Molecular aspects of MERS-CoV

doi:10.1007/s11684-017-0521-z

Front. Med.

2017, Vol. 11

Issue (3) : 365-377 https://doi.org/10.1007/s11684-017-0521-z

REVIEW

Molecular aspects of MERS-CoV

Ali A. Rabaan¹(

), Ali M. Bazzi², Shamsah H. Al-Ahmed³, Jaffar A. Al-Tawfiq^4,⁵

¹. Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
². Microbiology Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
³. Specialty Paediatric Medicine, Qatif Central Hospital, Qatif 32654, Saudi Arabia
⁴. Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
⁵. Indiana University School of Medicine, Indianapolis, IN 46202, USA

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Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a betacoronavirus which can cause acute respiratory distress in humans and is associated with a relatively high mortality rate. Since it was first identified in a patient who died in a Jeddah hospital in 2012, the World Health Organization has been notified of 1735 laboratory-confirmed cases from 27 countries, including 628 deaths. Most cases have occurred in Saudi Arabia. MERS-CoV ancestors may be found in Old World bats of the Vespertilionidae family. After a proposed bat to camel switching event, transmission of MERS-CoV to humans is likely to have been the result of multiple zoonotic transfers from dromedary camels. Human-to-human transmission appears to require close contact with infected persons, with outbreaks mainly occurring in hospital environments. Outbreaks have been associated with inadequate infection prevention and control implementation, resulting in recommendations on basic and more advanced infection prevention and control measures by the World Health Organization, and issuing of government guidelines based on these recommendations in affected countries including Saudi Arabia. Evolutionary changes in the virus, particularly in the viral spike protein which mediates virus-host cell contact may potentially increase transmission of this virus. Efforts are on-going to identify specific evidence-based therapies or vaccines. The broad-spectrum antiviral nitazoxanide has been shown to have in vitro activity against MERS-CoV. Synthetic peptides and candidate vaccines based on regions of the spike protein have shown promise in rodent and non-human primate models. GLS-5300, a prophylactic DNA-plasmid vaccine encoding S protein, is the first MERS-CoV vaccine to be tested in humans, while monoclonal antibody, m336 has given promising results in animal models and has potential for use in outbreak situations.

Keywords MERS-CoV Saudi Arabia spike protein transmission evolution vaccine

Corresponding Author(s): Ali A. Rabaan

Just Accepted Date: 14 April 2017 Online First Date: 17 May 2017 Issue Date: 29 August 2017

Cite this article:

Ali A. Rabaan,Ali M. Bazzi,Shamsah H. Al-Ahmed, et al. Molecular aspects of MERS-CoV[J]. Front. Med., 2017, 11(3): 365-377.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0521-z
https://academic.hep.com.cn/fmd/EN/Y2017/V11/I3/365

Fig.1 Phylogenetic tree of human and camel MERS-CoV. Adapted from: Zhang et al., 2016, Evolutionary dynamics of MERS-CoV: potential recombination, positive selection and transmission; available from: http://www.nature.com/articles/srep25049; licensed under a Creative Commons Attribution 4.0 International License: https://creativecommons.org/licenses/by/4.0/.

Fig.2 Replication cycle of MERS-CoV. From: Durai et al., 2015, Middle East respiratory syndrome coronavirus: transmission, virology and therapeutic targeting to aid in outbreak control; available from: http://www.nature.com/emm/journal/v47/n8/full/emm201576a.html; licensed under a Creative Commons Attribution 4.0 International License: https://creativecommons.org/licenses/by/4.0/legalcode.

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