新冠病毒变异株“奥密克戎”的研究进展

2021年11月在南非首次发现严重急性呼吸综合征冠状病毒2(SARS-CoV-2)Omicron变异株（B.1.1.529）,随后世卫组织将该毒株定义为第五种关注变体（VOC）。与其他四种VOC(Alpha、Beta、Gamma和Delta)相比,Omicron是突变最多的毒株,更易传播和发生免疫逃逸。如今Omicron正发展成为全球许多国家的主要毒株,给预防和控制2019年冠状病毒病（COVID-19）带来新的挑战。本文章旨在对Omicron变异株的流行病学、突变及来源、传染性、核酸和抗原检测、临床致病性、疫苗反应性等信息作一简要综述,以期为监测、预防和疫苗研发策略提供科学参考。     

综述与专论: 针对严重急性呼吸综合征冠状病毒2变异株Omicron的疫苗研究进展

2021年底,严重急性呼吸综合征冠状病毒2 Omicron变异株迅速取代Delta突变株在世界范围内广泛流行,其S蛋白具有36个位点突变,导致致病力和传播力发生明显变化,并且具备了免疫逃逸的能力。疫苗接种是目前疫情防控最普适的手段,研究发现,现有疫苗针对Omicron突变株的保护效果明显下降。新的免疫策略或特异性疫苗/多价疫苗针对Omicron有效性的评估均需要动物模型的支撑。在实验室条件下,利用动物模型进行活病毒攻击实验,是在体内验证保护性中和抗体、疫苗有效性的关键技术手段,本文将从动物模型方向综述国内外针对Omicron变异株的疫苗研究进展。     

全球新型冠状病毒变异株研究进展

截至2021年5月11日,基于Pango命名法,依据新型冠状病毒(SARS-CoV-2)的基因组变异变迁将其划分为1281种亚型或分支.而SARS-CoV-2刺突(spike,S)蛋白的变异直接影响病毒的生物学功能.2020年下半年至今,全球多个国家和地区监测发现SARS-CoV-2的S蛋白发生氨基酸突变,特别是受体结合区或单克隆抗体结合位点氨基酸突变引起病毒的传播力和致病力改变以及部分免疫逃逸等.世界卫生组织将重要变异株划分为"关切变异株(variant of concern,VOC)"和"关注变异株(variant of interest,VOI)".其中,VOC 有4个,分别是 VOC 202012/01、501Y.V2﹑P.1 和 B.1.617;VOI 有6个,分别是 CAL.20C、P.2、B.1.526、B.1.525、B.1.616和P.3.一些氨基酸突变在多个VOC和VOI病毒株中交叉出现或同时出现,E484K/Q等重要氨基酸突变引起的部分免疫逃逸导致全球现有疫苗免疫效力下降,但现有新冠疫苗对VOC和VOI变异株仍然有效.本文通过对SARS-CoV-2变异株流行概况及S蛋白重要氨基酸突变特征进行归纳分析,为新冠病毒变异株的监测、防控和二代疫苗的研制策略提供科学参考.     

SARS-CoV-2 Omicron变异株荧光定量PCR鉴别方法的建立及应用

开发和评价一种用于鉴别Omicron变异株的荧光定量PCR方法。我们针对Omicron变异株S基因的两个特异性突变位点开发了一种基于荧光定量PCR的Omicron变异株分型方法（Omicron RT-qPCR）。通过测试临床样本来评价方法的特异性,通过标准品评价方法的灵敏度。Omicron RT-qPCR分型方法显示能够可靠地区分Omicron变异株和“野生型” SARS-CoV-2及Alpha、Beta、Delta变异株及甲型流感病毒。选取68例新冠疑似样本,全基因组测序（Whole genome sequencing,WGS）结果显示44例为Omicron变异株,Omicron RT-qPCR分型结果均为阳性;11例为Delta变异株,Omicron RT-qPCR分型结果均为阴性;另外,通过WGS分析未能成功分型的7例样本,通过Omicron RT-qPCR分型方法成功鉴定为Omicron BA.1和BA.2变异株。我们开发的Omicron RT-qPCR分型方法可以在普通的PCR检测实验室应用,为我国疾控系统和医疗机构及时监测SARS-CoV-2 Omicron变异株的传播提供...     

