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onsdag 31 maj 2023

WHO News 30.5. 2023

Seventy-sixth World Health Assembly – Daily update: 30 May 2023

30 May 2023
Note for Media
Geneva, Switzerland
Reading time: 1 min (353 words)

WHO’s annual assembly ends with agreement on funding, and array of health topics

WHO’s 76th health assembly closed today, having addressed a vast array of issues, including behavioural sciences; best buys for non-communicable diseases; diagnostics; disabilities; drowning prevention; emergency, critical and operative care; food micronutrients; indigenous health; infection prevention and control; maternal and child health; medical oxygen; primary health care; refugee and migrant health; rehabilitation; traditional medicine, and WHO’s work in responding to dozens of emergencies while working with Member States to be better prepared to face new ones. 

Earlier in the day, delegates in Committee A agreed to note the roadmap towards the Global Health and Peace Initiative (along with a slight change in name from “Global Health for Peace Initiative”), and requested that the Director-General report on progress in strengthening the roadmap. 

In plenary, as the final approval step of the assembly, delegates adopted the resolutions and decisions of the two committees, and adopted their reports. This included approval of the budget for 2024-25, and a 20% increase in assessed contributions. The committee chairs and representatives from two regions spoke to recognize the work and progress of this Assembly. 

In his closing remarks, Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General, noted that “the increase in assessed contributions and the investment round are historic and a huge milestone.” He spoke about the year ahead, with high-level meetings on universal health coverage, tuberculosis and pandemic preparedness and response at this year’s UN General Assembly. He pointed to the continuing negotiations on the pandemic accord and amendments to the International Health Regulations as unprecedented—“generational”—opportunities to learn from the mistakes of the COVID-19 pandemic and ensure they are not repeated. 

Delegates also had the chance to hear from former WHO staff Gwen Carnelley, who turned 100 this year, who began working with WHO in 1949, just a year after WHO was founded 75 years ago.

Video of Closing of the 76th World Health AssemblyGwen Carnelley is introduced at 54:37 and speaks shortly afterwards.

Starting tomorrow, the 153rd meeting of Executive Board begins, where the outcomes of the Assembly will be discussed, among other things.

 


Sars-cov-2 varianttien ja rekombinaatioitten linjoja on jatkuvana virtana saatu määriteltyä

 https://github.com/cov-lineages/pango-designation/compare/v1.20...master

 

 https://github.com/cov-lineages/pango-designation/releases/tag/v1.20

tisdag 30 maj 2023

Ajatuksen häive

 Otin tänään käsiini  vanha rutoalaisen läkärikuntaohjeen suomalaislääkäreille enen toista maailmansotaa. Siinä käytettiin esimerkkeinä ensimäisen maailmansodan asiosita tehtyjä johtopäätöäksiä.  satuin aukaisemaan kirjan  taistelukaasuja käsittelevästä kohdasta.  Luin mm  niistä tqaistelukaasuista  arsiineista, jotka olivat  hermokaasujen  otsikon alla.  Siinä kuvattiin arsiinien vaikutusta keuhkoihin. Kuvas muistutti  niin paljon  niit teitoja mitä letaalien Sars-cov-2- keuhkoista  ja taudinkuvasta oli annettu, että sen takia etsin noita  tässä keräämiäni PubMed asioista  postmortem keuhkosita . Häivähtävänä ajatuksena olis e, että sars-Cov-2 omaa jonkin suoranaisen toksiinijaksonkin tai pystyy tekemään  niin toksisen miljöön että se vastaa  biokemiallisia  aseita. Mikä on se  toksinen jakso tai  asioiden  vääjäämätön prosessi, joka  luo sen   tappavan   ja  irreveresibeliin  kulun.  Luonnollisesti  hemoglobiinin funktion poistuminen on yksi.

. Vuoden 2023 artikkeleissa on hienosäädettyä  hoitotekniikkaa.

10 hakuartikkelia 2023 vuodelta Covidin aiheuttamasta keuhkoödemasta . Delta -variantti ollut pahin aiheuttaja.

