugates or pharmaceutical compositions of the invention can be co administered with a vaccine against rabies. Alternatively, the vaccine may also be administered before or after 15 administration of the molecules or compositions of the invention. Administration of the molecules or compositions of the invention with a vaccine is suitable for post exposure prophylaxis. Rabies'vaccines include, but are not limited to, purified chick embryo cell (PCEC) vaccine (RabAvert), human 20 diploid cell vaccine (HDCV; Imovax vaccine) or rabies vaccine adsorbed (RVA). The molecules are typically formulated in the compositions and pharmaceutical compositions of the invention in a therapeutically or diagnostically effective amount. 25 Dosage regimens can be adjusted to provide the optimum desired response (e.g., a therapeutic response). A suitable dosage range may for instance be 0.1-100 IU/kg body weight, preferably 1.0-50 IU/kg body weight and more preferably 10-30 IU/kg body weight, such as 20 IU/kg body weight. 30 Preferably, a single bolus of the binding molecules or pharmaceutical compositions of the invention are administered. The molecules and pharmaceutical compositions according to the 56 present invention are preferably sterile. Methods to render these molecules and compositions sterile are well known in the art. The dosing regimen of post exposure prophylaxis is administration of five doses of rabies vaccine intramuscularly 5 in the deltoid muscle on days 0, 3, 7, 14 and 28 days after exposure in individuals not previously immunized against rabies virus. The human binding molecules or pharmaceutical compositions according to the invention should be administered into and around the wounds on day 0 or otherwise as soon as 10 possible after exposure, with the remaining volume given intramuscularly at a site distant from the vaccine. Non vaccinated individuals are advised to be administered anti rabies virus human binding molecules, but it is clear to the skilled artisan that vaccinated individuals in need of such 15 treatment may also be administered anti-rabies virus human binding molecules. In another aspect, the invention concerns the use of binding molecules or functional variants thereof,, immunoconjugates according to the invention, nucleic acid 20 molecules according to the invention, compositions or pharmaceutical compositions according to the invention in the preparation of a medicament for the diagnosis, prophylaxis, treatment, or combination thereof, of a condition resulting from an infection by a lyssavirus. The lyssavirus can be a 25 virus from any of the known genotypes but is preferably rabies virus. Preferably the molecules mentioned above are used in the preparation of a medicament for the post exposure prophylaxis of rabies. Next to that, kits comprising at least one binding 30 molecule according to the invention, at least one functional variant thereof according to the invention, at least one immunoconjugate according to the invention, at least one 57 nucleic acid molecule according to the invention, at least one composition according to the invention, at least one pharmaceutical composition according to the invention, at least one vector according to the invention, at least one host 5 according to the invention or a combination thereof are also a part of the present invention. Optionally, the above described components of the kits of the invention are packed in suitable containers and labeled for diagnosis, prophylaxis and/or treatment of the indicated conditions. The above-mentioned 10 components may be stored in unit or multi-dose containers, for example, sealed ampoules, vials, bottles, syringes, and test tubes, as an aqueous, preferably sterile, solution or as a lyophilized, preferably sterile, formulation for reconstitution. The containers may be formed from a variety of is materials such as glass or plastic and may have a sterile access port (for example the container may be an intravenous solution bag or a vial having a stopper pierceable by a hypodermic injection needle). The kit may further comprise more containers comprising a pharmaceutically acceptable 20 buffer, such as phosphate-buffered saline, Ringer's solution and dextrose solution. It may further include other materials desirable from a commercial and user standpoint, including other buffers, diluents, filters, needles, syringes, culture medium for one or more of the suitable hosts. Associated with 25 the kits can be instructions customarily included in commercial packages of therapeutic, prophylactic or diagnostic products, that contain information about for example the indications, usage, dosage, manfacture, administration, contraindications and/or warnings concerning the use of such 30 therapeutic, prophylactic or diagnostic products. Currently, HRIG products are used for post exposure prophylaxis of rabies. An adult dose of HRIG of 1500 IU (75 kg 58 individual, 20 IU/kg) is only available in a volume of 10 ml. More concentrated BRIG products are not possible as the currently obtainable 10 ml dose contains 1-1.5 gram of total IgG. In view thereof the current BRIG products have two 5 drawbacks. Firstly, it is often not anatomically feasible to administer the recommended full dose in and around the bite wounds and secondly the administration of the current volume dose of HRIG is associated with significant pain. The present invention gives a solution to these drawbacks as it provides a 10 pharmaceutical composition comprising a full adult dose in a volume of approximately 2 ml or less, if desirable. Such a pharmaceutical composition may comprise for example two binding molecules capable of neutralizing rabies virus, preferably CR57 and CR04-098. The pharmaceutical composition 15 further comprises a pharmaceutically acceptable excipient and has a volume of around 2 ml. More is also possible, but less desirable in view of the pain associated with injecting larger volumes. Less than 2 mlis also possible. The pharmaceutical composition comprises the full adult dose (in IU) necessary 20 for successful post exposure prophylaxis. In an embodiment the pharmaceutical composition is stored in 10 ml vial such as for instance a 10 ml ready-to-use vial (type I glass) with a stopper. By providing a 10 ml vial the option is given to dilute the pharmaceutical composition towards a higher volume 25 in case an individual presents a large wound surface area. The invention also provides a kit comprising at least a container (such as a vial) comprising the pharmaceutical composition. The kit may further comprise a second container which holds a diluent suitable for diluting the pharmaceutical composition 30 towards a higher volume. Suitable diluents include, but are not limited to, the pharmaceutically acceptable excipient of the pharmaceutical composition and a saline solution.
59 Furthermore, the kit may comprise instructions for diluting the pharmaceutical composition and/or instructions for administering the pharmaceutical composition, whether diluted or not. 5 The invention further pertains to a method of detecting a rabies virus in a sample, wherein the method comprises the steps of a) contacting a sample with a diagnostically effective amount of a binding molecule, a functional variant or an immunoconjugate according to the invention, and b) 10 determining whether the binding molecule, functional variant, or immunoconjugate specifically binds to a molecule of the sample. The sample may be a biological sample including, but not limited to blood, serum, tissue or other biological material from (potentially) infected subjects. The 15 (potentially) infected subjects may be human subjects, but also animals that are suspected as carriers of rabies virus might be tested for the presence of rabies virus using the human binding molecules, functional variants or immunoconjugates of the invention. The sample may first be 20 manipulated to make it more suitable for the method of detection. Manipulation means inter alla treating the sample suspected to contain and/or containing rabies virus in such a way that the rabies virus will disintegrate into antigenic components such as proteins, (poly)peptides or other antigenic 25 fragments. Preferably, the binding molecules, functional variants or immunoconjugates of the invention are contacted with the sample under conditions which allow the formation of an immunological complex between the human binding molecules and rabies virus or antigenic components thereof that may be 30 present in the sample. The formation of an immunological complex, if any, indicating the presence of rabies virus in the sample, is then detected and measured by suitable means.
60 Such methods include, Inter alia, homogeneous and heterogeneous binding immunoassays, such as radioimmuroassays (RIA), ELISA, immunofluorescence, immunohistochemistry, FACS, BIACORE and Western blot analyses. 5 Furthermore, the binding molecules of the invention can be used to identify epitopes of rabies virus proteins such as the G protein. The epitopes can be linear, but also structural and/or conformational. In one embodiment, binding of binding molecules of the invention to a series of overlapping 10 peptides, such as 15-mer peptides, of a protein from rabies virus such as the rabies virus G protein can be analyzed by means of PEPSCAN analysis (see inter alla WO 84/03564, WO 93/09872, Slootstra et al. 1996). The binding of human binding molecules to each peptide can be tested in a PEPSCAN-based 15 enzyme-linked immuno assay (ELISA). In another embodiment, a random peptide library comprising peptides from rabies virus' proteins can be screened for peptides capable of binding to the human binding molecules of the invention. In the above assays the use of rabies virus neutralizing human binding 20 molecules may identify one or more neutralizing epitopes. The peptides/epitopes found can be used as vaccines and for the diagnosis of rabies. In a further aspect, the invention provides a method of screening a binding molecule or a functional variant of a 25 binding molecule for specific binding to a different, preferably non-overlapping epitope of rabies virus as the epitope bound by a binding molecule or functional variant of the invention, wherein the method comprises the steps of a) contacting a binding molecule or a functional variant to be 30 screened, a binding molecule or functional variant of the invention and rabies virus or a fragment thereof (such as for instance the rabies virus G protein), b) measure if the 61 binding molecule or functional variant to be screened is capable of competing for specifically binding to the rabies virus or fragment thereof with the binding molecule or functional variant of the invention. If no competition is 5 measured the binding molecules or functional variants to be screened bind to a different epitope. In a specific embodiment of the above screening method, human binding molecules or functional variants thereof may be screened to identify human binding molecules or functional variants capable of binding a 10 different epitope than the epitope recognized by the binding molecule comprising the CDR3 region comprising the amino acid sequence of SEQ ID NO:25. Preferably, the epitopes are non overlapping or non-competing. It is clear to the skilled person that the above screening method can also be used to 15 identify binding molecules or functional variants thereof capable of binding to the same epitope. In a further step it may be determined if the screened binding molecules that are not capable of competing, for specifically binding to the rabies virus or fragment thereof have neutralizing activity. 20 It may also be determined if the screened binding molecules that are capable of competing for specifically binding to the rabies virus or fragment thereof have neutralizing activity. Neutralizing anti-rabies virus binding molecules or functional variants thereof found in the screening method are another 25 part of the present invention. In the screening method "specifically binding to the same epitope" also contemplates specific binding to substantially or essentially the same epitope as the epitope bound by the human binding molecules of the invention. The capacity to block, or compete with, the 30 binding of the human binding molecules of the invention to rabies virus typically indicates that a binding molecule to be screened binds to an epitope or binding site on the rabies 62 virus that structurally overlaps with the binding site on the rabies virus that is immunospecifically recognized by the binding molecules of the invention. Alternatively, this can indicate that a binding molecule to be screened binds to an 5 epitope or binding site which is sufficiently proximal to the binding site immunospecifically recognized by the binding molecules of the invention to sterically or otherwise inhibit binding of the binding molecules of the invention to rabies virus or a fragment thereof. 10 In general, competitive inhibition is measured by means of an assay, wherein an antigen composition, i.e. a composition comprising rabies virus or fragments (such as G proteins) thereof, is admixed with reference binding molecules and binding molecules to be screened. In an embodiment the 15 reference binding molecule may be one of the human binding molecules of the invention and the binding molecule to be screened may be another human binding molecule of the invention. In another embodiment the reference binding molecule may be the binding molecule comprising the CDR3 20 region comprising the amino acid sequence of SEQ ID NO:25 and the binding molecule to be screened may be one of the human binding molecules of the invention. In yet another embodiment the reference binding molecule may be one of- the human binding molecule of the invention and the binding molecule to be 25 screened may be the binding molecule comprising the CDR3 region comprising the amino acid sequence of SEQ ID NO:25. Usually, the binding molecules to be screened are present in excess. Protocols based upon ELISAs are suitable for use in such simple competition studies. In certain embodiments, one 30 may pre-mix the reference binding molecules with varying amounts of the binding molecules to be screened (e.g., 1:10, 1:20, 1:30, 1:40, 1:50, 1:60, 1:70, 1:80, 1:90 or 1:100) for a 63 period of time prior to applying to the antigen composition. In other embodiments, the reference binding molecules and varying amounts of binding molecules to be screened can simply be admixed during exposure to the antigen composition. In any 5 event, by using species or isotype secondary antibodies one will be able to detect only the bound reference binding molecules, the binding of which will be reduced by the presence of a binding molecule to be screened that recognizes substantially the same epitope. In conducting a binding 10 molecule competition study between a reference binding molecule and any binding molecule to be screened (irrespective of species or isotype), one may first label the reference binding molecule with a detectable label, such as, e.g., biotin, an enzymatic, a radioactive or other label to enable 15 subsequent identification. In these cases, one would pre-mix or incubate the labeled reference binding molecules with the binding molecules to be screened at various ratios (e.g., 1:10, 1:20, 1:30, 1:40, 1:50, 1:60, 1:70, 1:80, 1:90 or 1:100) and (optionally after a suitable period of time) then assay 20 the reactivity of the labeled reference binding molecules and compare this with a control value in which no potentially competing binding molecule was included in the incubation. The assay may again be any one of a range of immunological assays based upon antibody hybridization, and the reference binding 25 molecules would be detected by means of detecting their label, e.g., using streptavidin in the case of biotinylated reference binding molecules or by using a chromogenic substrate in connection with an enzymatic label (such as 3,3'5,5' tetramethylbenzidine (TMB) substrate with peroxidase enzyme) 30 or by simply detecting a radioactive label. A binding molecule to be screened that binds to the same epitope as the reference binding molecule will be able to effectively compete for 64 binding and thus will significantly reduce reference binding molecule binding, as evidenced by a reduction in bound label. Binding molecules binding different non-competing epitopes will show no reduction. The reactivity of the (labeled) 5 reference binding molecule in the absence of a completely irrelevant binding molecule would be the control high value. The control low value would be obtained by incubating the labeled reference binding molecule with unlabelled reference binding molecules of exactly the same type, when competition 10 would occur and reduce binding of the labeled reference binding molecule. In a test assay, a significant reduction in labeled reference binding molecule reactivity in the presence of a binding molecule to be screened is indicative of a binding molecule that recognizes the same epitope, i.e., one 15 that "cross-reacts" with the labeled reference binding molecule. If no reduction is shown, the binding molecule may bind a different non-competing epitope. Binding molecules identifiedby these competition assays ("competitive binding molecules") include, but are not limited 20 to, antibodies, antibody fragments and other binding agents that bind to an epitope or binding site bound by the reference binding molecule as well as antibodies, antibody fragments and other binding agents that bind to an epitope or binding site sufficiently proximal to an epitope bound by the reference 25 binding molecule for competitive binding between the binding molecules to be screened and the reference binding molecule to occur. Preferably, competitive binding molecules of the invention will, when present in excess, inhibit specific binding of a reference binding molecule to a selected target 30 species by at least 10%, preferably by at least 25%, more preferably by at least 50%, and most preferably by at least 75%-90% or even greater. The identification of one or more 65 competitive binding molecules that bind to about, substantially, essentially or at the same epitope as the binding molecules of the invention is a straightforward technical matter. As the identification of competitive binding 5 molecules is determined in comparison to a reference binding molecule, it will be understood that actually determining the epitope to which the reference binding molecule and the competitive binding molecule bind is not in any way required in order to identify a competitive binding molecule that binds 10 to the same or substantially the same epitope as the reference binding molecule. Alternatively, binding molecules binding to different non-competing epitopes identified by these competition assays may also include, but are not limited to, antibodies, antibody fragments and other binding agents. 15 In another aspect the invention provides a method of identifying a binding molecule potentially having neutralizing activity against an infectious agent causing disease in a living being, r a nucleic acid molecule encoding a binding, molecule potentially having neutralizing activity against an 20 infectious agent causing disease in a living being, wherein the method comprises the steps of a) contacting a collection of binding molecules on the surface of replicable genetic packages with at least a cell expressing a protein of the infectious agent causing disease in a'living being on its 25 surface under conditions conducive to binding, b) separating and recovering binding molecules that bind to the cell expressing a protein of the infectious agent causing disease in a living being on its surface from binding molecules that do not bind said cell, c) isolating at least one recovered 30 binding molecule, d) verifying if the binding molecule isolated has neutralizing activity against the infectious agent causing disease in a living being. The cell expressing a 66 protein of the infectious agent causing disease in a living being on its surface can be a cell transfected with the protein. A person skilled in the art is aware that antigens of the infectious agent other than proteins can also be 5 successfully used in the method. In a specific embodiment the cell is a PER.C6@ cell. However, other (El-immortalized) cell lines could also be used to express the proteins such as BBK, CEO, NSO, HEK293, or 911 cells. In an embodiment the binding molecule is human. The infectious agent can be a virus, a 10 bacterium, a yeast, a fungus or a parasite. In an embodiment the protein is a protein normally expressed on the surface of the infectious agent or comprises at least a part of a protein that is surface accessible. In a specific embodiment the collection of binding molecules on the surface of replicable 15 genetic packages are subtracted/counterselected with the cells used for expressing of the protein of the infectious agent, i.e. the cells are identical to the cells used in step a with the proviso that they do not express the protein of the infectious agent on their surface. The cells used for 20 subtraction/counterselection can be untransfected cells. Alternatively, the cells can be transfected with a protein or (extracellular) part thereof that is similar and/or highly homologous in sequence or structure with the respective protein of the infectious agent and/or that is derived from an 25 infectious agent of the same family or even genus. Another aspect of the invention pertains to a binding molecule as defined herein having rabies virus neutralizing activity, characterized in that the human binding molecule comprises at least a heavy chain CDR3 region comprising the 30 amino acid sequence comprising SEQ ID NO:25 and further characterized in that the human binding molecule has a rabies virus neutralizing activity of at least 2500 IU/mg protein.
