Although strong evidence suggests that any antibody that can bind to the HIV spike will neutralize the virus, only a small number of epitopes that induced broadly neutralizing antibodies upon HIV infection have been defined. These include the α1→2 mannose residues recognized by 2G12 (
Trkola et al., 1996;
Scanlan et al., 2002), the central region of the CD4bs bound by b12 (
Barbas et al., 1992), and the V1/V2 and V3 loops recognized by PG9 and PG16 (
Walker et al., 2009;
Walker and Burton, 2010). Unfortunately, vaccination approaches using recombinant HIV envelope proteins and derivatives specifically engineered to elicit broadly neutralizing antibodies have all been disappointing to date. Thus, the identification of additional immunogenic targets of neutralizing antibodies on the HIV viral spike remains an important issue in HIV vaccine research (
Mascola and Montefiori, 2010). Optimal vaccine epitopes should be immunogenic in humans, conserved among HIV isolates and required for optimal viral infectivity. The core epitope fits all of these criteria.
Anti-core antibodies represent 18% of all anti-gp140 antibodies cloned from the memory B cell compartment of patients with high titers of broadly neutralizing antibodies (
Scheid et al., 2009), but most importantly, they represent the most frequent neutralizers, accounting for 32% of all HIV-1 neutralizing antibodies (
Scheid et al., 2009). In contrast, 18% of the neutralizing antibodies cloned in the same study showed binding properties similar to the anti-CD4bs antibody b12, 27% were anti-VL directed, and 23% recognized the CD4is (
Scheid et al., 2009).
Neutralizing antibodies targeting a region other than the “central region of the CD4bs” were found in the sera of patients with broadly neutralizing serologic activity (
Li et al., 2007). Anti-core plus anti-CD4bs containing serum and IgG fraction eluted from gp120
core (which lacks VL 1–3, and therefore the CD4is) was more potent in viral neutralization than the anti–CD4bs-antibody–enriched fraction alone (
Li et al., 2007). Thus, the serologic data are in agreement with the antibody-cloning experiments; both indicate that anti-core antibodies contribute significantly to the overall neutralizing activity in human serum.
Most antibodies that bind to HIV neutralizing epitopes are restricted in their neutralizing activity, including antibodies to the CD4bs. For example, among the antibodies that are like b12 and sensitive to the D368A mutation, most show neutralizing activity against tier 1 viruses, but much more limited activity against tier 2 viruses (
Wyatt and Sodroski, 1998;
Mascola, 2003;
Pantophlet and Burton, 2006;
Karlsson Hedestam et al., 2008;
Scheid et al., 2009;
Stamatatos et al., 2009). Similarly, most anti-core antibodies are not broad but are instead restricted to neutralize one or another strain of HIV-1. However, like the traditional anti-CD4bs antibodies, an occasional anti-core antibody, HJ16 exhibits a breadth of neutralizing activity comparable to, and generally complementary to b12, being able to neutralize approximately one third of all HIV-1 isolates tested, irrespective of clade (
Corti et al., 2010). HJ16 also showed selective neutralization of tier 2, and not tier 1, isolates, making it particularly interesting as a template for vaccine design (
Corti et al., 2010). Moreover, HJ16 was obtained from a clade C–infected patient, whereas the antibodies we cloned were obtained from clade B infected patients; therefore, the core epitope is immunogenic in humans even across different HIV isolates and clades.
Anti-core antibodies recognize a common epitope in close proximity to the CD4bs. We would therefore like to suggest that this group of antibodies should be referred to anti-CD4bs/DMR. Although this group of antibodies recognizes the same epitope, they are heterogeneous with respect to their neutralizing breadth and potency (
Scheid et al., 2009;
Corti et al., 2010). Similarly, traditional anti-CD4bs antibodies sensitive to the D368R mutation also show a wide range of neutralizing activity (
Chen et al., 2009;
Scheid et al., 2009;
Corti et al., 2010). The structural basis for the difference is not entirely clear for either of the two classes of antibodies despite extensive structural information on the more traditional CD4bs antibodies. For example, there were only subtle differences between the structures of CD4bs antibodies F105 and b12 bound to a fragment of gp120, despite enormous differences in neutralizing activity (
Chen et al., 2009). Further understanding of the molecular basis of differences in the neutralizing activity of these antibodies may require determining the structure of their cocrystals with native gp160.
Anti-CD4bs/DMR antibodies recognize a conformational epitope that includes the α5 helix at the outer-domain–inner-domain junction of gp120. The core epitope is highly conserved across different HIV-1 isolates and is essential for optimal infectivity, and therefore for viral fitness. Importantly, anti-CD4bs/DMR antibodies resemble b3 and b6 antibodies that were isolated as Fab fragments from a phage display library and lack neutralizing activity (
Burton et al., 1991;
Barbas et al., 1992;
Pantophlet et al., 2003). Based on the comparative analysis of the structure of b12, which is broadly neutralizing, and b6, which is not, it has been suggested that a stabilized core protein, which does not allow b6 (
Pantophlet et al., 2003;
Zhou et al., 2007) or anti-core antibody (
Scheid et al., 2009) binding, should be used as a vaccine immunogen (
Dey et al., 2007,
2009;
Mörner et al., 2009). However, antibodies to the core epitope can account for a significant fraction of the neutralizing activity in sera (
Li et al., 2007), and of the antibodies produced by memory B cells (
Scheid et al., 2009;
Corti et al., 2010), including potent and broadly neutralizing antibodies (
Corti et al., 2010). Therefore, we would like to suggest that an optimal HIV vaccine immunogen may require inclusion of the core epitope.