海南省三亚市15例新冠病毒Omicron变异株BA.5.1.3亚型的基因组特征分析

本文选取15例SARS-CoV-2感染病例的鼻咽拭子样本,采用新冠病毒全基因组三代Nanopore测序技术进行全基因组测序并对病毒的变异位点进行分析;结果显示,15株病毒均为BA.5.1.3变异株（Omicron）,NextStrain进化分析为22B。15株毒株共同发现了71个核苷酸突变位点,氨基酸的变异位点有54个,其中存在相同的16个同义突变。15株毒株具有5个特有的核苷酸变异,4个特有的氨基酸变异位点,个别毒株还具有其他突变位点。这是中国境内首次发现Omicron BA.5.1.3变异株,此变异株存在引发本地的流行和暴发风险,需要严密持续的对境外输入病例进行流行病学调查和病毒基因分子特征分析。本研究构建测序方法和分析结果可用于新冠病毒的变异分析和病例溯源,对新冠疫情防控具有重要意义。     

新型冠状病毒突变株Omicron核酸检测的TaqMan探针设计

Omicron（奥密克戎）作为最新的新型冠状病毒（SARS-CoV-2）突变株，其带有大量的突变位点，且突变位点主要位于S蛋白上，这不仅会增加再次感染病毒的风险，同时也会大幅降低疫苗和抗体疗法的的效果。Omicron携带的突变虽不影响国内现使用的核酸检测试剂，但这些检测试剂不能有效地鉴别出Omicron突变株。本研究通过对Omicron以及其他SARS-CoV-2突变株的基因序列进行分析，设计了能特异性检测Omicron突变株的TaqMan探针。同时，该探针可与现有的核酸检测体系进行结合，实现SARS-CoV-2核酸检测和Omicron突变株鉴别的双重功能。     

奥密克戎BA.1变异株在全球的流行和刺突蛋白的进化分析

新型冠状病毒Omicron变异株出现之后，在全球暴发流行过程中不断进化出传播速度更快、免疫逃逸能力更强的进化分支，为了探究BA.1变异株在全球暴发流行的特征及刺突蛋白(Spike,S)基因的进化特征，本研究对其全基因序列的全球报告情况和S基因的进化特征进行了分析。本文通过全球共享流感数据倡议组织(Global Initiative of Sharing All Influenza Data,GISAID)获取Omicron BA.1系列变异株的全基因序列信息，分析BA.1系列变异株S基因氨基酸突变并构建系统进化树和进行贝叶斯系统进化分析。本研究提示全球约有1.2亿人被BA.1系列变异株感染，全球提交的BA.1系列变异株序列数在其出现2个月后达到高峰，5个月后占新型冠状病毒的比例下降到4.38%，累计提交BA.1全基因序列最多的区域是欧洲、美洲；截止2022年10月，BA.1系列变异株中序列提交数占绝对优势的是BA.1.1(42.07%)，其次是BA.1(18.81%)。对S基因的氨基酸变异分析显示BA.1有56个进化分支，其中48个分支稳定遗传了Omicron原始株S蛋白中的18个氨基...     