67 More preferably, said human binding molecule has a rabies virus neutralizing activity of at least 2800 IU/mg protein, at least 3000 IU/mg protein, at least 3200 IU/mg protein, at least 3400 IU/mg protein, at least 3600 IU/mg protein, at 5 least 3800 IU/mg protein, at least 4000 IU/mg protein, at least 4200 IU/mg protein, at least 4400 IU/mg protein, at least 4600 IU/mg protein, at least 4800 IU/mg protein, at least 5000 IU/mg protein, at least 5200 IU/mg protein, at least 5400 IU/mg protein. The neutralizing activity of the 10 binding molecule was measured by an In vitro neutralization assay (modified RFFIT (rapid fluorescent focus inhibition test)). The assay is described in detail in the example section infra. In an embodiment the binding molecule comprises a 15 variable heavy chain comprising the amino acid sequence comprising SEQ ID NO:273. In another embodiment the binding molecule comprises a heavy chain comprising the amino acid sequence comprising SEQ ID NO:123. The variable light chain of the binding molecule may comprise the amino acid sequence 20 comprising SEQ ID NO:275. The light chain of the binding molecule may comprise the amino acid sequence comprising SEQ ID NO:125. A nucleic acid molecule encoding the binding molecules as described above is also a part of the present invention. 25 Preferably, the nucleic acid molecule comprises the nucleotide sequence comprising SEQ ID NO:122. In addition the nucleic acid molecule may also comprise the nucleotide sequence comprising SEQ ID NO:124. A vector comprising the nucleic acid molecules and a host cell comprising such a vector are also 30 provided herein. Preferably, the host cell is a mammalian cell such as a human cell. Examples of cells suitable for production of human binding molecules are inter alia HeLa, 68 911, AT1080, A549, 293 and EEK293T cells. Preferred mammalian cells are human retina cells such as 911 cells or the cell line deposited at the European Collection of Cell Cultures (ECACC), CAMR, Salisbury, Wiltshire SP4 OJG, Great Britain on 5 29 February 1996 under number 96022940 and marketed under the trademark PER.C6* (PER.C6 is a registered trademark of Crucell Holland B.V.). For the purposes of this application "PER.C6" refers to cells deposited under number 96022940 or ancestors, passages up-stream or downstream as well as descendants from 10 ancestors of deposited cells, as well as derivatives of any of the foregoing. EXAMPLES 15 To illustrate the invention, the following examples are provided. The examples are not intended to limit the scope of the invention in any way. Example 1 20 Epitope recognition of human anti-rabies antibodies CR-57 and CR-JB To address whether the human monoclonal antibodies called CR-57 and CR-JB recognize non-overlapping, non-competing epitopes, escape viruses of the human monoclonal antibodies 25 called CR-57 and CR-JB were generated. CR-57 and CR-JB were generated essentially as described (see Jones et al., 2003), via introduction of the variable heavy and light chain coding regions of the corresponding antibody genes into a single human IgG1 expression vector named pcDNA3002(Neo). The 30 resulting vectors pgSO57C11 and pgSOJBC11 were used for transient expression in cells from the cell line deposited at the European Collection of Cell Cultures (ECACC), CAMR, 69 Salisbury, Wiltshire SP4 OJG, Great Britain on 29 February 1996 under number 96022940 and marketed under the trademark PER.C6@. The nucleotide and amino acid sequences of the heavy and light chains of these antibodies are shown in SEQ ID 5 NO:122 - 129, respectively. Serial dilutions (0.5 ml) of rabies virus strain CVS-11 (dilutions ranging from 10-1 - 10-8) were incubated with a constant amount (-4 IU/ml) of antibody CR-57 or CR-JB (0.5 ml) for 1 hour at 370C/5% C02 before addition to wells containing mouse neuroblastoma cells (MMA 10 cells) or BSR cells (Baby Hamster Kidney-like cell line). After 3 days of selection in the presence of either human monoclonal antibody CR-57 or CR-JB, medium (1 ml) containing potential escape viruses was harvested and stored at 40C until further use. Subsequently, the cells were acetone-fixed for 20 15 minutes at 40C, and stained overnight at 37*C/5% C02 with an anti-rabies N-FITC antibody conjugate (Centocor). The number of foci per well were scored by immunofluorescence and medium of wells containing one to six foci were chosen for virus amplification. All E57 escape viruses were generated from 1 20 single focus with the exception of E57B1 (3 foci). EJB escape viruses were isolated from 1 focus (EJB3F), 3 foci (EJB2B, 4 foci (EJB2C), 5 foci (EJB2E, 2F), or 6 foci (EJB2D), respectively. Each escape virus was first amplified on a small scale on BSR or MNA cells depending on their growth 25 characteristics. These small virus batches were then used to further amplify the virus on a large scale on MNA or BSR cells. Amplified virus was then titrated on MNA cells to determine the titer of each escape virus batch as well as the optimal dilution of the escape virus (giving 80-100 % 30 infection after 24 hours) for use in a virus neutralization assay.
70 Modified RFFIT (rapid fluorescent focus inhibition test) assays were performed to examine cross-protection of E57 (the escape viruses of CR-57) and EJB (the escape viruses of CR-JB) with CR-JB and CR-57, respectively. Therefore, CR-57 or CR-JB 5 was diluted by serial threefold dilutions starting with a 1:5 dilution. Rabies virus (strain CVS-11) was added to each dilution at a concentration that gives 80-100% infection. Virus/IgG mix was incubated for 1 hour at 37"C/5% CO 2 before addition to MNA cells. 24 hours post-infection (at 34*C/5% CO2) 10 the cells were acetone-fixed for 20 minutes at 4 0 C, and stained for minimally 3 hours with an anti-rabies virus N-FITC antibody conjugate (Centocor). The wells were then analyzed for rabies virus infection under a fluorescence microscope to determine the 50% endpoint dilution. This is the dilution at 15 which the virus infection is blocked by 50% in this assay. To calculate the potency, an international standard (Rabies Immune Globulin Lot R3, Reference material from the laboratory of Standards and Testing DMPQ/CBER/FDA) was included in each modified RFFIT. The 50% endpoint dilution of this standard 20 corresponds with a potency of 2 IU/ml. The neutralizing potency of the single human monoclonal antibodies CR-57 and CR-JB as well as the combination of these antibodies were tested. EJB viruses were no longer neutralized by CR-JB or CR-57 25 (see Table 1), suggesting both antibodies bound to and induced amino acid changes in similar regions of the rabies virus glycoprotein. E57 viruses were no longer neutralized by CR-57, whereas 4 out of 6 E57 viruses were still neutralized by CR JB, although with a lower potency (see Table 1). A mixture of 30 the antibodies CR-57 and CR-JB (in a 1:1 IU/mg ratio) gave 71 similar results as observed with the single antibodies (data not shown). To identify possible mutations in the rabies virus glycoprotein the nucleotide sequence of the glycoprotein open 5 reading frame (ORF) of each of the EJB and E57 escape viruses was determined. Viral RNA of each of the escape viruses and CVS-l1 was isolated from virus-infected MNA cells and converted into cDNA by standard RT-PCR. Subsequently, cDNA was used for nucleotide sequencing of the rabies virus 10 glycoprotein ORFs in order to identify mutations. Both E57 and EJB escape viruses showed mutations in the same region of the glycoprotein (see Figure 1 and 2, respectively; see for all the sequences described in Figures 1 and 2 SEQ ID NO:130 - 151). This indicates that both 15 antibodies recognize overlapping epitopes. From the above can be concluded that the combination of CR-57 and CR-JB in a cocktail does not prevent the escape of neutralization resistant variants and is therefore not an ideal immunoglobulin preparation for rabies post exposure 20 prophylaxis. Example 2 Construction of a ScFv phage display library using peripheral blood lymphocytes of rabies vaccinated donors. 25 From four rabies vaccinated human subjects 50 ml blood was drawn from a vein one week after the last boost. Peripheral blood lymphocytes (PBL) were isolated from these blood samples using Ficoll cell density fractionation. The blood serum was saved and frozen at -20'C. The presence of 30 anti-rabies antibodies in the sera was tested positive using a FACS staining on rabies virus glycoprotein transfected 293T cells. Total RNA was prepared from the PBL using organic phase 72 separation (TRIZOLm) and subsequent ethanol precipitation. The obtained RNA was dissolved in DEPC-treated ultrapure water and the concentration was determined by OD 260 nm measurement. Thereafter, the RNA was diluted to a concentration of 100 5 ng/pl. Next, 1 pg of RNA was converted into cDNA as follows: To 10 pl total RNA, 13 pl DEPC-treated ultrapure water and 1 pl random hexamers (500 ng/pl) were added and the obtained mixture was heated at 65*C for 5 minutes and quickly cooled on wet-ice. Then, 8 pL 5X First-Strand buffer, 2 pl dNTP (10 mM 10 each), 2 pl DTT (0.1 M), 2 pl Rnase-inhibitor (40 U/pl) and 2 pl SuperscriptmIII MMLV reverse transcriptase (200 U/pl) were added to the mixture, incubated at room temperature for 5 minutes and incubated for 1 hour at 50*C. The reaction was terminated by heat inactivation, i.e. by incubating the 15 mixture for 15 minutes at 75 0 C. The obtained cDNA products were diluted to a final volume of 200 pl with DEPC-treated ultrapure water. The OD 260 nm of a 50 times diluted solution (in 10 mM Tris buffer) of the dilution of the obtained cDNA products gave a value of 0.1. 20 For each donor 5 to 10 pl of the diluted cDNA products were used as template for PCR amplification of the immunoglobulin gamma heavy chain family and kappa or lambda light chain sequences using specific oligonucleotide primers (see Tables 2-7). PCR reaction mixtures contained, besides the 25 diluted cDNA products, 25 pmol sense primer and 25 pmol anti sense primer in a final volume of 50 pl of 20 mM Tris-HCl (pH 8.4), 50 mM KC1, 2.5 mM MgCl2, 250 pM dNTPs and 1.25 units Taq polymerase. In a heated-lid thermal cycler having a temperature of 96*C, the mixtures obtained were quickly melted 30 for 2 minutes, followed by 30 cycles of: 30 seconds at 96*C, 30 seconds at 60*C and 60 seconds at 72*C.
73 In a first round amplification, each of seventeen light chain variable region sense primers (eleven for the lambda light chain (see Table 2) and six for the kappa light chain (see Table 3) were combined with an anti-sense primer 5 recognizing the C-kappa called HuCk 5'-ACACTCTCCCCTGTTGAAGCT CTT-3' (see SEQ ID NO:152) or C-lambda constant region HuCX2 5'-TGAACATTCTGTAGGGGCCACTG-3' (see SEQ ID NO:153) and HuCX7 5'-AGAGCATTCTGCAGGGGCCACTG-3' (see SEQ ID NO:154) (the HuCX2 and BuCX7 anti-sense primers were mixed to equimolarity before 10 use), yielding 4 times 17 products of about 600 basepairs. These products were purified on a 2% agarose gel and isolated from the gel using Qiagen gel-extraction columns. 1/10 of each of the isolated products was used in an identical PCR reaction as described above using the same seventeen sense primers, 15 whereby each lambda light chain sense primer was combined with one of the three Jlambda-region specific anti-sense primers and each kappa light chain sense primer was combined with one of the five Jkappa-region specific anti-sense primers. The primers used in the second amplification were extended with 20 restriction sites (see Table 4) to enable directed cloning in the phage display vector PDV-C06 (see Figure 3 and SEQ ID NO:155). This resulted in 4 times 63 products of approximately 350 basepairs that were pooled to a total of 10 fractions. This number of fractions was chosen to maintain the natural 25 distribution of the different light chain families within the library and not to over or under represent certain families. The number of alleles within a family was used to determine the percentage of representation within a library (see Table 5). In the next step, 2.5 pg of pooled fraction and 100 pg 30 PDV-C06 vector were digested with SalI and NotI and purified from gel. Thereafter, a ligation was performed overnight at 16*C as follows. To 500 ng PDV-C06 vector 70 ng pooled 74 fraction was added in a total volume of 50 pl ligation mix containing 50 mM Tris-HCi (pH 7.5), 10 mM MgCl2, 10 mM DTT, 1 mM ATP, 25 pg/ml BSA and 2.5 pl T4 DNA Ligase (400 U/pl) . This procedure was followed for each pooled fraction. The ligation 5 mixes were purified by phenol/chloroform, followed by a chloroform extraction and ethanol precipitation, methods well known to the skilled artisan. The DNA obtained was dissolved in 50 pl ultrapure water and per ligation mix two times 2.5 il aliquots were electroporated into 40 pl of TG1 competent E. 10 coli bacteria according to the manufacturer's protocol (Stratagene). Transformants were grown overnight at 37"C in a total of 30 dishes (three dishes per pooled fraction; dimension of dish: 240 mm x 240 nm) containing 2TY agar supplemented with 50 pg/ml ampicillin and 4.5% glucose. A 15 (sub)library of variable light chain regions was obtained by scraping the transformants from the agar plates. This (sub)library was directly used for plasmid DNA preparation using a Qiagens QIAFilter MAXI prep kit. For each donor the heavy chain immunoglobulin sequences 20 were amplified from the same cDNA preparations in a similar two round PCR procedure and identical reaction parameters as described above for the light chain regions with the proviso that the primers depicted in Tables 6 and 7 were used. The first amplification was performed using a set of nine sense 25 directed primers (see Table 6; covering all families of heavy chain variable regions) each combined with an IgG specific constant region anti-sense primer called HuCIgG 5'-GTC CAC CTT GGT GTT GCT GGG CTT-3' (SEQ ID NO:156) yielding four times nine products of about 650 basepairs. These products were 30 purified on a 2% agarose gel and isolated from the gel using Qiagen gel-extraction columns. 1/10 of each of the isolated products was used in an identical PCR reaction as described 75 above using the same nine sense primers, whereby each heavy chain sense primer was combined with one of the four JH-region specific anti-sense primers. The primers used in the second round were extended with restriction sites (see Table 7) to 5 enable directed cloning in the light chain (sub)library vector. This resulted per donor in 36 products of approximately 350 basepairs. These products were pooled for each donor per used (VH) sense primer into nine fractions. The products obtained were purified using Qiagen PCR Purification 10 columns. Next, the fractions were digested with SfiI and XhoI and ligated in the light chain (sub)library vector, which was cut with the same restriction enzymes, using the same ligation procedure and volumes as described -above for the light chain (sub)library. Alternatively, the fractions were digested with 15 NcoI and XhoI and ligated in the light chain vector, which was cut with the same restriction enzymes, using the same ligation procedure and volumes as described above for the light chain (sub)library. Ligation purification and subsequent transformation of the resulting definitive library was also 20 performed as described above for the light chain (sub)library and at this point the ligation mixes of each donor were combined per VE pool. The transformants were grown in 27 dishes (three dishes per pooled fraction; dimension of dish: 240 mm x 240 mm) containing 2TY agar supplemented with 50 25 pg/ml ampicillin and 4.5% glucose. All bacteria were harvested in 2TY culture medium containing 50 pg/ml ampicillin and 4.5% glucose, mixed with glycerol to 15% (v/v) and frozen in 1.5 ml aliquots at -80*C. Rescue and selection of each library were performed as described below. 30 Example 3 76 Selection of phages carrying single chain FV fragments specifically recognizing rabies virus glycoprotein Antibody fragments were selected using antibody phage display libraries, general phage display technology and 5 MAbstract" technology, essentially as described in US Patent Number 6,265,150 and in WO 98/15833 (both of which are incorporated by reference herein). The antibody phage libraries used were two different semi-synthetic scFv phage libraries (JK1994 and WT2000) and the immune scFv phage 10 libraries (RAB-03-GO1 and RAB-04-G01) prepared as described in Example 2 above. The first semi-synthetic scFv phage library (JK1994) has been described in de Kruif et al. (1995b), the second one (WT2000) was build essentially as described in de Kruif et al. (1995b). Briefly, the library has a semi 15 synthetic format whereby variation was incorporated in the heavy and light chain V genes using degenerated oligonucleotides that incorporate variation within CDR regions. OnLy VE3 heavy chain genes were used, in combination with kappa- and lambda light chain genes. CDR1 and CDR3 of the 20 heavy chain and CDR3 of the light chain were recreated synthetically in a PCR-based approach similar as described in de Kruif et al. (1995b). The thus created V region genes were cloned sequentially in scFv format in a phagemid vector and amplified to generate a phage library as described before. 25 Furthermore, the methods and helper phages as described in WO 02/103012 (incorporated by reference herein) were used in the present invention. For identifying phage antibodies recognizing rabies virus glycoprotein phage selection experiments were performed using whole rabies virus (rabies 30 virus Pitman-Moore strain) inactivated by treatment with beta propiolactone, purified rabies virus glycoprotein (rabies 77 virus ERA strain), and/or transfected cells expressing rabies virus G protein (rabies virus ERA strain). The G protein was purified from the rabies virus ERA strain as follows. To a virus solution, 1/10 volume of 10% 5 octyl-beta-glucopyranoside was added and mixed gently. Upon a 30 minutes incubation at 4*C the virus sample was centrifuged (36,000 rpm, 4 0 C) in a SW51 rotor. The supernatant was collected and dialyzed overnight at 4*C against 0.1 M Tris/EDTA. Subsequently, the glycoprotein was collected from 10 the dialysis chamber, aliquotted, and stored at -80 0 C until further use. The protein concentration was determined by OD 280 nm and the integrity of the G protein was analyzed by SDS PAGE. Whole inactivated rabies virus or rabies virus G protein 15 were diluted in phosphate buffered saline (PBS), 2-3 ml was added to MaxiSorp Nunc-Immuno Tubes (Nunc) and incubated overnight at 4 0 C on a rotating wheel. An aliquot of a phage library (500 pl, approximately 1013 cfu, amplified using CT helper phage (see WO 02/103012)) was blocked in blocking 20 buffer (2% Protifar in PBS) for 1-2 hours at room temperature. The blocked phage library was added to the immunotube (either preincubated with or without CR-57 scFv to block the epitope recognized by CR-57), incubated for 2 hours at room temperature, and washed with wash buffer (0.1% Tween-20 25 (Serva) in PBS) to remove unbound phages. Bound phages were then eluted from the antigen by incubation for 10 minutes at room temperature with 1 ml of 50 mM Glycine-HCl pH 2.2. Subsequently, the eluted phages were mixed with 0.5 ml of 1 M Tris-HCl pH 7.5 to neutralize the pH. This mixture was used to 30 infect 5 ml of a XL1-Blue E. coli culture that had been grown at 37 0 C to an OD 600 nm of approximately 0.3. The phages were 78 allowed to infect the XL1-Blue bacteria for 30 minutes at 37*C. Then, the mixture was centrifuged for 10 minutes, at 3200*g at room temperature and the bacterial pellet was resuspended in 0.5 ml 2-trypton yeast extract (2TY) medium. 