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Although vaccination and other various prevention and control measures are being carried out globally, the new coronavirus (SARS-CoV-2) pneumonia (COVID-19) epidemic that originated in early 2020 has not yet stopped.
Humans and SARS- The long-term or even permanent coexistence of CoV-2 seems to be becoming a reality
.
One of the difficulties in the fight against SARS-CoV-2 is that the virus is constantly evolving to better invade the human body, which has caused the effectiveness of the vaccine to be weakened to some extent
.
Therefore, if the path of virus evolution can be blocked, it will help end this pandemic as soon as possible
On August 5, local time, researchers from the Fred Hutchinson Cancer Research Center, Johns Hopkins University, the US Military HIV Research Program, and the University of North Carolina published an article on NEJM to prevent the virus from continuing to evolve into a more powerful Strains provide ideas
.
The article pointed out that those people with low immunity should receive greater attention, and their unique immune response may create opportunities for SARS-CoV-2 to evolve into a super strain
.
So far, a number of studies have revealed that SARS-CoV-2 has undergone many mutations after entering the body of immunosuppressed people
.
In December 2020, NEJM reported that a 45-year-old male immunosuppressive patient with antiphospholipid syndrome had 12 mutations in the viral spike protein within 152 days after being infected with SARS-CoV-2, of which 7 were Located in a fragment of the receptor binding domain composed of 24 amino acids, some mutations are located at points related to immune escape
In an article published recently on the preprint platform "Research Square", SARS-CoV-2 existed in an immunocompromised cancer patient for 318 days, and eventually accumulated 40 mutations, affecting 26 viral genes.
Of the 18, 8 mutations occurred in the spike (S) protein gene
.
In addition to these special cases, in February this year, "Nature" reported that an immunocompromised cancer patient infected with SARS-CoV-2 had an increased frequency of viral mutations in the body after receiving convalescent plasma treatment; MedRxiv revealed in March this year The evolution of the virus in 3 patients with acute b-lymphocytic leukemia
.
In the latest report, the researchers pointed out that the mutations in the virus in these special cases have some key commonalities with the closely watched new crown variants such as Alpha, Beta and Gamma, such as in the N-terminal domain (NTD), NTD The super sites of the virus and the deletion of the receptor binding domain (RBD) gene may be related to the virus's escape neutralizing antibody or stronger transmission power, and the endless emergence of mutants also reveals the continuous evolution of the virus
.
The spike protein structure and phylogenetic tree of SARS-CoV-2 virus
The spike protein structure and phylogenetic tree of SARS-CoV-2 virus The spike protein structure and phylogenetic tree of SARS-CoV-2 virusThese commonalities indicate that it is necessary for clinicians to determine whether certain forms of immunosuppressive therapy are related to the presence of multiple mutations in the virus to increase the risk of escape.
These populations may become more infectious or more pathogenic after being infected with SARS-CoV-2.
Sexual mutant strains are produced, and patients will be in a state of virus shedding for a long time, becoming a reservoir for viruses that can spread in the community
.
For this reason, this report proposes that medical institutions should take strengthened preventive measures to prevent SARS-CoV-2 from evolving among immunocompromised patients and leading to hospital transmission
.
At the same time, immunological research should be carried out among these populations to evaluate the effects of vaccines induced antibody and T cell responses in these populations in alleviating disease symptoms and reducing virus replication.
Senior author of the report, Dr.
Morgane Rolland, a viral geneticist of the U.
S.
Military HIV Research Program, said: “The virus can last for weeks or months in immunocompromised individuals and develop into a variant strain carrying a series of mutations.
Some seem to be worrying variants that are currently threatening the prevention and control of the epidemic
.
"
In conclusion, this study shows that it is necessary to monitor, treat and prevent SARS-CoV-2 infection in immunosuppressed people at the time when the new crown variant strains are raging.
This will help reduce the patient’s risk of disease and prevent potential The mutant strain came out
.
Of course, more scientific research is also needed to understand the antibody and T cell responses triggered by vaccines among immunosuppressed populations, and to develop next-generation vaccines and therapeutic drugs that are more effective against mutations
More importantly, the dark cloud of the epidemic has not yet dissipated.
Original source:
Original source:Lawrence Corey, et al.
SARS-CoV-2 Variants in Patients with Immunosuppression Leave a message here