2022年海南省新型冠状病毒奥密克戎（BA.1.1）变异株基因特征分析

为进一步积累和完善海南省新型冠状病毒（Severe acute respiratory syndrome coronavirus 2,SARS-CoV-2）奥密克戎（Omicron）变异株病原学特点的认识,本研究对2022年海南省14例感染奥密克戎（BA.1.1）变异株病例进行新冠病毒基因特征分析。应用Illumina公司MiSeqDX深度测序平台进行全基因组序列测定,Nextclade在线分析平台和DNASTAR 7.0.1生物信息学软件进行多序列比对和基因组特征分析,采用MEGA 10.1.8邻位归并法（Neighbour-joining）绘制系统进化树,结合流行病学调查进行回顾性溯源分析。海南省14例病例感染的奥密克戎（BA.1.1）变异株基因组高度相似,同武汉参考序列（GenBank No.NC＿045512）相比,存在63或64个核苷酸突变位点,39个核苷酸位点缺失,22204位点有9个核苷酸插入,引起43个氨基酸突变和16个氨基酸位点缺失。刺突（Spike, S）蛋白存在32个氨基酸突变位点,S1蛋白RBD区R346K是VOC/Omicron(BA.1.1)变异株特征性突变...     

福建省慢性HBV感染者HBV基因S区、基本核心启动子区和前C区基因变异特征分析

为研究福建省慢性HBV感染者HBV基因多样性及变异规律,了解该人群HBV-DNA的病毒学特征。收集慢性HBV感染者血清标本,通过巢式PCR法扩增其HBV基因序列,比对NCBI数据库中标准基因型序列,分析HBV基因S区,基本核心启动子区(BCP)及前C区的序列变异情况,并对这些变异可能造成的病毒抗原表达,疫苗逃逸,患者病症改变等情况进行探讨。最终成功扩增82例HBV全长基因序列,其中B基因型56例,C基因型26例。基因组特定功能区序列分析发现慢性HBV感染者HBV基因在S区(23.2%)、BCP区(61.0%)和前C区(29.3%)均出现了不同程度的变异。其中主蛋白(HBsAg)主要抗原决定簇a决定簇45.8%位点出现了变异,这些变异位点中包括与肝炎重症化及免疫逃逸密切相关的位点(aa126、aa129、aa145等)。位点G1896A(19.5%),G1764A(11.0%)和A1762T(9.8%)依然是BCP/前C区的主要突变位点。而位点A1752G(25.6%)高突变率的出现在BCP区应引起关注。此外位点G1764A(χ~2=5.742,P=0.030)、A1896G(χ~2=14.392,P=0.000)以及A1762T/G1764A(χ~2=7.289,P=0.012)的突变更容易发生在HBeAg阴性的样品中;而位点A1846T(χ~2=11.882,P=0.003)、A1762T(χ~2=6.561,P=0.038)和A1896G(χ~2=6.958,P=0.030)的突变与HBV-DNA的病毒载量存在一定相关性。总之,福建省慢性HBV感染者在HBV不同基因功能区域均存在不同程度的变异,一些与HBeAg表达情况、HBV-DNA载量、疫苗免疫逃避及肝细胞癌发生具有相关联的变异位点已经出现,BCP区A1752G位点的高频率出现应值得关注,对于这些变异位点的患者应加强监测。     

一株人源抗狂犬病病毒单克隆抗体的表位及中和活性的研究

目的通过ELISA相加试验和狂犬病毒(Rabies virus,RV)逃逸突变试验对一株人源抗狂犬病病毒单克隆抗体(human anti-rabies virus monoclonal antibody,Ab1)进行抗原表位分析。方法将已知表位的对照抗体(CR57和CR4098)和Ab1进行ELISA相加试验;以及对RV逃逸株氨基酸突变位点分析进一步验证Ab1针对的抗原表位,用小鼠中和试验(mouse neutralization test,MNT)分析Ab1的体内抗狂犬病病毒中和活性。结果 Ab1和CR57可同时与RV结合;与CR4098存在竞争,Ab1的逃逸株在氨基酸位点333、336发生突变,MNT检测体内中和活性为550.32 IU/mg,MNT和快速荧光灶抑制试验(rapid fluorescent focus inhibition test,RFFIT)结果基本一致。结论该抗体针对III号抗原表位且具有较高的抗狂犬病病毒中和活性。     