5 The obtained bacterial suspension was divided over two 2TY agar plates supplemented with tetracyclin, ampicillin and glucose. After incubation overnight of the plates at 37 0 C, the colonies were scraped from the plates and used to prepare an enriched phage library, essentially as described by De Kruif 10 et al. (1995a) and WO 02/103012. Briefly, scraped bacteria were used to inoculate 2TY medium containing ampicillin, tetracycline and glucose and grown at a temperature of 37 0 C to an OD 600 nm of -0.3. CT helper phages were added and allowed to infect the bacteria after which the medium was changed to 15 2TY containing ampicillin, tetracycline and kanamycin. Incubation was continued overnight at 30*C. The next day, the bacteria were removed from the 2TY medium by centrifugation after which the phages in the medium were precipitated using polyethylene glycol (PEG) 6000/NaCl. Finally, the phages were 20 dissolved in 2 ml of PBS with 1% bovine serum albumin (BSA), filter-sterilized and used for the next round of selection. Phage selections were also performed with rabies virus glycoprotein transfected cells. The cells used were cells from the cell line deposited at the European Collection of Cell 25 Cultures (ECACC), CAMR, Salisbury, Wiltshire SP4 OJG, Great Britain on 29 February 1996 under number 96022940 and marketed under the trademark PER.C6*. They are hereinafter referred to as PER.C6P cells. Here, the blocked phage library (2 ml) was first added to 1*107 subtractor cells (in DMEM/10% FBS) and 30 incubated for 1 hour at 4 0 C on a rotating wheel. The subtracter cells were PER.C6" cells that expressed the Vesicular Stomatitis Virus (VSV) glycoprotein ecto domain on their 79 surface fused to the rabies virus transmembrane and cytoplasmic domain. With this subtraction step phages recognizing either VSV glycoprotein or antigens specific for PER.C6* cells were removed from the phage library. The 5 phage/cell mixture was centrifuged (5 minutes at 40C at 500xg) to remove cell-bound phages, and the supernatant was added to a new tube containing 3 ml of 1*107 subtractor cells. The subtraction step was repeated twice with the respective supernatant. Subsequently, the subtracted phages were 10 incubated for 1.5 hours at 4"C on a rotating wheel with the rabies virus glycoprotein expressing transfected cells (PER.C6 cells (3*106 cells)). Before that, the transfected cells were preincubated either with or without CR-57 scFv to block the epitope recognized by CR-57. After incubation the cells were 15 washed five times with 1 ml of DMEM/10%FBS (for each wash, the cells were resuspended and transferred to new tube), phages were eluted and processed as described above. Typically, two rounds of selections were performed before isolation of individual phage antibodies. After the second 20 round of selection, individual E. coli colonies were used to prepare monoclonal phage antibodies. Essentially, individual colonies were grown to log-phase in 96 well plate format and infected with VCSM13 helper phages after which phage antibody production was allowed to proceed overnight. The produced 25 phage antibodies were PEG/NaCl-precipitated and filter sterilized and tested in ELISA for binding to both whole inactivated rabies virus and purified rabies virus G protein. From the selection a large panel of phage antibodies was obtained that demonstrated binding to both whole inactivated 30 rabies virus and rabies virus G protein (see example below). Two selection strategies were followed with the above described immune libraries. In the first strategy 736 phage 80 antibodies were selected after two selection rounds using in the first and second selection round inactivated virus or purified G protein. In the second strategy 736 phage antibodies were selected after two selection rounds using in 5 the first selection round cell surface expressed recombinant G protein and in the second selection round inactivated virus or purified G protein. The number of unique phage antibodies obtained by the first strategy was 97, while the second strategy yielded 70 unique ones. The 97 unique phage 10 antibodies found by means of the first strategy gave rise to 18 neutralizing antibodies and the 70 unique clones identified by means of the second strategy yielded 33 neutralizing antibodies. This clearly demonstrates that selections that included rabies virus glycoprotein tranfected cells, i.e. cell 15 surface expressed recombinant G protein, as antigen appeared to yield more neutralizing antibodies compared to selections using only purified G protein and/or inactivated virus. Example 4 20 Validation of the rabies virus glycoprotein specific single chain phage antibodies. Selected single-chain phage antibodies that were obtained in the screens described above, were validated in ELISA for specificity, i.e. binding to rabies virus G protein, purified 25 as described supra. Additionally, the single-chain phage antibodies were also tested for binding to 5% FBS. For this purpose, the rabies virus G protein or 5% FBS preparation was coated to Maxisorp m ELISA plates. After coating, the plates were blocked in PBS/1% Protifar for 1 hour at room 30 temperature. The selected single-chain phage antibodies were incubated for 15 minutes in an equal volume of PBS/1% Protifar to obtain blocked phage antibodies. The plates were emptied, 81 and the blocked phage antibodies were added to the wells. Incubation was allowed to proceed for one hour, the plates were washed in PBS containing 0.1% Tween-20 and bound phage antibodies were detected (using OD 492 nm measurement) using 5 an anti-M13 antibody conjugated to peroxidase. As a control, the procedure was performed simultaneously using no single chain phage antibody, a negative control single chain phage antibody directed against CD8 (SC02-007) or a positive control single chain phage antibody directed against rabies virus 10 glycoprotein (scFv S057). As shown in Table 8, the selected phage antibodies called SC04-001, SC04-004, SC04-008, SC04 010, SC04-018, SC04-021, SC04-026, SC04-031, SC04-038, SC04 040, SC04-060, SC04-073, SC04-097, SC04-098, SC04-103, SC04 104, SC04-108, SC04-120, SC04-125, SC04-126, SC04-140, SC04 15 144, SC04-146, and SC04-164 displayed significant binding to the immobilized purified rabies virus G protein, while no binding to FBS was observed. Identical results were obtained in ELISA using the w hole inactivated rabies virus prepared as described supra (data not shown). 20 Example 5 Characterization of the rabies virus specific scFvs From the selected specific single chain phage antibody (scFv) clones plasmid DNA was obtained and nucleotide 25 sequences were determined according to standard techniques. The nucleotide sequences of the scFvs (including restriction sites for cloning) called SC04-001, SC04-004, SC04-008, SC04 010, SC04-018, SC04-021, SC04-026, SC04-031, SC04-038, SC04 040, SC04-060, SC04-073, SC04-097, SC04-098, SC04-103, SC04 30 104, SC04-108, SC04-120, SC04-125, SC04-126, SC04-140, SC04 144, SC04-146, and SC04-164 are shown in SEQ ID NO:157, SEQ ID NO:159, SEQ ID NO:161, SEQ ID NO:163, SEQ ID NO:165, SEQ ID 82 NO:167, SEQ ID NO:169, SEQ ID NO:171, SEQ ID NO:173, SEQ ID NO:175, SEQ ID NO:177, SEQ ID NO:179, SEQ ID NO:181, SEQ ID NO:183, SEQ ID NO:185, SEQ ID NO:187, SEQ ID NO:189, SEQ ID NO:191, SEQ ID NO:193, SEQ ID NO:195, SEQ ID NO:197, SEQ ID 5 NO:199, SEQ ID NO:201 and SEQ ID NO:203, respectively. The amino acid sequences of the scFvs called SC04-001, SC04-004, SC04-008, SC04-010, SC04-018, SC04-021, SC04-026, SC04-031, SC04-038, SC04-040, SC04-060, SC04-073, SC04-097, SC04-098, SC04-103, SC04-104, SC04-108, SC04-120, SC04-125, SC04-126, 10 SC04-140, SC04-144, SC04-146, and SC04-164 are shown in SEQ ID NO:158, SEQ ID NO:160, SEQ ID NO:162, SEQ ID NO:164, SEQ ID NO:166, SEQ ID NO:168, SEQ ID NO:170, SEQ ID NO:172, SEQ ID NO:174, SEQ ID NO:176, SEQ ID NO:178, SEQ ID NO:180, SEQ ID NO:182, SEQ ID NO:184, SEQ ID NO:186, SEQ ID NO:188, SEQ ID 15 NO:190, SEQ ID NO:192, SEQ ID NO:194, SEQ ID NO:196, SEQ ID NO:198, SEQ ID NO:200, SEQ ID NO:202 and SEQ ID NO:204, respectively. The VH and VL gene identity (see Tomlinson IM, Williams SC, Ignatovitch 0, Corbett SJ, Winter G. V-BASE Sequence 20 Directory. Cambridge United Kingdom: MRC Centre for Protein Engineering (1997)) and heavy chain CDR3 compositions of the scFvs specifically binding the rabies virus G protein are depicted in Table 9. 25 Example 6 In vitro neutralization of rabies virus by rabies virus specific scFvs (modified RFFIT) In order to determine whether the selected scFvs were capable of blocking rabies virus infection, in vitro 30 neutralization assays (modified RFFIT) were performed. The scFv preparations were diluted by serial threefold dilutions starting with a 1:5 dilution. Rabies virus (strain CVS-11) was 83 added to each dilution at a concentration that gives 80-100 % infection. Virus/scFv mix was incubated for 1 hour at 37 0 C/5%
CO
2 before addition to MNA cells. 24 hours post-infection (at 34"C/5% CO 2 ) the cells were acetone-fixed for 20 minutes at 5 4*C, and stained for minimally 3 hours with an anti-rabies N FITC antibody conjugate (Centocor). The cells were then analyzed for rabies virus infection under a fluorescence microscope to determine the 50% endpoint dilution. This is the dilution at which the virus infection is blocked by 50% in 10 this assay (see Example 1). Several scFvs were identified that showed neutralizing activity against rabies virus (see Table 10). Additionally, it was investigated by means of the in vitro neutralization assay (modified RFFIT) as described 15 above, if the selected scFvs were capable of neutralizing the E57 escape viruses as prepared in Example 1 (E57A2, E57A3, E57B1, E57B2, E57B3 and E57C3). Several scFvs were identified that showed neutralizing activity against the E57 escape viruses (see Tables 11A and 11B). 20 Example 7 Rabies virus G protein competition ELISA with scFvs To identify antibodies that bind to non-overlapping, non competing epitopes, a rabies glycoprotein competition ELISA 25 was performed. Nunc-Immunom Maxisorp F96 plates (Nunc) were coated overnight at 4*C with a 1:1000 dilution of purified rabies virus glycoprotein (1 mg/ml; rabies virus ERA strain) in PBS (50 pl). Uncoated protein was washed away before the wells were blocked with 100 g1 PBS/1% Protifar for 1 hour at 30 room temperature. Subsequently, the blocking solution was discarded and 50 sl of the non-purified anti-rabies virus scFvs 84 in PBS/1% Protifar (2x diluted) was added. Wells were washed five times with 100 pl of PBS/0.05% Tween-20. Then, 50 pl biotinylated anti-rabies virus competitor IgG, CR-57bio, was added to each well, incubated for 5 minutes at room 5 temperature, and the wells were washed five times with 100 pl of PBS/0.05% Tween-20. To detect the binding of CR-57bio, 50 s1 of a 1:2000 dilution of streptavidin-HRP antibody (Becton Dickinson) was added to the wells and incubated for 1 hour at room temperature. Wells were washed again as above and the 10 ELISA ias further developed by addition of 100 pl of OPD reagens (Sigma). The reaction was stopped by adding 50 pl 1 M
H
2 SO4 before measuring the OD at 492 nm. The signal obtained with CR-57bio alone could be reduced to background levels when co-incubated with scFv S057, i.e. 15 the scFv form of CR-57 (for nucleotide and amino acid sequence of S057 see SEQ ID NO:205 and 206, respectively) or scFv SOJB, i.e. the scFv form of CR-JB (for nucleotide and amino acid sequence of SOJB see SEQ ID NO:312 and 313, respectively). This indicates that the scFvs S057 and SOJB compete with the 20 interaction of CR-57bio to rabies virus glycoprotein by binding to the same epitope or to an overlapping epitope as CR-57bio, respectively. In contrast, an irrelevant scFv called SC02-007, i.e. a scFv binding to CD8, did not compete for binding. The anti-rabies virus scFvs called SC04-004, SC04 25 010, SC04-024, SC04-060, SC04-073, SC04-097, SC04-098, SC04 103, SC04-104, SC04-120, SC04-125, SC04-127, SC04-140, SC04 144 and SC04-146 did also not compete with CR-57bio, indicating that these scFvs bind to a different epitope 'than the epitope recognized by CR-57 (see Figure 4). 30 Similar results were obtained with the following experiment. First, the rabies virus antibody CR-57 was added 85 to wells coated with rabies virus G protein. Next, the competing scFvs were added. In this set-up the anti-rabies virus scFvs were detected with anti-VSV-HRP by virtue of the presence of a VSV-tag in the scFv amino acid sequences (see 5 Figure 5). Example 8 Construction of fully human immunoglobulin molecules (human monoclonal anti-rabies virus antibodies) from the selected 10 anti-rabies virus single chain Fv's Heavy and light chain variable regions of the scFvs called SC04-001, SC04-008, SC04-018, SC04-040 and SC04-126 were PCR-amplified using oligonucleotides to append restriction sites and/or sequences for expression in the IgG 15 expression vectors pSyn-C03-HCyl (see SEQ ID No:277) and pSyn C04-Ck (see SEQ ID No:278), respectively. The VE and VL genes were amplified using the oligonucleotides as shown in Table 12 and 13, respectively, and the PCR products were cloned into the vectors pSyn-C03-HCy1 and pSyn-C04-C2, respectively. 20 Heavy and light chain variable regions of the scFvs called SC04-004, SC04-010, SC04-021, SC04-026, SC04-031, SC04 038, SC04-060, SC04-073, SC04-097, SC04-098, SC04-103, SCO4 104, SC04-108, SC04-120, SC04-125, SC04-140, SC04-144, SC04 146 and SC04-164 were also PCR-amplified using 25 oligonucleotides to append restriction sites and/or sequences for expression in the IgG expression vectors pSyn-C03-HCyl and pSyn-C05-CK (see SEQ ID No:279), respectively. The VE and VL genes were amplified using the oligonucleotides as given in Table 12 and 13, respectively, and the PCR products were 30 cloned into the vectors pSyn-C03-HCy1 and pSyn-C05-Ck, respectively. The oligonucleotides are designed such that they correct any deviations from the germline sequence that have 86 been introduced during library construction, due to the limited set of oligonucleotides that have been used to amplify the large repertoire of antibody genes. Nucleotide sequences for all constructs were verified according to standard 5 techniques known to the skilled artisan. The resulting expression constructs pgG104-001C03, pgG104-008C03, pgG104-018C03, pgG104-040C03 and pgG104-126C0 3 encoding the anti-rabies virus human IgG1 heavy chains in combination with the relevant pSyn-C04-VX construct encoding 10 the corresponding light chain were transiently expressed in 293T cells and supernatants containing IgG1 antibodies were obtained. The expression constructs pgG104-004C03, pgG104 010C03, pgG104-021C03, pgG104-026C03, pgGl04-031C03, pgGl04 038C03, pgG104-060C03, pgG104-073C03, pgGl04-097C03, pgG104 15 098C03, pgG104-103C03, pgG104-104C03, pgGl04-108C03, pgG104 120C03, pgG104-125C03, pgG104-140C03, pgGl4-144C03, pgG104 146C03 and pgG104-164C03 encoding the anti-rabies virus human IgG1 .heavy chains in combination with the relevant pSyn-C05-VK construct encoding the corresponding light chain were 20 transiently expressed in 293T cells and supernatants containing IgG1 antibodies were obtained. The nucleotide and amino acid sequences of the heavy and light chains of the antibodies called CR04-001, CR04-004, CR04-008, CR04-010, CR04-018, CR04-021, CR04-026, CR04-031, 25 CR04-038, CR04-040, CR04-060, CR04-073, CR04-097, CR04-098, CR04-103, CR04-104, CR04-108, CR04-120, CR04-125, CR04-126, CR04-140, CR04-144, CR04-146 and CR04-164 were determined according to standard techniques. Subsequently, the recombinant human monoclonal antibodies were purified over a 30 protein-A column followed by a buffer exchange on a desalting column using standard purification methods used generally for 87 immunoglobulins (see for instance WO 00/63403 which is incorporated by reference herein). Additionally, for CR04-098, a single human IgG1 expression vector named pgGl04-098C10 was generated as 5 described above for vectors pgSO57C1l and pgSOJBC11 encoding CR-57 and CR-JB, respectively (see Example 1). The nucleotide and amino acid sequences of the heavy and light chains of antibody CR04-098 encoded by vector pgG104-098C10 are shown in SEQ ID NO:334 - 337, respectively. Vectors pgSO57Cll (see 10 Example 1) and pgG104-098C10 were used for stable expression of CR-57 and CR04-098, respectively, in cells from the cell line deposited at the European Collection of Cell Cultures (ECACC), CAMR, Salisbury, Wiltshire SP4 OJG, Great Britain on 29 February 1996 under number 96022940 and marketed under the 15 trademark PER.C6@. The stably produced CR-57 and CR04-098 have a calculated isoelectric point of 8.22 and 8.46, respectively. The experimentally observed isoelectric points are between 8.1-8.3 for CR-57 and 9.0-9.2 for CR04-098. .The recombinant human monoclonal antibodies were purified as described above. 20 Unless otherwise stated, for CR04-001, CR04-004, CR04-008, CR04-010, CR04-018, CR04-021, CR04-026, CR04-031, CR04-038, CR04-040, CRO4-060, CR04-073, CR04-097, CR04-098, CR04-103, CR04-104, CR04-108, CR04-120, CR04-125, CR04-126, CR04-140, CR04-144, CR04-146 and CR04-164 use was made of recombinant 25 human monoclonal antibodies transiently expressed by the two vector system as described above and for CR57 use was made of recombinant human monoclonal antibody transiently expressed by the one vector system as described in Example 1.