 

Lung Injury in COVID-19 Has Pulmonary Edema as an Important Component and Treatment with Furosemide and Negative Fluid Balance (NEGBAL) Decreases Mortality.
Santos JLF, Zanardi P, Alo V, Dos Santos V, Bovone L, Rodriguez M, Magdaleno F, De Langhe V, Villoldo A, Martinez Souvielle R, Alconcher J, Quiros D, Milicchio C, Garcia Saiz E. J Clin Med. 2023 Feb 15;12(4):1542. doi: 10.3390/jcm12041542. PMID: 36836076 Free PMC article.
The result is excessive retention of water, producing a state of noxious hypervolemia. Consequently, in COVID-19 injury lung is pulmonary edema. Our report is a case-control study, retrospective. We included 116 patients with moderate-severe
Histopathological Lung Findings in COVID-19 B.1.617.2 SARS-CoV-2 Delta Variant.
Jeican II, Inișca P, Gheban D, Anton V, Lazăr M, Vică ML, Mironescu D, Rebeleanu C, Crivii CB, Aluaș M, Albu S, Siserman CV. J Pers Med. 2023 Jan 31;13(2):279. doi: 10.3390/jpm13020279. PMID: 36836513 Free PMC article.
BACKGROUND: The Delta variant (Pango lineage B.1.617.2) is one of the most significant and aggressive variants of SARS-CoV-2. To the best of our knowledge, this is the first paper specifically studying pulmonary morphopathology in COVID- …
Morphological and functional findings in COVID-19 lung disease as compared to Pneumonia, ARDS, and High-Altitude Pulmonary Edema.
Zubieta-Calleja GR, Zubieta-DeUrioste N, de Jesús Montelongo F, Sanchez MGR, Campoverdi AF, Rocco PRM, Battaglini D, Ball L, Pelosi P. Respir Physiol Neurobiol. 2023 Mar;309:104000. doi: 10.1016/j.resp.2022.104000. Epub 2022 Nov 29. PMID: 36460252 Free PMC article. Review.
Coronavirus disease-2019 (COVID-19) may severely affect respiratory function and evolve to life-threatening hypoxia. The clinical experience led to the implementation of standardized protocols assuming similarity to severe acute
Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis.
Watanabe A, Yasuhara J, Karube T, Watanabe K, Shirasu T, Takagi H, Sumitomo N, Lee S, Kuno T. Pediatr Crit Care Med. 2023 May 1;24(5):406-416. doi: 10.1097/PCC.0000000000003113. Epub 2022 Nov 17. PMID: 36516348 Free PMC article.
The most common indications for ECMO were multisystem inflammatory syndrome in children (52% [47/90]) and severe acute respiratory distress syndrome (40% [36/90]). ...CONCLUSIONS: The mortality of children on ECMO for COVID-19 was …
Upper Airway Complications in COVID-19: A Case Series.
Shrestha S, Shin Y, Sostin OV, Pinkhasova P, Chronakos J. Cureus. 2023 Apr 5;15(4):e37163. doi: 10.7759/cureus.37163. eCollection 2023 Apr. PMID: 37153305 Free PMC article.
Prolonged intubations were particularly common during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to present a series of five cases of upper airway complications in patients who underwent mechanical ventilati …
Montelukast as a potential treatment for COVID-19.
McCarthy MW. Expert Opin Pharmacother. 2023 Apr;24(5):551-555. doi: 10.1080/14656566.2023.2192866. Epub 2023 Mar 19. PMID: 36927284 Review.
AREAS COVERED: Montelukast has also been noted to have anti-inflammatory properties, suggesting it may have a role in the treatment of coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome
Fibrinolytic system and COVID-19: From an innovative view of epithelial ion transport.
Fu Y, Xue H, Wang T, Ding Y, Cui Y, Nie H. Biomed Pharmacother. 2023 Jul;163:114863. doi: 10.1016/j.biopha.2023.114863. Epub 2023 May 9. PMID: 37172333 Free PMC article. Review.
Lifeways of worldwide people have changed dramatically amid the coronavirus disease 2019 (COVID-19) pandemic, and public health is at stake currently. In the early stage of severe acute respiratory syndrome coronavirus
Prospective Roles of Tumor Necrosis Factor-Alpha (TNF-α) in COVID-19: Prognosis, Therapeutic and Management.
Mohd Zawawi Z, Kalyanasundram J, Mohd Zain R, Thayan R, Basri DF, Yap WB. Int J Mol Sci. 2023 Mar 24;24(7):6142. doi: 10.3390/ijms24076142. PMID: 37047115 Free PMC article. Review.
Several previous studies revealed the impact of the imbalanced innate immune response on the progression of COVID-19 and its disease outcomes. High levels of proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukins are produced read …
Inter-rater reliability and prognostic value of baseline Radiographic Assessment of Lung Edema (RALE) scores in observational cohort studies of inpatients with COVID-19.
Al-Yousif N, Komanduri S, Qurashi H, Korzhuk A, Lawal HO, Abourizk N, Schaefer C, Mitchell KJ, Dietz CM, Hughes EK, Brandt CS, Fitzgerald GM, Joyce R, Chaudhry AS, Kotok D, Rivera JD, Kim AI, Shettigar S, Lavina A, Girard CE, Gillenwater SR, Hadeh A, Bain W, Shah FA, Bittner M, Lu M, Prendergast N, Evankovich J, Golubykh K, Ramesh N, Jacobs JJ, Kessinger C, Methe B, Lee JS, Morris A, McVerry BJ, Kitsios GD. BMJ Open. 2023 Jan 12;13(1):e066626. doi: 10.1136/bmjopen-2022-066626. PMID: 36635036 Free PMC article.
OBJECTIVES: To reliably quantify the radiographic severity of COVID-19 pneumonia with the Radiographic Assessment of Lung Edema (RALE) score on clinical chest X-rays among inpatients and examine the prognostic value of baseline RALE scores on COVID- …