COVID-19: Omicron – the latest,the least virulent,but probably not the last variant of concern of SARS-CoV-2

The Omicron variant rapidly became the dominant SARS-CoV-2 strain in South Africa and elsewhere. This review explores whether this rise was due to an increased transmission of the variant or its escape from population immunity by an extensively mutated spike protein. The mutations affected the structure of the spike protein leading to the loss of neutralization by most, but not all, therapeutic monoclonal antibodies. Omicron also shows substantial immune escape from serum antibodies in convalescent patients and vaccinees. A booster immunization increased, however, the titre and breadth of antiviral antibody response. The cellular immune response against Omicron was largely preserved explaining a satisfying protection of boosted vaccinees against severe infections. Clinicians observed less severe infection with Omicron, but other scientists warned that this must not necessarily reflect less intrinsic virulence. However, in animal experiments with mice and hamsters, Omicron infections also displayed a lesser virulence than previous VOCs and lung functions were less compromised. Cell biologists demonstrated that Omicron differs from Delta by preferring the endocytic pathway for cell entry over fusion with the plasma membrane which might explain Omicron’s distinct replication along the respiratory tract compared with Delta. Omicron represents a distinct evolutionary lineage that deviated from the mainstream of evolving SARS-CoV-2 already in mid-2020 raising questions about where it circulated before getting widespread in December 2021. The role of Omicron for the future trajectory of the COVID-19 pandemic is discussed.     

The humoral and cellular immune evasion of SARS-CoV-2 Omicron and sub-lineages

The recently discovered SARS-CoV-2 variant Omicron (B.1.1.529) has rapidly become a global public health issue. The substantial mutations in the spike protein in this new variant have raised concerns about its ability to escape from pre-existing immunity established by natural infection or vaccination. In this review, we give a summary of current knowledge concerning the antibody evasion properties of Omicron and its subvariants (BA.2, BA.2.12.1, BA.4/5, and BA.2.75) from therapeutic monoclonal antibodies and the sera of SARS-CoV-2 vaccine recipients or convalescent patients. We also summarize whether vaccine-induced cellular immunity (memory B cell and T cell response) can recognize Omicron specifically. In brief, the Omicron variants demonstrated remarkable antibody evasion, with even more striking antibody escape seen in the Omicron BA.4 and BA.5 sub-lineages. Luckily, the third booster vaccine dose significantly increased the neutralizing antibodies titers, and the vaccine-induced cellular response remains conserved and provides second-line defense against the Omicron.     

Characteristics of replication and pathogenicity of SARS-CoV-2 Alpha and Delta isolates

The continuously arising of SARS-CoV-2 variants has been posting a great threat to public health safety globally, from B.1.17 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.617.2 (Delta) to B.1.1.529 (Omicron). The emerging or reemerging of the SARS-CoV-2 variants of concern is calling for the constant monitoring of their epidemics, pathogenicity and immune escape. In this study, we aimed to characterize replication and pathogenicity of the Alpha and Delta variant strains isolated from patients infected in Laos. The amino acid mutations within the spike fragment of the isolates were determined via sequencing. The more efficient replication of the Alpha and Delta isolates was documented than the prototyped SARS-CoV-2 in Calu-3 and Caco-2 cells, while such features were not observed in Huh-7, Vero E6 and HPA-3 cells. We utilized both animal models of human ACE2 (hACE2) transgenic mice and hamsters to evaluate the pathogenesis of the isolates. The Alpha and Delta can replicate well in multiple organs and cause moderate to severe lung pathology in these animals. In conclusion, the spike protein of the isolated Alpha and Delta variant strains was characterized, and the replication and pathogenicity of the strains in the cells and animal models were also evaluated.     