88 Example 9 Rabies virus G protein competition ELISA with IgGs To address whether the human monoclonal anti-rabies virus 5 G protein IgGs bind to non-overlapping, non-competing epitopes, competition experiments are performed. Wells with coated rabies virus G protein are incubated with increasing concentrations (0-50 gg/ml) of unlabeled anti-rabies virus G protein IgG for 1 hour at room temperature. Then, 50 pl of a 10 different biotinylated anti-rabies virus IgG (1 pg/ml) is added to each well, incubated for 5 minutes at room temperature, and immediately washed five times with 100 gl of PBS/0.05% Tween 20. Subsequently, wells are incubated for 1 hour at room temperature with 50 gl of a 1:2000 dilution of streptavidin-HRP 15 (Becton Dickinson), washed and developed as described above. A decrease in signal with increasing concentration of unlabeled IgG indicates that the two antibodies are competing with each other and recognize the same epitope or overlapping epitopes. Alternatively, wells coated with rabies virus G protein 20 (ERA strain) were incubated with 50 gg/ml of unlabeled anti rabies virus G protein IgG for 1 hour at room temperature. Then, 50 pl of biotinylated CR57 (0.5-5 gg/ml; at subsaturated levels) was added to each well. The further steps were performed as described supra. The signals obtained were 25 compared to the signal obtained with only biotinylated CR57 (see Figure 6; no competitor). From Figure 6 can be deduced that the signal could not be reduced with the antibody called CR02-428 which served as a negative control. In contrast, competition with unlabeled CR57 (positive control) or CR-JB 30 reduced the signal to background levels. From Figure 6 can further be deduced that none of the anti-rabies virus G 89 protein IgGs competed significantly with CR-57, which is in agreement with the scFv competition data as described in Example 7. In addition, competition experiments were performed on 5 rabies virus G protein (ERA strain) transfected PER.C6 cells by means of flow cytometry. Transfected cells were incubated with 20 p1 of unlabeled anti-rabies virus G protein IgG (50 sg/ml) for 20 minutes at 4 *C. After washing of the cells with PBS containing 1% BSA, 20 g1 of biotinylated CR57 (0.5-5 pg/ml; at 10 subsaturated levels) were added to each well, incubated for 5 minutes at 4*C, and immediately washed twice with 100 IL1 of PBS containing 1% BSA. Subsequently, wells were incubated for 15 minutes at 4 0 C with 20 gl of a 1:200 dilution of streptavidin PE (Caltag), washed and developed as described above. The 15 signal obtained with biotinylated CR57 could not be reduced significantly with the negative control antibody CR02-428 (see Figure 7). In contrast, competition with unlabeled CR57 (positive control) or CR-JB reduced the signal to background levels. None of the anti-rabies virus G protein IgGs competed 20 significantly with CR-57, with the exception of CR04-126 which reduced the signal to approximately 30% (see Figure 7). The latter did not compete in ELISA (see Figure 6). This may be caused by the difference in the way the glycoprotein is presented to the antibody in FACS experiments compared to 25 ELISA experiments. The binding of CR04-126 could be.more dependent on the conformation of the glycoprotein, resulting in the competitive effect observed with CR04-126 in the FACS based competition assay and not in the ELISA-based competition assay. Additionally, CR04-008 and CR04-010 reduced the signal 30 to approximately 50% (see Figure 7) in the FACS-based competition assay indicating that they might compete with 90 CR57. For CR04-010 this was however not confirmed by the scFv competition data or the ELISA-based competition assay. For the other IgGs, the FACS data were in agreement with the respective ELISA data of both the scFvs and the IgGs. 5 Example 10 Additive/synergistic effects of anti-rabies IgGs in in vitro neutralization of rabies virus (modified RFFIT) In order to determine whether the anti-rabies virus G 10 protein IgGs have additive or synergistic effects in neutralization of rabies virus, different combinations of the IgGs are tested. First, the potency (in IU/mg) of each individual antibody is determined in a modified RFFIT (see Example 1) . Then, antibody combinations are prepared based on 15 equal amounts of IU/mg and tested in the modified RFFIT. The potencies of each antibody combination can be determined and compared with the expected potencies. If the potency of the antibody combination is equal to the sum of the. potencies of each individual antibody present in the combination, the 20 antibodies have an additive effect. If the potency of the antibody combination is higher, the antibodies have a synergistic effect in neutralization of rabies virus. Alternatively, additive or synergistic effects can be determined by the following experiment. First, the potency of 25 the antibodies to be tested, e.g. CR-57 and CR04-098, is determined in a standard RFFIT (see Laboratory techniques in rabies, Edited by: F.-X Meslin, M.M. Kaplan and H. Koprowski (1996), 4th edition, Chapter 15, World Health Organization, Geneva). Then, the antibodies are mixed in a 1:1 ratio based 30 on IU/ml. This antibody mixture, along with the individual antibodies at the same concentration, are tested in six independent RFFIT experiments to determine the 50% 91 neutralizing endpoint. Subsequently, the combination index (CI) is determined for the antibody mixture using the formula CI = (C1/Cxl) + (C2/Cx2) + (C1C2/CxlCx2) as described by Cbou et al. (1984). Cl and C2 are the amount (in pg) of monoclonal 5 antibody 1 and monoclonal antibody 2 that lead to 50% neutralization when used in combination and Cxl and Cx2 are the amount (in pg) of monoclonal antibody 1 and monoclonal antibody 2 that lead to 50% neutralization when used alone. CI = 1, indicates an additive effect, CI < 1 indicates a 10 synergistic effect and CI > 1 indicates an antagonistic effect of the monoclonal antibodies. Example 11 Identification of epitopes recognized by recombinant human 15 anti-rabies virus antibodies by PEPSCAN-ELISA 15-mer linear and looped/cyclic peptides were synthesized from the extracellular domain of the G protein of the rabies virus strain ERA (see SEQ ID NO:207 for the complete amino acid sequence of the glycoprotein G of the rabies virus strain 20 ERA, the extracellular domain consists of amino acids 20-458; the protein-id of the glycoprotein of rabies virus strain ERA in the EMBL-database is J02293) and screened using credit-card format mini-PEPSCAN cards (455 peptide formats/card) as described previously (Slootstra et al., 1996; WO 93/09872). 25 All peptides were acetylated at the amino terminus. In all looped peptides position-2 and position-14 were replaced by a cysteine (acetyl-X CXXXXXXXXCX-minicard) . If other cysteines besides the cysteines at position-2 and position-14 were present in a prepared peptide, the other cysteines were 30 replaced by an alanine. The looped peptides were synthesized using standard Fmoc-chemistry and deprotected using trifluoric acid with scavengers. Subsequently, the deprotected peptides 92 were reacted on the cards with an 0.5 mM solution of 1,3 bis (bromomethyl)benzene in ammonium bicarbonate (20 mM, pH 7.9/acetonitril (1:1 (v/v)). The cards were gently shaken in the solution for 30-60 minutes, while completely covered in 5 the solution. Finally, the cards were washed extensively with excess of H 2 0 and sonicated in disrupt buffer containing 1% SDS/0.1% beta-mercaptoethanol in PBS (pH 7.2) at 70*C for 30 minutes, followed by sonication in H 2 0 for another 45 minutes. The human monoclonal antibodies were prepared as described 10 above. Binding of these antibodies to each linear and looped peptide was tested in a PEPSCAN-based enzyme-linked immuno assay (ELISA). The 455-well creditcard-format polypropylene cards, containing the covalently linked peptides, were incubated with the antibodies (10 pg/ml; diluted in blocking 15 solution, which contained 5% horse-serum (v/v) and 5% ovalbumin (w/v)) (4*C, overnight). After washing, the peptides were incubated with anti-human antibody peroxidase (dilution 1/1000) (1 hour, 25 0 C), and subsequently, after washing the peroxidase substrate 2,2'-azino-di-3-ethylbenzthiazoline 20 sulfonate (ABTS) and 2 pl/ml 3% H 2 0 2 was added. Controls (for linear and looped) were incubated with anti-human antibody peroxidase only. After 1 hour the color development was measured. The color development of the ELISA was quantified with a CCD-camera and an image processing system. The set-up 25 consisted of a CCD-camera and a 55 mm lens (Sony CCD Video Camera XC-77RR, Nikon micro-nikkor 55 mm f/2.8 lens), a camera adaptor (Sony Camera adaptor DC-77RR) and the Image Processing Software package Optimas, version 6.5 (Media Cybernetics, Silver Spring, MD 20910, U.S.A.). Optimas ran on a pentium II 30 computer system. The human anti-rabies virus G protein monoclonal antibodies were tested for binding to the 15-mer linear and 93 looped/cyclic peptides synthesized as described supra. A peptide is considered to relevantly bind to an antibody when OD values are equal to or higher than two times the average OD-value of all peptides (per antibody). See Table 14 for 5 results of the binding of the human monoclonal antibodies called CR57, CRJB and CR04-010 to the linear peptides of the extracellular domain of glycoprotein G of rabies virus strain ERA. Regions' showing significant binding to the respective antibodies are highlighted in grey (see Table 14). 10 Antibody CR57 bound to the linear peptides having an amino acid sequence selected from the group consisting of SLKGACKLKLCGVLG (SEQ ID NO:314), LKGACKLKLCGVLGL (SEQ ID NO:315), KGACKLKLCGVLGLR (SEQ ID NO:316), GACKLKLCGVLGLRL (SEQ ID NO:317), ACKLKLCGVLGLRLM (SEQ ID NO:318), CKLKLCGVLGLRLMD 15 (SEQ ID NO:319), KLKLCGVLGLRLMDG (SEQ ID NO:320), LKLCGVLGLRLMDGT (SEQ ID NO:321) and KLCGVLGIRLMDGTW (SEQ ID NO:322) (see Table 14). The peptides having the amino acid sequejpces GACKLKLCGVLGLRL (SEQ ID NO:317), ACKLKLC.VLGLRM (SEQ ID NO:318) have an OD-value that is lower than twice the 20 average value. Nevertheless these peptides were claimed, because they are in the near proximity of a region of antigenic peptides recognised by antibody CR57. Binding was most prominent to the peptide with the amino acid sequence KLCGVLGLRLMDGTW (SEQ ID NO:322). 25 Antibody CR04-010 bound to the linear peptides having an amino acid sequence selected from the group consisting of GFGKAYTIFNKTLME (SEQ ID NO:323), FGKAYTIFNKTLMEA (SEQ ID NO:324), GKAYTIFNKTLMEAD (SEQ ID NO:325), KAYTIFNKTLMEADA (SEQ ID NO:326), AYTIFNKTLMEADAH (SEQ ID NO:327), YTIFNKTLMEADAHY 30 (SEQ ID NO:328), TIFNKTLMEADAHYK (SEQ ID NO:329), IFNKTLMEADAHYKS (SEQ ID NO:330) and FNKTLMEADAHYKSV (SEQ ID NO:331). The peptides having the amino acid sequences 94 AYTIFNKTLMEADAH (SEQ ID NO:327), YTIFNKTLMEADAEY (SEQ ID NO:328) have an OD-value that is lower than twice the average value. Nevertheless these peptides were claimed, because they are in the near proximity of a region of antigenic peptides 5 recognized by antibody CR04-010. Binding was most prominent to the peptides with the amino acid sequence TIFNKTLMEADAHYK (SEQ ID NO:329), IFNKTLMEADAHYKS (SEQ ID NO:330) and FNKTLMEADAHYKSV (SEQ ID NO: 331). CRJB and the antibodies called CR04-040, CR04-098 and 10 CR04-103 (data not shown) did not recognize a region of linear antigenic peptides. Any of the above peptides or parts thereof represents good candidates of a neutralizing epitope of rabies virus and could form the basis for a vaccine or for raising neutralizing 15 antibodies to treat and/or prevent a rabies virus infection. SLKGACKLKLCGVLGLRLMDGTW (SEQ ID NO:332) and GFGKAYTIFNKTLMEADAHYKSV (SEQ ID NO:333) are particularly interesting regions of the glycoprotein based on their high reactivity in PEPSCAN. 20 From the above PEPSCAN data can further be deduced that the human monoclonal antibodies called CR57 and CR04-010 bind to different regions of the rabies virus G protein indicating that they recognize non-competing epitopes. 