A comprehensive review on Covid-19 Omicron (B.1.1.529) variant

The world has been combating different variants of SARS-COV-19 since its first outbreak in Wuhan city. SARS-COV-19 is caused by the coronavirus. The corona virus mutates and becomes more transmissible than earlier variants as the day passes. Till 24 November 2021, SARS-COV-19 has four variants Alpha, Beta, Gamma, and Delta, respectively. Among them, the delta variant caused severe havoc across the world. South Africa registered a new variant with the World Health Organization (WHO) on 24 November 2021, which is much more transmissible than previous variants. The WHO classified it as a variant of concern (VOC) on 26 November 2021 and called it the Greek letter Omicron (B.1.1.529), the fifteenth letter in the alphabet. Here a serious attempt was made to comprehend the omicron variant’s origin, nomenclature, characteristics, mutations, the difference between delta and omicron variant, epidemiology, transmission, clinical features, impact on immunity, immune evasion, vaccines efficacy, etc.     

Clinical characteristics of 310 SARS-CoV-2 Omicron variant patients and comparison with Delta and Beta variant patients in China

Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has spread, data on the clinical characteristics of infected patients are limited. In this study, the demographic, clinical characteristics, and laboratory data of 310 SARS-CoV-2 Omicron variant patients treated at Haihe Hospital of Tianjin were collected and analyzed. Information on these patients was compared to 96 patients with the Delta variant of concern (VOC) and 326 patients with the Beta VOC during the previous coronavirus disease 2019 (COVID-19) outbreak in Harbin. Of the 310 patients infected with the Omicron variant, the median age was 35 years. Most patients were clinically classified as mild (57.74%), and the most common symptoms were cough (48.71%), fever (39.35%), and sore throat (38.26%). The results for different vaccination groups in the Omicron group showed that the median of “SARS-CoV-2 specific IgG” after 2 or 3 doses of vaccination was higher than the unvaccinated group (all Ps < 0.05). Older age was associated with a higher proportion of moderate cases and lower asymptomatic and mild cases based on clinical classifications. Compared to the Delta and Beta groups, the median age of the Omicron group was younger. The total number of asymptomatic patients and mild patients in the Omicron virus group was higher than the Delta and Beta groups (60.97% vs. 54.17% vs. 47.55%). This study presented the clinical characteristics of the first group of patients infected with the Omicron variant in Tianjin, China, and compared their clinical features with patients infected by the Delta and Beta variants, which would increase our understanding of the characteristics of SARS-CoV-2 Omicron variant.     

Evidence for a mouse origin of the SARS-CoV-2 Omicron variant

The rapid accumulation of mutations in the SARS-CoV-2 Omicron variant that enabled its outbreak raises questions as to whether its proximal origin occurred in humans or another mammalian host. Here, we identified 45 point mutations that Omicron acquired since divergence from the B.1.1 lineage. We found that the Omicron spike protein sequence was subjected to stronger positive selection than that of any reported SARS-CoV-2 variants known to evolve persistently in human hosts, suggesting a possibility of host-jumping. The molecular spectrum of mutations (i.e., the relative frequency of the 12 types of base substitutions) acquired by the progenitor of Omicron was significantly different from the spectrum for viruses that evolved in human patients but resembled the spectra associated with virus evolution in a mouse cellular environment. Furthermore, mutations in the Omicron spike protein significantly overlapped with SARS-CoV-2 mutations known to promote adaptation to mouse hosts, particularly through enhanced spike protein binding affinity for the mouse cell entry receptor. Collectively, our results suggest that the progenitor of Omicron jumped from humans to mice, rapidly accumulated mutations conducive to infecting that host, then jumped back into humans, indicating an inter-species evolutionary trajectory for the Omicron outbreak.     