25 Example 12 Determination of neutralizing potency of anti-rabies G protein IgGs using an in vitro neutralization assay (modified RFFIT) . The neutralizing potency of each of the produced human monoclonal antibodies was determined in a modified RFFIT as 30 described in Example 1. Sixteen IgGs neutralized rabies strain CVS-11 with a potency higher than 1000 IU/mg, whereas only two IgGs had a potency lower than 2 IU/mg (see Table 15). Eight of 95 the sixteen antibodies outperformed transiently produced CR-57 with regard to potency, suggesting a higher efficiency in post exposure prophylaxis of rabies virus than CR-57. The potency of transiently produced CR-57 was approximately 3800 IU/mg 5 protein (see Tables 1 and 15), whereas stably produced CR-57 displayed a potency of 5400 IU/mg protein (data not shown). Interestingly, the majority of the neutralizing human monoclonal antibodies identified contain a variable heavy 3-30 germline gene (see Table 9). 10 Based on the affinity of the antibodies for rabies virus (data not shown) and 100% endpoint dilution of the antibodies in a modified RFFIT assay (data not shown), a panel of six unique IgGs, i.e. CR04-010, CR04-040, CR04-098, CR04-103, CR04-104, and CR04-144, were chosen for further development. 15 Within this panel, antibody CR04-098 was particularly interesting as it displayed the highest potency, i.e. approximately 7300 IU/mg protein (see Table 15). A similar potency was also .found for stably produced CR04-098 (data noty shown). 20 Example 13 In vitro neutralization of E57 escape viruses by anti-rabies virus IgGs To further characterize the novel human monoclonal anti 25 rabies antibodies the neutralizing activity of the IgGs against E57 escape viruses was tested in a modified RFFIT as described above. The majority of the anti-rabies virus IgGs had good neutralizing activity against all six E57 escape viruses (see Table 16). In contrast, CR04-008, CR04-018 and 30 CR04-126 did not neutralize 6/6, 2/6 and 3/6 E57 escape viruses, respectively. No neutralization means that no 50% endpoint was reached at an antibody dilution of 1:100. CR04- 96 021, CR04-108, CR04-120, CR04-125, and CR04-164 showed a significant decrease in neutralizing activity against a number of escape viruses. This suggests that the epitope of these antibodies has been affected either directly or indirectly in 5 the E57 escape virus glycoprotein. On the basis of the 'above several anti-rabies virus IgGs may be compatible with CR-57 in an anti-rabies cocktail for post exposure prophylaxis treatment. In particular, the panel of six unique IgGs as identified above, i.e. antibodies CR04-010, CR04-040, CR04 10 098, CR04-103, CR04-104, and CR04-144, displayed good neutralizing potency towards the E57 escape viruses suggesting that epitope(s) recognized by these antibodies was/were not affected by the amino acid mutations induced by CR-57. Antibody CR04-098 appeared most promising since it had a 15 potency higher than 3000 IU/mg for each of the escape viruses. Example 14 Epitop recognition of anti-rabies antibodies CR-57v and CR04 098 20 To confirm that the human monoclonal antibodies called CR-57 and CR04-098 recognize non-overlapping, non-competing epitopes, escape viruses of the human monoclonal antibody called CR04-098 were generated essentially as described for escape.viruses of CR57 (see Example 1). In short, the number 25 of foci per well was scored by iumunofluorescence and medium of wells containing preferably one focus were chosen for virus amplification. All E98 escape viruses were generated from 1 single focus with the exception of E98-2 (2 foci) and E98-4 (4 foci). A virus was defined as an escape variant if the 30 neutralization index was <2.5 logs. The neutralization index was determined by subtracting the number of infectious virus particles/ml produced in BSR cell cultures infected with virus 97 plus monoclonal antibody (- 4 IU/ml) from the number of infectious virus particles/ml produced in BSR or MNA cell cultures infected with virus alone ([log focus forming units/ml virus in absence of monoclonal antibody minus log 5 ffu/ml virus in presence of monoclonal antibody]). An index lower than 2.5 logs was considered as evidence of escape. To further investigate that CR04-098 binds to a different non-overlapping, non-competing epitope compared to CR-57, CR 57 was tested against E98 escape viruses in a modified RFFIT 10 assay as described above. As shown in Table 17, CR-57 had good neutralizing activity against all five E98 escape viruses. Additionally, antibodies CR04-010 and CR04-144 were tested for neutralizing activity against the E98 escape viruses. Both antibodies did not neutralize the E98 escape viruses (data not 15 shown) suggesting that the epitope recognized by both antibodies is either directly or indirectly affected by the amino acid mutation induced by antibody CR04-098. The antibodies CR04-018 and CR04-126 were tested for neutralizing activity against only one of the E98 escape viruses, i.e. E98 20 4. CR04-018 was capable of neutralizing the escape virus, while CR04-126 only had a weak neutralizing potency towards the escape virus. This suggests that the epitope recognized by CR04-018 is not affected by the mutation induced by antibody CR04-098. Additionally, the antibodies CR04-010, CR04-038, 25 CR04-040, CR04-073, CR04-103, CR04-104, CR04-108, CR04-120, CR04-125, CR04-164 did not neutralize E98-4 suggesting that they recognize the same epitope as CR04-098 (data not shown). To identify possible mutations in the rabies glycoprotein of each of the E98 escape viruses, the nucleotide sequence of 30 the glycoprotein open reading frame (ORF) was determined as described before for the E57 and EJB escape viruses. All E98 escape viruses showed the mutation N to D at amino acid 98 position 336 of the rabies glycoprotein (see Figure 8). This region of the glycoprotein has been defined as antigenic site III comprising of amino acids 330-338 (numbering without signal peptide). In contrast, CR-57 recognized an epitope 5 located at amino acids 226-231 (numbering without signal peptide), which overlaps with antigenic site I. In addition to the N336D mutation the E98 escape virus called E98-5 showed the mutation H to Q at amino acid position 354 (codon change CAT to CAG) of the rabies glycoprotein (data not shown). 10 Moreover, pepscan analysis of binding of CR57 to peptides harbouring a mutated CR57 epitope (as observed in E57 escape viruses) did show that interaction of CR57 was abolished (data not shown). Strikingly, CR04-098 was still capable of binding to the mutated glycoprotein (comprising the N336D mutation) 15 expressed on PER.C6@ cells, as measured by flow cytometry (data not shown), even though viruses containing this mutation were no longer neutralized. Furthermrxe, epitope mapping studies and affinity ranking studies were performed using surface plasmon resonance 20 analysis using a BIAcore3000 2 m analytical system. Purified rabies glycoprotein (ERA strain) was immobilized as a ligand on a research grade CM5 4-flow channel (Fc) sensor chip (Biacore AB, Sweden) using amine coupling. Ranking was performed at 2.5*C with HBS-EP (Biacore AB, Sweden) as running 25 buffer. 50 pl of each antibody was injected at a constant flow rate of 20 pl/min. Then, running buffer was applied for 750 seconds followed by regeneration of the CM5 chip with 5 p1 2M NaOH, 5 pl 45 mM HCl and 5 pl 2 mM NaOH. The resonance signals expressed as resonance units (RU) were plotted as a function 30 of time and the increase and decrease in RU as a measure of association and dissociation, respectively, were determined and used for ranking of the antibodies. The actual KD values 99 for CR57 and CR04-098 as determined by surface plasmon resonance analysis were 2.4 nM and 4.5 nM, respectively. The epitope mapping studies further confirmed that CR57 and CRO4 098 bind to different epitopes on rabies glycoprotein. 5 Injection of CR57 resulted in a response of 58 RU (data not shown). After injection of CR04-098 an additional increase in response level (24 RU) was obtained, suggesting that binding sites for CR04-098 were not occupied (data not shown). Similar results were observed when the reverse order was applied 10 showing that each antibody reached similar RU levels regardless of the order of injection (data not shown). These results further demonstrate that CR57 and CR04-098 can bind simultaneously and recognize different epitopes on the rabies virus glycoprotein. 15 Overall, the above data further confirm that the antibodies CR-57 and CR04-098 recognize distinct non overlapping epitopes, i.e. epitopes in antigenic site I and III, respectively. The data are in good agreement with the ELISA/FACS competition data indicating that CR-57 and CR04-098 20 do not compete for binding to ERA G and the good neutralizing activity of antibody CR04-098 against all E57 escape viruses. On the basis of these results and the fact that in vitro exposure of rabies virus to the combination of CR57 and CR04 098 (selection in the presence of 4 IU/ml of either antibody) 25 yielded no escape viruses (data not shown), it was concluded that the antibodies CR-57 and CR04-098 recognize non overlapping, non-competing epitopes and can advantageously be used in an anti-rabies virus antibody cocktail for post exposure prophylaxis treatment. 30 Example 15 100 Assessment of conservation of the epitope recognized by CR57 and CR04-098 The minimal binding region of CR-57 (amino acids KLCGVL within SEQ ID NO:332, the region of the glycoprotein of rabies 5 virus recognized by CR57 as determined by means of PEPSCAN and alanine scanning technology) was aligned with nucleotide sequences of 229 genotype 1 rabies virus isolates to assess the conservation of the epitope (see Table 18). The sample set contained human isolates, bat isolates and isolates from 10 canines or from domestic animals most likely bitten by rabid canines. Frequency analysis of the amino acids at each position within the minimal binding region revealed that the critical residues constituting the epitope were highly conserved. The lysine at position one was conserved in 99.6% 15 of the isolates, while in only 1/229 isolates a conservative K>R mutation was observed. Positions two and three (L and C) were completely conserved. It is believed that the central cysteine residue is structurally involved in the glycoprotein folding and is conserved among all lyssaviruses (see Badrane 20 and Tordo, 2001). The glycine at position four was conserved in 98.7% of the isolates, while in 3/229 isolates mutations towards charged amino acids (G>R in 1/229; G>E in 2/229) were observed. The fifth position was also conserved with the exception of one isolate where a conservative V>I mutation was 25 observed. At the sixth position, which is not a critical residue as determined by an alanine-replacement scan, significant heterogeneity was observed in the street isolates: L in 70.7%, P in 26.7% and S in 2.6% of the strains, respectively. Taken together, approximately 99 percent of the 30 rabies viruses that can be encountered are predicted to be recognized by the CR-57 antibody.
101 123 of these 229 virus isolates were analyzed for the presence of mutations in both the CR-57 and CR04-098 epitope. None of these 123 street viruses did contain mutations in both epitopes. The N>D mutation as observed in the E98 escape 5 viruses was present in only five virus isolates. These viruses were geographically distinct and isolated from animals in Africa (see Figure 9 for phylogenetic tree; the five virus isolates, i.e. AF325483, AF325482, AF325481, AF325480 and AF325485, are indicated in bold). The phylogenetic analysis of 10 glycoprotein sequences revealed that rabies viruses with mutated CR57 epitopes are only distantly related to rabies viruses bearing a mutated CR04-098 epitope. Therefore, the likelihood of encountering a rabies virus resistant to neutralization by a cocktail of CR-57 and CR04-098 is 15 virtually absent. Unless the context indicates otherwise, the reference to any prior art in this specification is not, and should not be taken as, an acknowledgment or any form of suggestion that the prior art forms part of the common general knowledge in Australia. Throughout this specification and the claims which follow, unless the context requires otherwise, the word "comprise", and variations such as "comprises" and "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.