Genomic Perspectives on the Emerging SARS-CoV-2 Omicron Variant

A new variant of concern for SARS-CoV-2, Omicron (B.1.1.529), was designated by the World Health Organization on November 26, 2021. This study analyzed the viral genome sequencing data of 108 samples collected from patients infected with Omicron. First, we found that the enrichment efficiency of viral nucleic acids was reduced due to mutations in the region where the primers anneal to. Second, the Omicron variant possesses an excessive number of mutations compared to other variants circulating at the same time (median: 62 vs. 45), especially in the Spike gene. Mutations in the Spike gene confer alterations in 32 amino acid residues, more than those observed in other SARS-CoV-2 variants. Moreover, a large number of nonsynonymous mutations occur in the codons for the amino acid residues located on the surface of the Spike protein, which could potentially affect the replication, infectivity, and antigenicity of SARS-CoV-2. Third, there are 53 mutations between the Omicron variant and its closest sequences available in public databases. Many of these mutations were rarely observed in public databases and had a low mutation rate. In addition, the linkage disequilibrium between these mutations was low, with a limited number of mutations concurrently observed in the same genome, suggesting that the Omicron variant would be in a different evolutionary branch from the currently prevalent variants. To improve our ability to detect and track the source of new variants rapidly, it is imperative to further strengthen genomic surveillance and data sharing globally in a timely manner.     

Mutations in spike protein T cell epitopes of SARS-COV-2 variants: Plausible influence on vaccine efficacy

With emerging SARS-CoV-2 variants, vaccines approved so far are under scrutiny for long term effectiveness against the circulating strains. There is a prevalent obsession with humoral immunity as in vitro studies have indicated diminished effects of vaccine-induced neutralizing antibodies. However, this need not clinically translate to vaccine resistance as immune response against all forms of present vaccine preparations is T dependent unlike that against native viral particles which can induce T independent immune responses. Thus, we focused on this major correlate of protection against infections, T cell response. Using bioinformatics tools, we analyzed SARS-CoV-2 Spike protein T cell epitopes and their diversity across Delta plus/B.1.617.2.1, Gamma/P.1 (variant of concern), B.1.1.429, Zeta/P.2 and Mink cluster 5/B.1.1.298 variants as well as Omicron/B.1.1.529 (variant of concern). We also compared HLA restriction profiles of the mutant epitopes with that of the native epitopes (from Wuhan_hu_1 strain, used in vaccine formulations). Our observations show ~90% conservation of CD4+ and CD8+ epitopes across Delta plus/B.1.617.2.1, Gamma/P.1 (variant of concern), B.1.1.429, Zeta/P.2 and Mink cluster 5/B.1.1.298. For the Omicron/B.1.1.529 variant, ~75% of CD4+ and ~ 87% CD8+ epitopes were conserved. Majority of the mutated CD4+ and CD8+ epitopes of this variant were predicted to retain the HLA restriction pattern as their native epitopes. The results of our bioinformatics analysis suggest largely conserved T cell responses across the studied variants, ability of T cells to tackle new SARS-CoV-2 variants and aid in protection from COVID-19 post vaccination. In conclusion, the results suggest that current vaccines may not be rendered completely ineffective against new variants.     

SARS-CoV-2 VOCs,Mutational diversity and clinical outcome: Are they modulating drug efficacy by altered binding strength?

The global COVID-19 pandemic continues due to emerging Severe Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC). Here, we performed comprehensive analysis of in-house sequenced SARS-CoV-2 genome mutations dynamics in the patients infected with the VOCs - Delta and Omicron, within Recovered and Mortality patients. Statistical analysis highlighted significant mutations - T4685A, N4992N, and G5063S in RdRp; T19R in NTD spike; K444N and N532H in RBD spike, associated with Delta mortality. Mutations, T19I in NTD spike, Q493R and N440K in the RBD spike were significantly associated with Omicron mortality. We performed molecular docking for possible effect of significant mutations on the binding of Remdesivir. We found that Remdesivir showed less binding efficacy with the mutant Spike protein of both Delta and Omicron mortality compared to recovered patients. This indicates that mortality associated mutations could have a modulatory effect on drug binding which could be associated with disease outcome.