102 Table 1: Neutralizing potency of CR-57 and CR-JB against wild type and escape viruses. Potency Potency Potency Potency CR-57 CR-JB CR-57 CR-JB Virus (IU/mg) (IU/mg) Virus (IU/mg) (IU/mg) CVS-11 3797 605 CVS-11 3797 605 E57A2 0 <0.2 EJB2B 0.004 0.6 E57A3 0 419 EJB2C <0.004 2 E57B1 0 93 EJB2D <0.004 3 E57B2 0 <0.3 EJB2E <0.2 <0.3 E57B3 0 419 EJB2F <0.06 3 E57C3 0 31 EJB3F <0.04 0. 5 103 Table 2: Human lambda chain variable region primers (sense). Primer nam Primer nucleotide SEQ ID NO sequence HuVMdA St-CAGTCTGTGCTGACT SEQ ID NO:208 CAGCCACC-3f HuV2~1B 5'-CAGTCTGTGYTGACG SEQ ID NO:209 CAGCCGCC-3' HUVx1C 5'-CAGTCTGTCGTGACG SEQ ID NO:210 CAGCCGCC-3' HuV2L2 5F-CPARTCTGCCCTGACT SEQ ID NO:211 CAGCCT-31 HuVX3A 51-TCCTATGWGCTGACT SEQ ID NO:212 CAGCCACC-31 HuVX3B 51-TCTTCTGAGCTGACT SEQ ID NO:213 CAGGACCC-31 HuV2A4 5' -CACGTTATACTGACT SEQ ID NO:214 CAACCGCC-3' HuVX5 51-CAGGCTGTGCTGACT SEQ ID NO:215 CAGCCGTC-31 HuVW6 51-AATTTTATGCTGACT *SEQ ID NO:216 CAGCCCCA-31 HuVX7/8 51-CAGRCTGTGGTGACY SEQ ID NO:217 CAGGAGCC-31 HUVIX9 51-CWGCCTGTGCTGACT SEQ ID NO:218 CAGCCMCC-31 104 Table 3: Human kappa chain variable region primers (sense). Primer name Primer nucleotide SEQ ID NO sequence HuVK1B 5r-GACATCCAGNTGACCC SEQ ID NO:219 AGTCTCC-3' HuVK2 5'-GATGTTGTGATGACT SEQ ID NO:220 CAGTCTCC-3' HuVK3 5'-GAAATTGTGWTGACR SEQ ID NO:221 CAGTCTCC-3' HuVK4 51-GATATTGTGATGACC SEQ ID NO:222 CACACTCC-3' HuVK5 5'-GAAACGACACTCACG SEQ ID NO:223 CAGTCTCC-3' HuVx6 5'-GAAATTGTGCTGACTC SEQ ID NO:224 AGTCTCC-3' 105 Table 4: Human kappa chain variable region primers extended with SalI restriction sites (sense), human kappa chain J region primers extended with NotI restriction sites (asense), human lambda chain variable region primers extended 5 with SalI restriction sites (sense) and human lambda chain J region primers extended with NotI restriction sites (anti sense). Primer name Primer nucleotide SEQ ID NO sequence HuVxlB-SalI 5'-TGAGCACACAGGTCG SEQ ID NO:225 ACGGACATCCAGWTGACC CAGTCTCC-3' HuVK2-SalI 5'-TGAGCACACAGGTCG SEQ ID NO:226 ACGGATGTTGTGATGACT CAGTCTCC-3' HuVK3B-SalI 5'-TAGCACACAGGTCG SEQ ID NO:227 ACGGAAATTGTGWTGACR CAGTCTCC-3' BuVx4B-SalI 5'-TGAGCACACAGGTCG SEQ ID NO:228 ACGGATATTGTGATGACC CACACTCC-3' HuVx5-SalI 5'-TGAGCACACAGGTCGACG SEQ ID NO:229 GAAACGACACTCACGCAGTCT CC-3' HuV6-SalI 5'-TGAGCACACAGGTCG SEQ ID NO:230 ACGGAAATTGTGCTGACT CAGTCTCC-3' HuJxl-NotI 5'-GAGTCATTCTCGACTTGC SEQ ID NO:231 GGCCGCACGTTTGATTTCCAC CTTGGTCCC-3' HUJK2-NotI 5'-GAGTCATTCTCGACT SEQ ID NO:232 106 TGCGGCCGCACGTTTGAT CTCCAGCTTGGTCCC-31 HuJx3-NotI 5'-GAGTCATTCTCGACTTGC SEQ ID NO:233 GGCCGCACGTTTGATATCCAC TTTGGTCCC-3' HuJx4-NotI 5'-GAGTCATTCTCGACT SEQ ID NO:234 TGCGGCCGCACGTTTGAT CTCCACCTTGGTCCC-3' HuJicS-NotI 5'-GAGTCATTCTCGACTTGC SEQ ID NO:235 GGCCGCACGTTTAATCTCCAG TCGTGTCCC-3'* HuVX1A-SalI 5'-TGAGCACACAGGTCGACG SEQ ID NO:236 CAGTCTGTGCTGACTCAGCCA CC-31 HuVX1B-SalI 5'-TGAGCACACAGGTCGACG SEQ ID NO:237 CAGTCTGTGYTGACGCAGCCG CC-3' HuVkl~C-Sa1I 51-TGAGCACACAGGTCGACG SEQ ID NO:238 CAGTCTGTCGTGACGCAGCCG CC-31 HuVX2-SalI 51-TGAGCACACAGGTCGACG SEQ ID NO:239
CARTCTGCCCTGACTCAGCCT
3' HuVX3A-SalI 5' -TGAGCACACAGGTCGACG SEQ ID NO:240 TCCTATGWGCTGACTCAGCCA CC-31 RuVX3B-SalI 51-TGAGCACACAGGTCGACG SEQ ID NO:241 TCTTCTGAGCTGACTCAGGAC CC-3' HuV)X4-Sa1I 5f-TGAGCACACAGGTCGACG SEQ ID NO:242
CACGTTATACTGACTCAACCG
107 CC-3' HuV5-SaLI 5'-TGAGCACACAGGTCGACG SEQ ID NO:243 CAGGCTGTGCTGACTCAGCCG TC-31 EuV2X6-Sa1Il 51-TGAGCACACAGGTCGACG SEQ ID NO:244 AATTTTATGCTGACTCAGCCC CA-.3' HtiV7/8-SalI 5'-TGAGCACACAGGTCGACG SEQ ID NO:245 CAGRCTGTGGTGACYCAGGAG CC-3' HuV)X9-SalI 5'-TGAGCACACAGGTCGACG SEQ ID NO:246 CWGCCTGTGCTGACTCAGCCM CC-3' HuJXl-NotI 51-GAGTCATTCTCGACTTGC SEQ iD No:247 GGCCGCACCTAGGACGGTGAC CTTGGTCCC-31 HuJ2X2/3-NotI 5'-GAGTCATTCTCGACTTGC SEQ ID NO:248 GGCCCCACCTAGGACGGTCAG ty CTTGGTCCC-31 HuJX4/5-NotI 5F-GAGTCATTCTCGACTTGC SEQ ID NO:249 GGCCGCACYTAAAACGGTGAG CTGGGTCCC-31 108 Table 5: Distribution of the different light chain products over the 10 fractions. Light chain Number of Fraction alleles/fr action products alleles number Vk1B/Jkl-5 19 1 and 2 9.5 Vk2/Jkl-5 9 3 9 Vk3B/Jkl-5 7 4 7 Vk4B/Jkl-5 1 Vk5/Jkl-5 1 5 5 Vk6/Jkl-5 3 VX1A/Jl1-3 VX1B/J11-3 5 6 5 VXI/J1-3 VA2/Jll-3 5 7 5 VX3A/Jl1-3 9 8 9 VX3B/Jll-3 V4/J1-3 3 V5/J1-3 1' 9 5 Vx6/J11-3 1 VA7/8/Ji1-3 3 10 6 Vx9/Jll-3 3 109 Table 6: Human IgG heavy chain variable region primers (sense). Primer name Primer nucleotide SEQ ID NO sequence HuVH1B/7A 5'-CAGRTGCAGCTGGTG SEQ ID NO:250 CARTCTGG-3' HuVH1C 5'-SAGGTCCAGCTGGTR SEQ ID NO:251 CAGTCTGG-3' HuVH2B 5'-SAGGTGCAGCTGGTG SEQ ID NO:252 GAGTCTGG-3' HuVH3B 5'-SAGGTGCAGCTGGTG SEQ ID NO:253 GAGTCTGG-3' HuVH3C 5'-GAGGTGCAGCTGGTG SEQ ID NO:254 GAGWCYGG-3' HuVH4B 5'-CAGGTGCAGCTACAG SEQ ID NO:255 CAGTGGGG-3' HuVB4C 5'-CAGSTGCAGCTGCAG SEQ ID NO:256 GAGTC6GG-3' HuVH5B 5'-GARGTGCAGCTGGTG SEQ ID NO:257 CAGTCTGG-3' HuVH6A 5'-CAGGTACAGCTGCAG SEQ ID NO: 258 CAGTCAGG-3' 110 Table 7: Human IgG heavy chain variable region primers extended with SfiI/NcoI restriction sites (sense) and human IgG heavy chain J-region primers extended with XhoI/BstEII restriction sites (anti-sense). Primer name Primer nucleotide SEQ ID NO sequence HuVHB/7A-SfiI 5'-GTCCTCGCAACTGCG SEQ ID NO:259 GCCCAGCCGGCCATGGCC CAGRTGCAGCTGGTGCAR TCTGG-3' HuVH1C-SfiI 5'-GTCCTCGCAACTGCG SEQ ID NO:260 GCCCAGCCGGCCATGGCC SAGGTCCAGCTGGTRCAG TCTGG-3' HuVH2B-SfiI 5'-GTCCTCGCAACTGCG SEQ ID NO:261 GCCCAGCCGGCCATGGCC CAGRTCACCTTGAAGGAG TCTGG-3 1 HuVB3B-SfiI 5'-GTCCTCGCAACTGCGGCC SEQ ID NO:262 CAGCCGGCCATGGCCSAGGTG CAGCTGGTGGAGTCTGG-3' HuVH3C-SfiI 5'-GTCCTCGCAACTGCG SEQ ID NO:263 GCCCAGCCGGCCATGGCC GAGGTGCAGCTGGTGGAG WCYGG-3' HuVH4B-SfiI 5'-GTCCTCGCAACTGCG SEQ ID NO:264 GCCCAGCCGGCCATGGCC CAGGTGCAGCTACAGCAG TGGGG-3' HuVH4C-SfiI 5'-GTCCTCGCAACTGCGGCC SEQ ID NO:265
CAGCCGGCCATGGCCCAGSTG
CAGCTGCAGGAGTCSGG-31 HUVH5B-SfiI 51-GTCCTCGCAACTGCG SEQ ID NO:266 GCCCAGCCGGCCATGGCC GARGTGCAGCTGGTGCAG TCTGG-31 HuVH6A-SfiI 51-GTCCTCGCAACTGCG SEQ ID NO:267 GCCCAGCCGGCCATGGCC CAGGTACAGCTGCAGCAG TCAGG-31 HuJ1I1/2-XhoI 5f-GAGTCATTCTCGACTCGA SEQ ID NO:268 GACGGTGACCAGGGTGCC-3' HuJH3-XhoI 5'-GAGTCATTCTCGACT SEQ ID NO:269 CGAGACGGTGACCATTGT CCC-3' BuJ1H4/5-XhoI 5'-GAGTCATTCTCGACT SEQ ID NO;270 CGAGACGGTGACCAGGGT TCC-3' HuJH6-XhoI 5'-GAGTCATTCTCGACTCGA '~SEQ ID NO:271 GACGGTGACCGTGGTCCC-3' 112 Table 8: Binding of single-chain (scFv) phage antibodies to rabies virus G protein (ERA strain) and to FBS as measured by ELISA. Name phage antibody Rabies virus G FBS protein (OD492nm) (OD492nm) SC04-001 0.828 0.053 SC04-004 0.550 0.054 -SC04-008 0.582 0.058 SC04-010 0.915 0.043 SC04-018 0.247 0.052 SC04-021 0.278 0.052 SC04-026 0.212 0.054 SC04-031 0.721 0.065 SC04-038 0.653 0.061 SC04-040 0.740 0.053 SC04-060 0.923 0.056 SC04-073 0.657 0.054 SC4-097 0.835 0.056 SC04-098 0.798 0.060 SC04-103 0.606 0.059 SC04-104 0.566 0.063 SC04-108 0.363 0.052 SC04-120 0.571 0.052 SC04-125 0.735 0.049 SC04-126 0.232 0.051 SC04-140 0.865 0.057 SC04-144 0.775 0.054 SC04-146 0.484 0.057 SC04-164 0.547 0.057 control (S057) 0.650 0.055 control (02-007) 0.063 0.052 113 Table 9: Data of the single-chain Fv's capable of binding rabies virus G protein. Name SEQ ID NO SEQ ID NO BCDR3 Vo-locus VV-locus of nucl. of amino (SEQ ID NO:) scFV sequence acid (libr.) sequence sc04-001 157 158 GLYGELFDY 3-20 V13 (31 (JK1994) _ (SEQ ID NO:1) (DP32) - V2-13) 159 160 VkI sc04-004 DYLYPTTDFDY 3-23 (012/02 (WT2000) (SEQ ID NO:2) (DP47) DPK9) scD4-008 161 162 (RAB-03- MGFTGTYFDY 2-70 V13 (3h GO1) (SEQ ID NO:3) (DP28) - V2-14) sc04-010 163 164 (RAB-03- DGLDLTGTIQPFGY 3-30 VkI (L11 G01) (SEQ ID NO:4) (DP49) - DPK3) sc04-018 165 166 (RAB-03- VSVTTGAFNI 4-04 Vil (1C GO1) (SEQ ID NO:5) (DP70) - V1-16) sc04-021 167 168 (RAB-03- GSVLGDAFDI 3-30 GO1) ._(SEQ ID NO:6) (DP49) VkI (L8) sc04-026 169 170 VkII (RAB-03- TSNWNYLDRFDP 5-51 (A19/03 G01) (SEQ ID NO:7) (DP73) DPK15) sc04-031 171 172 (RAB-03- GSVLGDAFDI * 3-30 VkI (L5 G01) (SEQ ID NO:8) (DP49) - DPK5) sc04-038 173 174 (RAB-03- GSVLGDAFDI 3-30 VkI (L5 G01) (SEQ ID NO:9) (DP49) - DPK5) sc04-040 175 176 (RAB-03- GSKVGDFDY 3-30 V13 (3h GO1) (SEQ ID NO:10) (DP49) - V2-14) sc04-060 177 178 EKEKYSDRSGYSYY VkI (RAB-04- YYYMDV 4-59 (012/02 G01) (SEQ ID NO:11) (DP71) DPK9) sc04-073 179 180 (RAB-04- DGLDLTGTIQPFGY 3-30 G01) (SEQ ID NO:12) (DP49) VkI (L12) sc04-097 181 182 (RAB-04- TASNLGRGGMDV 3-23 GO1) (SEQ ID NO:13) (DP47) VkI (LB) sc04-098 183 184 (RAB-04- VAVAGTHFDY 3-30 G01) (SEQ ID NO:14) (DP49) VkI (A30) sc04-103 185 186 (RAB-04- VAVAGESFDS 3-30 VkI (L5 Gal) _(SEQ ID NO:15) (DP49) - DPK5) 114 scO4-104 187 188 (RAB-04- IVVVTALDAFDI 3-30 G01) ______(SEQ ID NO:16) (DP49) VkI (L12) sc04-108 189 190 (RAB-04- FMIVADDAFDI 3-30 G01) ______(SEQ ID NO:17) (DP49) VkI (Li) sc04-120 191 192 (RAB- 04- GGKTGEFDY 3-30 G0l) ___________(SEQ ID NO:18) (DP49) VkI (LB) sc04-125 193 194 (RAB-04- IATAGTGFDY 3-30 GOlU_____ (SEQ ID NO:19) (DP49) VkI (LB) scO4-126 195 196 (RAB-04- MGFTGTYFDY 2-70 V13 (3h G0l) ______(SEQ ID NO:20) (DP28) - V2-14) scO4-140 197 198 (RAB-04- VTNPGDAFDI 3-30 VII G01) ______(SEQ ID NO:.21) (DP49) (L4/18a) scO4-144 199 200 (P.AB-04- GGKTGEFDY 3-30 G01) ______(SEQ ID NO:22) (DP49) VkI (L8) scO4-146 201 202 (RAB-04- GGKTGEFDY 3-30 VkIlII (L2 G01) ___________(SEQ ID NO:23) (DP49) - DPK21) scO4-164 203 204 (RAB-04- GSVLGDAFDI 3-30 VkI (L1 9 G01) ________ __(SEQ ID NO:24) (DP49) - DPK6) 205 206 ENLDNSGTYYYFSG WFDP 1-69 V12 (2e S057 ____________(SEQ ID NO:25) (DP1O) -V1-3) 312 313 RQHISSFPWFDS (SEQ ID V13 (3h S0OJB ______ _____ 4:276) 2-05 -V2-14)J 115 Table 10: Data of assay for rabies virus neutralizing activity of scFvs. Name scFv 50% endpoint 50% endpoint Potency dilution dilution WHO (IU/ml) standard (2 IU/ml) SC04-001 270 405 1.3 SC04-004 3645 405 18 SC04-008 >10935 405 >54 SC04-010 810 405 4 SC04-018 15 405 0.1 SC04-021 270 405 1.3 SC04-026 45 270 0.3 SC04-031 90 270 0.7 SC04-038 270 270 2 SC04-040 45 270 0.3 SC04-060 30 270 0.2 SC04-073 405 270 3 SC04-097 30 270 0.2 SC04-098 1215 270 9 SC04-103 45 270 0.3 SC04-104 135 270 1 SC04-108 135 270 1 SC04-120 810 270 6 SC04-125 405 270 3 SC04-126 10 270 0.1 SC04-140 135 270 1 SC04-144 810 270 6 SC04-146 405 270 3 SC04-164 45 270 0.3 116 Table 11A: Data of assay for measuring neutralizing activity of scFvs for E57 escape viruses E57A2, E57A3 and E57B1. Name E57A2 E57A3 E57B1 scFv 1* 2* 3* 1* 2* 3* 1* 2* 3* SC04-001 10 90 0.2 10 90 0.2 30 45 1.3 SC04-004 810 90 18.0 1215 90 27.0 810 45 36.0 SC04-008 10 90 0.2 15 90 0.3 270 45 12.0 SC04-010 270 90 6.0 270 90 6.0 270 45 12.0 SC04-018 5 90 0.1 15 90 0.3 15 45 0.7 SC04-021 10 90 0.2 30 90 0.7 10 90 0.2 SC04-026 <5 90 0.0 <5 45 0.0 <5 90 0.0 SC04-031 10 90 0.2 30 90 0.7 10 90 0.2 SC04-038 90 90 2.0 90 90 2.0 45 90 1.0 SC04-040 15 90 0.3 5 90 0.1 5 90 0.1 SC04-060 5 90 0.1 5 90 0.1 <5 90 0.0 SC04-073 135 90 3.0 90 30 6.0 30 30 2.0 SC04-097 <5 90 0.0 <5 90 0.0 <5 90 0.0 SC04-098 810 90 18.0 270 30 18.0 270 30 18.0 SC04-103 <5 90 0.0 10 90 0.2 5 90 0.1 SC04-104 90 90 2.0 30 30 2.0 30 30 2.0 SC04-108 15 90 0.3 <5 90 0.0 <5 90 0.0 SC04-120 45 90 1.0 30 30 2.0 10 30 0.7 SC04-125 135 90 3.0 135 30 9.0 90 30 6.0 SC04-126 <5 90 0.0 <5 45 0.0 <5 90 0.0 SC04-140 30 45 1.3 90 30 6.0 45 90 1.0 SC04-144 270 45 12.0 270 30 18.0 135 90 3.0 SC04-146 90 45 4.0 90 30 6.0 90 90 2.0 SC04-164 15 45 0.7 30 30 2.0 15 90 0.3 1* is 50% endpoint dilution 2* is 50% endpoint dilution WHO standard (2 IU/ml) 5 3* is Potency (IU/ml) 117 Table 11B: Data of assay for measuring neutralizing activity of scFvs for E57 escape viruses E57B2, E57B3 and E57C3. Name E57B2 E57B3 E57C3 scFv 1* 2* 3* 1* 2* 3* 1* 2* 3* SC04-001 30 45 1.3 90 270 0.7 5 90 0.1 SC04-004 5 45 0.2 2430 270 18.0 270 90 6.0 SC04-008 5 45 0.2 45 270 0.3 10 90 0.2 SCO4-010 45 45 2.0 405 270 3.0 270 90 6.0 SC04-018 15 45 0.7 15 270 0.1 30 90 0.7 SCO4-021 10 90 0.2 30 270 0.2 10 90 0.2 SC04-026 <5 45 0.0 <5 45 0.0 <5 30 0.0 SCO4-031 10 90 0.2 30 270 0.2 30 90 0.7 SC04-038 30 90 0.7 90 270 0.7 90 90 2.0 SC04-040 5 90 0.1 15 135 0.2 10 90 0.2 SCO4-060 <5 90 0.0 10 135 0.1 5 90 0.1 SCO4-073 30 90 0.7 90 270 0.7 90 90 2.0 SC04-097 <5 90 0.0 <5 135 0.0 <5 90 0.0 SCO4-098 90 90 2.0 810 270 6.0 270 90 6.0 SC04-103 <5 90 0.0 10 135 0.1 10 90 0.2 SC04-104 45 90 1.0 45 270 0.3 90 90 2.0 SC04-108 10 90 0.2 <5 135 0.0 15 90 0.3 SCO4-120 15 90 0.3 45 270 0.3 30 90 0.7 SCO4-125 90 90 2.0 270 270 2.0 270 90 6.0 SCO4-126 <5 45 0.0 <5 45 0.0 <5 30 0.0 SC04-140 30 90 0.7 90 90 2.0 270 90 6.0 SC04-144 90 90 2.0 270 90 6.0 405 90 9.0 SC04-1 6 30 90 0.7 90 90 2.0 90 90 2.0 SC04-164 15 90 0.3 15 90 0.3 30 90 0.7 1* is 50% endpoint dilution 2* is 50% endpoint dilution WHO standard (2 IU/ml) 5 3* is Potency (IU/ml) 118 Table 12: Oligonucleotides used for PCR amplification of Vo genes. Name and nucleotide sequence VE gene SEQ ID NO: 5H-B: SC04-001 280 acctgtcttgaattctccatggccgaggtgcagct ggtggagtctg 5H-C: SC04-021 281 acctgtcttgaattctccatggcccaggtgcagct SC04-031 ggtggagtctgg SC04-125 SC04-164 5H-C-long: SC04-010 282 acctgtcttgaattctccatggcccaggtgcagct SC04-038 ggtggagtctgggg SC04-040 SC04-073 SC04-098 SC04-103 SC04-104 SC04-108 SC04-120 SC04-140 SC04-144 SC04-146 5H-F: SC04-018 283 acctgtcttgaattctccatggcccaggtgcagct SC04-060 gcaggagtccggccc 5H-H: SC04-026 284 acctgtcttgaattctccatggccgaggtgcagct ggtgcagtctgg 5H-I: SC04-004 285 acctgtcttgaattctccatggccgaggtgcagct SC04-097 gctggagtctgg 119 5H-M: SC04-008 286 acctgtcttgaattctccatggcccaggtgacctt SC04-12 6 gaaggagtctgg sy3H-A: SC04-001 287 gcccttggtgctagcgctggagacgtcaccaggg SC04-0 04 tgccctggccCc SC04-008 SC04-010 SC04-026 SC04-040 SC04-073 SC04-098 SC04-120 SC04-125 SC04-126 SC04-144 SC04-146 sy3H-C: SC04-097 288 gcccttggtgctagcgctggagacggtcacggtgg tgccctggcccc sy3H-C-long: SC04-060 289 gcccttggtgctagcgctggagacggtcacggtgg tgcccttgccccagacgtc sy3H-D: SC04-018 290 gcccttggtgctagcgctggacacggtcaccatgg SC0 4-021 tgccctg'gcccc SC04-031 SC04-038 SC04-104 SC04-108 SC04-140 SC04-164 By3H-E: SC04-103 291 120 gcccttggtgctagcgctggacacggtcaccaggg tgccccggcccc 121 Table 13: Oligonucleotides used for PCR amplification of VL genes. Name and nucleotide sequence VL gene SEQ ID NO: 3L-B: SC04-001 292 ttttccttagcggccgcgactcacctaggacggtc agcttggtc 5K-B: SC04-031 293 acctgtctcgagttttccatggctgacatccagat SC04-060 gacccagtc SC04-073 SC04-098 SC04-103 SC04-104 SC04-108 SC04-164 5K-C: 8C04-004 294 acctgtctcgagttttccatggctgacatccagat gacccagtctccatcctccc 5K-G: SC04-026 295 acctgtctcgagttttccatggctgacatcgtgat gacccagtctcc 5K-K: SC04-010 296 acctgtctcgagttttccatggctgccatccagat gacccagtctcc 5K-M: SC04-021 297 acctgtctcgagttttccatggctgacatccagct SC04-097 gacccagtc SC04-120 SC04-125 SC04-144 5K-N: SC04-038 298 acctgtctcgagttttccatggctgacatccagat gactcagtc 122 5K-0: SC04-140 299 acctgtctcgagttttccatggctgcctccagct gacccagtcI SK-Q: SC04-146 300 acctgtctcgagttttccatggctgagatcgtgat gactcagtc 5L-E: SC04-008 301 acctgtctcgagttttccatggcttcctacgtgct gactcagccg 5L-F: SC04-018 302 acctgtctcgagttttccatggctcagtccgtgCt gactcagcc 5L-G: SC04-040 303 acctgtctcgagttttccatggcttcctacgtgct SC04-126 gactcagcc sy3K-F: SC04-004 304 gctgggggcggccacggtccgcttgatctccacct SC0 4-010 tggtccc SC04-021 SC04-031 SC04-098 SC04-104 SC04-125 SC04-140 SC04-144 SC04-164 sy3K-I: RCO4-038 305 gctgggggcggccacg'gtccgcttgatctccagcc SC04-0 97 gtgtccc SC04-103 SC04-108 SC04-14 6 sy3K-J: SC04-026 306 123 gctgggggcggccacggtccgcttgatctccagct SC04-060 tggtccc SC0 4-073 sy3K-K: SC04-120 307 gctgggggcggccacggtccgcttgatgtccacct tggrtccc sy3L-A: SC04-018 308 ccagcacggtaagcttcagcacggtcaccttggtg SC04-12 6 ccagttcc sy3L-C: SC04-040 309 ccagcacggtaagcttcagcacggtcagcttggtg cctccgcc sy3L-D: SC04-008 310 ccagcacggtaagcttcaacacggtcagctgggtc cc sy5L-A: SC04-001 311 acctgtctcgagttttccatggcttcctccgagct gacccaggaccctgctg 124 Table 14: Binding of the human monoclonal antibodies CR57, CRJB and CR04-010 (10 pg/ml) to linear peptides of the extracellular domain of glycoprotein G of rabies virus strain ERA. Amino acid sequence CR57 CRJB CR04-010 of linear peptide PIYTILDKLGPWS 71 97 1 PIYTILDKLGPWSP 42 105 39 IYTILDKLGPWSPI 36 89 87 YTILDKLGPWSPID 44 97 104 ILDKLGPWSPIDI 48 114 91 ILDKLGPWSPIDIH 76 96 88 LDKLGPWSPIDIHH 54 104 69 KLGPWSPIDIHHL 55 99 107 KLGPWSPIDIHHLS 62 103 93 PWSPIDIHHLSC 72 105 45 GPWSPIDIHHLSCP 69 112 19 PWSPIDIHHLSCPN 68 114 33 SPIDIHHLSCPNN 62 104 47 SPIDIHHLSCPNNL 80 106 11 PIDIHHLSCPNNLV 74 85 1 IDIHHLSCPNNLVV 46 93 90 DIHHLSCPNNLVVE 69 102 55 IHHLSCPNNLVVED 38 96 78 HHLSCPNNLVVEDE 37 85 113 SCPNNLVVEDEG 56 76 117 CPNNLVVEDEGC 65 119 111 SCPNNLVVEDEGCT 69 117 127 CPNNLVVEDEGCTN 83 114 91 _PNNLVVEDEGCTNL 77 97 49 PNNLVVEDEGCTNLS 78 107 97 NNLVVEDEGCTNLSG 72 99 97 DEGCTNLSGF 75 119 55 LVVEDEGCTNLSGFS 76 103 52 VVEDEGCTNLSGFSY 73 107 91 _EDEGCTNLSGFSYM 74 103 31 DEGCTNLSGFSYME 54 90 7 DEGCTNLSGFSYMEL 1 23 1 E __GCTNLSGFSYMELK 51 114 129 GCTNLSGFSYMELKV 55 114 118 CTNLSGFSYMELKVG 47 110 137 I'NLSGFSYMELKVGY 43 106 161 SLSGFSYMELKVGYI 61 115 170 LSGFSYMELKVGYIL 71 132 169 125 GFSYMELKVGYILA 79 132 161 FSYMELKVGYILAI 65 111 141 SYMELKVGYILAIK 89 112 192 YNELKVGYILAIKM 65 123 152 GYILAIKMN 78 114 150 LKVGYILAIKMNG 76 141 107 LKVGYILAIKMNGF 87 132 76 GYILAIKMNGFT 78 112 118 GYILAIKMNGFTC 78 118 68 GYILAIRMGFTCT 77 93 1 ILAIKMNGFTCTG 75 90 1 ILAIXMNGFTCTGV 47 107 107 LAIKMNGFTCTGVV 79 103 104 GFTCTGVVT 68 130 159 KMNGFTCTGVVTE 47 103 152 GFTCTGVVTEA 68 108 138 GFTCTGVVTEAE 76 104 133 GFTCTGVVTEAEN 69 99 148 GFTCTGVVTEAENY 69 101 138 FTCTGVVTEAENYT 71 86 129 CTGVVTEAENYTN 83 125 154 CTGVVTEAENYTNF 92 112 129 TGVVTEAENYTNFV 76 123 150 GVVTEAENYTNFVG 85 110 154 GVVTEAENYTNFVGY 86 111 110 TNFVGYV 87 106 114 GYVT 79 90 73 GYVTT 68 84 8 GYVTTT 69 117 142 TNFVGYVTTTF 66 106 110 TNFVGYVTTTFK 44 112 183 GYVTTTFKR 49 114 174 iTNFVGYVTTTFKRK 51 104 138 TNFVGYVTTTFKRKH 71 125 165 GYVTTTFKRKHF 65 107 154 GYVTTTFKRKHFR 70 ill 152 GYVTTTFKRKHFRP 75 113 155 YVTTTFKRKHFRPT 70 123 160 TTFKRKHFRPTP 85 106 160 TTFKRKHFRPTPD 79 105 119 TTFKRKHFRPTPDA 80 108 137 FKRKHFRPTPDAC 74 99 110 TPDACR 96 111 108 TPDACRA 64 92 62 TPDACRAA 65 93 1 RKHFRPTPDACRAAY 64 107 99 126 TPDACRAAYN 73 112 124 TPDACRAAYNW 46 113 118 TPDACRAAYNWK 43 112 148 PDACRAAYNWKM 77 101 129 TPDACRAAYNWKMA 99 125 143 PDACRAAYNWKMAG 92 132 160 DACRAAYNWKMAGD 61 124 147 CRAAYNWKMAGDP 84 113 136 CRAAYNWKMAGDPR 82 116 138 YNMAGDPRY 87 118 137 YNWKMAGDPRYE 90 130 120 AYNWKMAGDPRYEE 68 106 120 YNWKMAGDPRYEES 96 94 77 GDPRYEESL 83 118 116 GDPRYEESLH 58 101 69 GDPRYEESLHN 69 101 1 GDPRYEESLHNP 62 102 84 GDPRYEESLHNPY 64 116 112 GDPRYEESLHNPYP 40 101 125 DPRYEESLHNPYPD 36 98 123 PRYEESLHNPYPDY 57 110 118 RYEESLHNPYPDYR 73 115 129 YEESLHNPYPDYRW 69 112 125 SLHNPYPDYRWL 58 106 120 SLHNPYPDYRWLR 76 123 141 SLHNPYPDYRWLRT 92* 132 125 LHNPYPDYRWLRTV 78 111 137 YPDYRWLRTVK 79 106 142 PYPDYRWLRTVKT 86 108 146 YPDYRWLRTVKTT 85 102 151 YPDYRWLRTVKTTK 65 93 103 PDYRWLRTVKTTKE 72 97 97 DYRWLRTVKTTKES 76 85 27 YRWLRTVKTTKESL 54 111 105 TVKTTKESLV 46 117 125 TVKTTESLVI 40 110 120 TVKTTKSLVII 41 104 125 TVETTKESLVIIS 65 104 161 TVKTTKESLVIISP 82 120 150 TKESLVIISPS 76 116 150 TESLVIISPSV 71 120 154 LVIISPSVA 101 112 147 SLVIISPSVAD 78 121 141 LVIISPSVADL 86 112 132 SLVIISPSVADLD 86 117 111 SLVIISPSVADLDP 88 125 143 127 LVIISPSVADLDPY 68 105 125 VIISPSVADLDPYD 85 107 93 IISPSVADLDPYDR 59 98 50 ISPSVADLDPYDRS 83 125 14 SPSVADLDPYDRSL 50 119 91 PSVADLDPYDRSLH 59 114 118 SVADLDPYDRSLHS 44 114 118 VADLDPYDRSLHSR 49 106 129 ADLDPYDRSLHSRV 71 113 141 LDPYDRSLHSRVF 70 121 141 LDPYDRSLHSRVFP 111 152 127 DPYDRSLHSRVFPS 99 142 106 PYDRSLHSRVFPSG 90 120 134 YDRSLHSRVFPSGK 86 120 130 DRSLHSRVFPSGKC 364 818 127 RSLHSRVFPSGKCS 98 142 141 LHSRVFPSGKCSG 87 141 156 SLHSRVFPSGKCSGV 69 ill 141 SRVFPSGKCSGVA 78 114 129 SRVFPSGKCSGVAV 97 118 111 RVFPSGKCSGVAVS 100 125 24 RVFPSGKCSGVAVSS 69 110 106 VFPSGKCSGVAVSST 74 114 142 FPSGKCSGVAVSSTY 64 134 146 SGKCSGVAVSSTYC 56 112 132 GKCSGVAVSSTYCS 64 121 120 CSGVAVSSTYCST 92 143 145 CSGVAVSSTYCSTN 88 130 130 SGVAVSSTYCSTNH 110 165 143 GVAVSSTYCSTNHD 79 110 115 GVAVSSTYCSTNHDY 79 114 108 AVSSTYCSTNHDYT 85 114 118 VSSTYCSTNEDYTI 71 105 102 SSTYCSTNHDYTIW 78 107 121 STYCSTNHDYTIWM 76 107 121 TYCSTNHDYTIW 86 99 119 YCSTNHDYTIWE 96 107 74 CSTNHDYTIMPEN 47 92 29 STNHDYTIWMPENP 52 106 86 TNHDYTIWMPENPR 60 112 107 DYTIWMPENPRL 69 129 119 HDYTIWMPENPRLG 71 119 130 DYTIWMPENPRLGM 82 125 123 YTIWMPENPRLGMS 93 127 123 TIWMPENPRLGMSC 97 132 143 TIWMPENPRLGMSCD 69 106 134 128 WMPENPRLGMSCDI 98 110 101 ENPRLGMSCDIF 88 113 120 ENPRLGMSCDIFT 105 121 143 ENPRLGMSCDIFTN 83 111 104 RLGMSCDIFTNS 71 118 111 RLGMSCDIFTNSR 90 113 138 GMSCDIFTNSRG 72 112 105 GMSCDIFTNSRGK 88 106 113 CDIFTNSRGKR 76 110 114 GMSCDIFTNSRGKRA 54 120 101 CDIFTNSRGKRAS 46 110 106 CDIFTNSRGKRASK 44 111 98 IFTNSRGKRASKG 42 104 117 IFTNSRGKRASKGS 70 107 111 FTNSRGKRASKGSE 77 125 87 SRGKRASKGSET 83 111 119 SRGKRASKGSETC 68 108 110 SRGERASKGSETCG 92 100 119 RGKRASKGSETCGF 64 93 90 GKRASKGSETCGFV 75 104 115 KASKGSETCGFVD 92 124 118 KGSETCGFVDE 92 106 129 KGSETCGFVDER 86 110 134 KGSETCGFVDERG 97 108 103 KGSETCGFVDERGL 92 102 76 GSETCGFVDERGLY 90 97 4' SETCGFVDERGLYK 57 115 92 ETCGFVDERGLYKS 33 116 86 TCGFVDERGLYKSL 64 120 138 CGFVDERGLYKSLK 47 120 125 GFVDERGLYKSLKG 72 115 120 FVDERGLYKSLKGA 84 120 129 ERGLYKSLKGAC 86 121 124 ERGLYKSLKGACK 50 108 110 DRGLYKSLKGACKL 90 119 54 GLYKSLKGACKLK 90 118 106 GLYKSLKGACKLKL 90 121 121 LYKSLKGACKLKLC 94 129 92 YKSLKGACKLKLCG 93 136 141 LKGACKLKLCGV 80 112 110 LKGACKLKLCGVL 129 113 110 LKGACKLKLCGVLG 111 124 GACKLKLCGVLGL 90 23 GACKLKLCGVLGLR 111 100 CKLKLCGVLGLRL 134 129 CKLKLCGVLGLRLM 117 142 129 CGVLGLRLMD 111 147 CGVLGLRLMDG 120 114 CGVLGLRLMDGT 145 148 CGVLGLRLMDGTW 132 86 CGVLGLRLMDGTWV 83 138 129 GVLGLRLMDGTWVA 99 117 104 GLRLMDGTWVAM 89 148 117 GLRLMDGTWVAMQ 90 141 127 GLLMDGTWVAMQT 102 115 97 LRLMDGTWVAMQTS 104 138 120 GTWVAMQTSN 103 114 118 TWVAMQTSNE 100 113 130 GTWVAMQTSNET 96 106 106 GTWVAMOTSNETK 97 97 110 GTWVAMQTSNETKW 69 114 92 TWVAMQTSNETKWC 58 113 82 TAMQTSNETKWCP 78 118 107 AMQTSNETKWCPP 50 114 116 QTSNETKWCPPD 86 104 151 ATSNETKWCPPDQ 104 114 128 QTSNETKWCPPDQL 104 132 125 TSNETKWCPPDQLV 92 120 155 SNETKWCPPDQLVN 97 ill 90 NETKWCPPDQLVNL 99 129 110 TKWCPPDQLVNLH 90 128 107 TKWCPPDQLVNLHD 105 e 120 118 CPPDQLVNLHDF 85 125 125 CPPDQLVNLHDFR 89 113 121 CPPDQLVNLHDFRS 101 119 99 PPDQLVNLHDFRSD 93 137 127 PDQLVNLHDFRSDE 107 120 56 DQLVNLHDFRSDEI 35 106 63 LVNLHDFRSDEIE 54 117 97 LVNLHDFRSDEIEH 60 113 106 VNLHDFRSDEIEHL 47 104 100 DFRSDEIEHLV 83 129 98 DFRSDEIEHLVV 83 113 110 DFRSDEIEHLVVE 93 115 121 FRSDEIEHLVVEE 69 107 150 FRSDEIEHLVVEEL 99 103 110 DEIEHLVVEELV 86 114 116 DEIEHLVVEELVR 100 138 104 DEIEHLVVEELVRK 101 117 118 EIEHLVVEELVRKR 94 123 143 IEHLVVEELVRKRE 82 113 121 IEHLVVEELVRKREE 90 129 118 130 EHLVVEELVRKREEC 82 114 106 CL 82 123 46 CLD 64 100 79 LVRKREECLDA 62 108 97 ECLDAL 58 111 101 CLDALE 69 112 123 CLDALES 82 113 117 LVRKREECLDALESI 86 130 124 CLDALESIM 58 181 151 ECLDALESIM 73 110 137 CLDALESIMTT 102 113 97 CLDALESIMTTK 94 110 106 CLDAL-ESIMTTKS 82 120 133 CLDALESIMTTKSV 91 112 125 LDALESIMTTKSVS 101 146 155 DALESIMTTKSVSF 97 116 152 ALESIMTTKSVSFR 104 120 188 SIMTTKSVSFRR 97 132 137 SIMTTKSVSFRRL 48 114 130 SIMTTKSVSFRRLS 62 111 114 IMTTKSVSFRRLSH 54 130 97 TKSVSFRRLSHL 43 101 111 SVSFRRLSHLR 59 116 125 TKSVSFRRLSHLRK 66 118 111 SVSFRRLSHLRKL 83 125 123 SFRRLSHLRKLV ' 108 124 129 VSFRRLSHLRKLVP 64 123 117 SFRRLSHLRKLVPG 90 111 105 SFRRLSHLRKLVPGF 92 110 96 FRRLSHLRKLVPGFG 90 108 111 RRLSHLRKLVPGFGK 92 143 118 RLSHLRKLVPGFGKA 93 123 148 LSHLRKLVPGFGKAY 96 139 150 HLRKLVPGFGKAYT 113 132 132 VPGFGKAYTI 99 111 102 VPGFGKAYTIF 83 118 82 VPGFGKAYTIFN 47 115 86 VPGFGKAYTIFNK 47 ~114 123 VPGFGKAYTIFNKT 54 112 139 FGKAYTIFNKTL 58 114 138 GFGKAYTIFNKTLM 78 113 157 GFGKAYTIFNKTLME 78 123 GKAYTIFNKTLMEA 90 151 GKAYTIFNKTLMEAD 76 127 YTIFNKTLMEADA 101 123 AYTIFNKTLMEADAH 86 121 131 IFNKTLMEADAHY 104 147 IFNKTLMEADAHYK 107 123 FNKTLMEADAHYKS 100 118 TMEADAHYKSV 111 141 TLMEADAHYKSVR 104 116 141 LMEADAHYKSVRT 91 98 123 VRTW 100 114 90 AHYKSVRTWN 73 107 97 TWNE 62 129 83 VRTWNEI 58 97 106 AHYKSVRTWNEIL 56 100 100 AEYKSVRTWNEILP 59 121 112 YKSVRTWNEILPS 112 160 125 VRTWNEILPSK 80 130 123 SVRTWNEILPSKG 66 137 116 VRTWNEILPSKGC 115 125. 114 TWNEILPSKGCL 106 138 118 TWNEILPSKGCLR 90 124 133 TWNEILPSKGCLRV 120 127 120 ILPSKGCLRVG 97 146 127 ILPSKGCLRVGG 102 136 117 ILPSKGCLRVGGR 104 130 163 ILPSKGCLRVGGRC 104 112 128 LPSKGCLRVGGRCH 79 113 107 PSKGCLRVGGRCHP 77 119 100 SKGCLRVGGRCHPH 69 138 91 KGCLRVGGRCHPHV 72 121 ._103 GCLRVGGRCHPHVN 68 130 115 LRVGGRCHPHVNG 85 125 123 LRVGGRCHPVNGV 102 132 134 VGGRCHPHVNGVF 104 143 133 VGGRCHPHVNGVFF 86 143 99 GGRCHPHVNGVFFN 120 136 120 GGRCHPHVNGVFFNG 86 119 119 CHPHVNGVFFNGI 117 113 117 CHPHVNGVFFNGII 98 141 143 'HPHVNGVFFNGIIL 97 150 151 PHVNGVFFNGIILG 104 138 164 HVNGVFFNGIILGP 93 173 146 GVFFNGIILGPD 97 123 114 GVFFNGIILGPDG 68 116 85 GVFFNGIILGPDGN 66 117 97 GIILGPDGNV 58 116 100 FNGIILGPDGNVL 55 132 108 FNGIILGPDGNVLI 92 143 105 GIILGPDGNVLIP 61 139 130 132 GIILGPDGNVLIPE 102 146 141 IILGPDGNVLIPEM 107 132 123 ILGPDGNVLIPEMQ 85 118 93 LGPDGNVLIPEMQS 125 134 119 GPDGNVLIPEMOSS 100 134 150 PDGNVLIPEMQSSL 86 154 157 DGNVLIPEMQSSLL 87 129 139 IPEMQSSLLQ 123 134 169 IPEMQSSLLQQ 96 120 168 IPEMQSSLLQQH 72 120 150 IPEMQSSLLQQHM 92 104 142 IPEMQSSLLQQHME 89 111 85 PEMQSSLLQQHMEL 89 128 129 PEMQSSLLQQHMELL 62 133 93 QSSLLQQHMELLE 58 129 142 MQSSLLQQHMELLES 65 113 117 _SSLLQQHMRT.T.RSS 82 114 132 SSLLQQHMELLESSV 90 128 132 LLQQHMELLESSVI 124 163 133 LLQQHMELLESSVIP 78 111 121 LQQHMELLESSVIPL 106 134 128 _QHMELLESSVIPLV 103 134 133 QHMT.T.RSSVIPLVH 98 146 139 ESSVIPLVHP 110 129 134 ESSVIPLVHPL 90 125 152 *BLLESSVIPLVHPLA 90 133' 155 SSVIPLVHPLAD 72 117 118 SSVIPLVHPLADP 90 128 128 SSVIPLVHPLADPS 104 138 143 SVIPLVHPLADPST 73 104 93 VIPLVHPLADPSTV 72 137 107 PLVHPLADPSTVF 69 141 123 PLVHPLADPSTVFK 96 156 188 LVHPLADPSTVFKD 93 112 138 VHPLADPSTVFKDG 164 174 188 PLADPSTVFKDGD 98 138 125 PLADPSTVFKDGDE 74 141 117 LADPSTVFKDGDEA 99 125 90 PSTVFKDGDEA 68 116 113 PSTVFKDGDEAED 147 152 110 PSTVFKDGDEAEDF 98 147 137 PSTVFKDGDEAEDFV 104 143 141 STVFKDGDEAEDFVE 104 120 125 TVFKDGDEAEDFVEV 107 124 96 VFKDGDEAEDFVEVH 100 106 93 FKDGDEAEDFVEVHL 65 76 119 133 KDEAEDFVEVHLP 72 93 76 GDEAEDFVEVHLPD 85 123 91 DEAEDFVEVHLPDV 46 124 113 DEAEDFVEVHLPDVH 68 136 123 DFVEVHLPDVHN 76 117 114 FVEVHLPDVHNQ 123 138 123 EDFVEVHLPDVHNOV 90 141 123 DFVEVHLPDVHNOVS 96 141 118 FVEVHLPDVHNQVSG 92 143 102 VEVHLPDVHNQVSGV 106 141 123 _VHLPDVHNOVSGVD 91 150 139 VHLPDVHNQVSGVDL 110 114 137 PDVHNQVSGVDLG 104 150 129 DVHNQVSGVDLGL 104 154 154 PDVHNQVSGVDLGLP 106 129 115 DVHNQVSGVDLGLPN 117 133 113 QVSGVDLGLPNW 100 119 38 HNQVSGVDLGLPNWG 76 106 38 NQVSGVDLGLPNWGK 78 138 98 Average 91.9 119.5 130.9 StDV 157.9 37.6 169.8 134 Table 15: Neutralizing potencies of anti-rabies virus G protein IgGs. Name IgG IU/mg CR04-001 89 CR04-004 5 CR04-008 1176 CR04-010 3000 CR04-018 1604 CR04-021 1500 CR04-026 <2 CR04-031 272 CR04-038 2330 CR04-040 3041 CR04-060 89 CR04-073 6116 CR04-097 <1 CR04-098 7317 CR04-103 3303 CR04-104 4871 CR04-108 4871 CR04-120 4938 CR04-125 4718 CR04-126 2655 CR04-140 478 CR04-144 6250 CR04-146 ND CR04-164 4724 CR57 3800 CRJB 605 ND = not determined 135 Table 16: Neutralizing potencies of anti-rabies virus G protein IgGs against E57 escape viruses. Name IgG E57A2 E57A3 E57B1 E57B2 E57B3 E57C3 (IU/mg) (IU/mg) (IU/mg) (IU/mg) (IU/mg) (IU/mg) CR04-008 0* 0 0 0 0 0 CR04-010 8127 1355 5418 1355 2709 4064 CR04-018 1604 0 1604 0 59 535 CR04-021 450 2 150 8 50 50 CR04-038 9437 1573 9437 1049 6291 1573 CR04-040 8209 2736 24628 1368 5473 912 CR04-073 8256 1835 11008 1835 3669 1835 CR04-098 9878 3293 9878 3293 3293 3293 CR04-103 8917 2972 17835 2972 5945 2972 CR04-104 3288 2192 6576 2192 4384 1096 CRO4-108 3288 731 4384 731 2192 731 CR04-120 1111 14 741 82 247 41 CR04-125 708 39 236 79 157 79 CROA-126 88 0 18 0 18 0 CR04-144 5625 2813 11250 2813 5625 1875 CR04-164 4252 472 4252 472 945 709 * 0 indicates no 50% endpoint at a dilution of 1:100 of the antibody 5 Table 17. Neutralizing potency of CR-57 against E98 escape viruses. E98-2 E98-4 E98-5 E98-6 E98-7 (IU/mg) (IU/mg) (IU/mg) (IU/mg) (U/mg) CR-57 2813 8438 4219 2813 8438 CR04-098 0* 0 0 0 0 * Zero indicates no 50% endpoint at a dilution of 1:1000 of 10 the antibody.
C:\RonbnDCC\TKU7I633.DOC-1 1/23/201 - 136 Table 18: Occurrence of amino acid residues in the minimal binding region of CR57 within genotype 1 rabies viruses. Wild type K L C G V L K L C G V L (99.6)* 100%) (100%) (98.7%) (99.6%) (70.7) R E I P (0.4%) (0.9%) (0.4%) (26.7%) R S (0.4%) (2.6%) * Percentage of occurrence of each amino acid is shown within 229 rabies virus isolates. The reference in this specification to any prior publication (or information derived from it), or to any matter which is known, is not, and should not be taken as an acknowledgment or admission or any form of suggestion that that prior publication (or information derived from it) or known matter forms part of the common general knowledge in the field of endeavour to which this specification relates. Throughout this specification and the claims which follow, unless the context requires otherwise, the word "comprise", and variations such as "comprises" and "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.
137 REFERENCES Ameyama S, Toriumi H, Takahashi T, Shimura Y, Nakahara T, Honda Y, Mifune K, Uchiyama T and Kawai A (2003), Monoclonal antibody #3-9-16 recognizes one of the two isoforms of rabies 5 virus matrix protein that exposes its N-terminus on the virion surface. Microbiol. Immunol. 47:639-651. Badrane H and Tordo N (2001), Host switching in Lyssavirus history from the Chiroptera to the Carnivora orders. J. Virol. 10 75:8096-8104. Benmansour A, Leblois H, Coulon P, Tuffereau C, Gaudin Y, Flamand A, and Lafay F (1991), Antigenicity of rabies virus glycoprotein. J. Virol. 65:4198-4203. 15 Boel E, Verlaan S, Poppelier MJ, Westerdaal NA, Van Strijp JA and Logtenberg T (2000), Functional human monoclonal antibodies of all isotypes constructed from phage display library-derived single-chain Fv antibody fragments. J. 20 Immunol. Methods 239:153-166. Bunschoten H, Gore M, Claassen IJ, Uytdehaag FG, Dietzschold B, Winner WH, and Osterhaus AD (1989), Characterization of a new virus-neutralizing epitope that denotes a sequential 25 determinant on the rabies virus glycoprotein. J. Gen. Virol. 70 (Pt 2):291-8. Burton DR and Barbas CF (1994), Human antibodies from combinatorial libraries. Adv. Immunol. 57:191-280. 30 Champion JM, Kean RB, Rupprecht CE, Notkins AL, Koprowski H, Dietzschold B, and Hooper DC (2000), The development of -138 monoclonal human rabies virus-neutralizing antibodies as a substitute for pooled human immune globulin in the prophylactic treatment of rabies virus exposure. J. Immunol. Methods 235:81-90. 5 Chou TC and Talalay P (1984), Quantitative analysis of dose effect relationships: the combined effects of multiple drugs or enzyme inhibitors. Adv. Enzyme Regul. 22:27-55. 10 Coulon P, Ternaux JP, Flamand A, and Tuffereau C (1998), An avirulent mutant of rabies virus is unable to infect motoneurons in vivo and in vitro. J. Virol. 72:273-278. De Kruif J, Terstappen L, Boel E and Logtenberg T (1995a), 15 Rapid selection of cell subpopulation-specific human monoclonal antibodies from a synthetic phage antibody library. Proc. Natl. Acad. Sci. USA 92:3938. De Kruif J, Boel E and Logtenberg T (1995b), Selection and 20 application of human single-chain Fv antibody fragments from a semi-synthetic phage antibody display library with designed CDR3 regions. J. Mol. Biol. 248:97-105. Dietzschold B, Wunner WH, Wiktor TJ, Lopes AD, Lafon M, Smith 25 CL, and Koprowski H (1983), Characterization of an antigenic determinant of the glycoprotein that correlates with pathogenicity of rabies virus. Proc. Natl. Acad. Sci. USA 80:70-74. 30 Dietzschold B, Gore M, Casali P, Ueki Y, Rupprecht CE, Notkins AL, and Koprowski H (1990), Biological characterization of -139 human monoclonal antibodies to rabies virus. J. Virol. 64:3087-3090. Hanlon CA, DeMattos CA, DeMattos CC, Niezgoda M, Hooper DC, 5 Koprowski H, Notkins A, and Rupprecht CE (2001), Experimental utility of rabies virus neutralizing human monoclonal antibodies in post-exposure prophylaxis. Vaccine 19:3834-3842. Huls G, Heijnen IJ, Cuomo E, van der Linden J, Boel E, van de 10 Winkel J and Logtenberg T (1999), Antitumor immune effector mechanisms recruited by phage display-derived fully human IgG1 and IgAl monoclonal antibodies. Cancer Res. 59:5778-5784. Jones D, Kroos N, Anema R, van Montfort B, Vooys A, van der 15 Kraats S, van der Helm E, Smits S, Schouten J, Brouwer K, Lagerwerf F, van Berkel P, Opstelten DJ, Logtenberg T and Bout A (2003), High-level expression of recombinant IgG in the human cell line PER.C6. Biotechnol. Prog. 19:163-168. 20 Lafon M, Wiktor TJ, and Macfarlan RI (1983), Antigenic sites on the CVS rabies virus glycoprotein: analysis with monoclonal antibodies. J. Gen. Virol. 64 (Pt 4):843-851. Luo TR, Minamoto N, Ito H, Goto H, Hiraga S, Ito N, Sugiyama 25 M, and Kinjo T (1997), A virus-neutralizing epitope on the glycoprotein of rabies virus that contains Trp251 is a linear epitope. Virus Res. 51:35-41. Madhusudana SN, Shamsundar R and Seetharaman S (2004), In 30 vitro inactivation of the rabies virus by ascorbic acid. Int. J. Infect. Dis. 8:21-25.
-140- - Ni Y, Tominaga Y, Honda Y, Morimoto K, Sakamoto S, and Kawai A (1995), Mapping and characterization of a sequential epitope on the rabies virus glycoprotein which is recognized by a neutralizing monoclonal antibody, RG719. Microbiol. Immunol. 5 39:693-702. Prehaud C, Coulon P, LaFay F, Thiers C, and Flamand A (1988), Antigenic site II of the rabies virus glycoprotein:structure and role in viral virulence. J. Virol. 62:1-7. 10 Schumacher CL, Dietzschold B, Ertl HC, Niu HS, Rupprecht CE, and Koprowski H (1989), Use of mouse anti-rabies monoclonal antibodies in postexposure treatment of rabies. J. Clin. Invest. 84:971-975. 15 Seif I, Coulon P, Rollin E, and Flamand A (1985) Rabies virulence: effect on pathogenicicty and sequence characterization of rabies virus mutations affecting antigenic site III of the glycoprotein. J. Virol. 53:926-934. 20 Slootstra JW, Puijk WC, Ligtvoet GJ, Langeveld JP, Meloen RH 1996. Structural aspects of antibody-antigen interaction revealed through small random peptide libraries. Mol. Divers. 1:87-96. 25 Tordo N (1996), Characteristics and molecular biology of rabies virus. In Meslin F-X, Kaplan NM, Koprowski H, editors. Laboratory Techniques in rabies, 4t edition Geneva, Switzerland: World Health Organization. 30 White LA and Chappell WA (1982), Inactivation of rabies virus in reagents used for the fluorescent rabies antibody test. J.
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Claims (7)

  1. 2. A pharmaceutical composition comprising two rabies virus neutralizing binding molecules that are capable of binding to different, non-competing epitopes of the rabies virus, the composition comprising: a first rabies virus neutralizing binding molecule capable of binding to an epitope located in antigenic site I of the rabies virus G protein, said first rabies virus neutralizing antibody comprising: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 273 or a sequence that is at least 80% homologous thereto, and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 275 or a sequence that is at least 80% homologous thereto, and a second rabies virus neutralizing binding molecule capable of binding to an epitope located in antigenic site III of the rabies virus G protein.
  2. 3. The pharmaceutical composition of claim 2, wherein the second rabies virus neutralizing binding molecule comprises: a heavy chain variable region comprising SEQ ID NO: 29 and a light chain variable region comprising SEQ ID NO: 53; or a heavy chain variable region comprising SEQ ID NO: 35 and a light chain variable region comprising SEQ ID NO: 59; or a heavy chain variable region comprising SEQ ID NO: 39 and a light chain variable C:NRPonbl\DCC\FMT\48(2635_lDOC- 12/ 1/2012 - 143 region comprising SEQ ID NO: 63; or a heavy chain variable region comprising SEQ ID NO: 40 and a light chain variable region comprising SEQ ID NO: 64; or a heavy chain variable region comprising SEQ ID NO: 41 and a light chain variable region comprising SEQ ID NO: 65; or a heavy chain variable region comprising SEQ ID NO: 47 and a light chain variable region comprising SEQ ID NO: 71.
  3. 4. The pharmaceutical composition of any one of the claims I to 3, wherein the first rabies virus binding molecule is an IgG and the second rabies virus binding molecule is an IgG.
  4. 5. A pharmaceutical composition comprising at least two rabies virus neutralizing monoclonal antibodies or antigen-binding fragments thereof, that are capable of reacting with different, non-competing epitopes of the rabies virus, wherein a first rabies virus neutralizing monoclonal antibody or antigen-binding fragment thereof, is capable of reacting with an epitope located in antigenic site I wherein the epitope comprises amino acids 226-23 1 of the rabies virus G protein, and a second rabies virus neutralizing monoclonal antibody or antigen-binding fragment thereof is capable of reacting with an epitope located in antigenic site III of the rabies virus G protein, wherein said rabies virus neutralizing antibodies or antigen-binding fragments are human antibodies or antigen binding fragments.
  5. 6. A method of preventing or treating a rabies virus infection in a subject, comprising administering to the subject the pharmaceutical composition of any one of claims 1 to 5.
  6. 7. Use of the pharmaceutical composition of any one of claims I to 5 for the preparation of a medicament for the prevention or treatment of a rabies virus infection.
  7. 8. The pharmaceutical composition of any one of claims 1 to 5, substantially as hereinbefore described with reference to the Examples and/or Figures.
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EP0402029B1 (en) * 1989-06-08 1994-01-12 The Wistar Institute Monoclonal antibodies for post exposure treatment of rabies

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EP0402029B1 (en) * 1989-06-08 1994-01-12 The Wistar Institute Monoclonal antibodies for post exposure treatment of rabies

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