Keuhkojen painon lisäys ja muut muutokset letaalissa Covid-19 keuhkossa( post mortem)

 

. 2020;82(6):63-69.
doi: 10.17116/patol20208206163.[Organ changes found by postmortem examination in COVID-19 patients]
[Article in Russian]
Abstract

The postmortem study results presented in 20 sources of literature on 186 COVID-19 patients were analyzed. Pathological changes were noted in multiple organs, by involving predominantly the respiratory, circulatory, and excretory systems. The changes in the lungs were characterized by an increase in organ weight (59.3%), a dark red color of the parenchyma (47.4%), compaction of lung tissue (56%), and signs of lung congestion (37.3%). The histological characteristics found during postmortem lung tissue examination, which were indicative of diffuse alveolar damage, were proliferation of type II alveolocytes in 65.2% of cases, the appearance of hyaline membranes lining the alveoli in 64.4%, and interstitial edema in 54.2%. In the analyzed sources, 22% of cases were noticed to have severe thrombosis and pulmonary artery branch embolism that was associated with lower extremity deep vein thrombosis. In all the sources of literature, acute tubular necrosis, tubular luminal dilatation, and interstitial edema were detected in the kidneys.

Keywords: COVID-19; SARS-CoV-2; acute respiratory distress syndrome; diffuse alveolar damage.

Veren viskositeetin nousu ja punsasolujen liikaklimppiytyvisyys vaikeassa Covid-19 infektiossa

 

. 2022 Mar 1;97(3):283-292.
doi: 10.1002/ajh.26440. Epub 2021 Dec 23. Increased blood viscosity and red blood cell aggregation in patients with COVID-19
DOI: 10.1002/ajh.26440 Free article
Abstract

The aim of this study was to (1) analyze blood viscosity, red blood cell (RBC) deformability, and aggregation in hospitalized patients with Coronavirus disease 19 (COVID-19); (2) test the associations between impaired blood rheology and blood coagulation; and (3) test the associations between impaired blood rheology and several indicators of clinical severity. A total of 172 patients with COVID-19, hospitalized in COVID-unit of the Internal Medicine Department (Lyon, France) participated in this study between January and May 2021. Clinical parameters were collected for each patient. Routine hematological/biochemical parameters, blood viscosity, RBC deformability and aggregation, and RBC senescence markers were measured on the first day of hospitalization. A control group of 38 healthy individuals was constituted to compare the blood rheological and RBC profile. Rotational thromboelastography was performed in 76 patients to study clot formation dynamics. Our study demonstrated that patients with COVID-19 had increased blood viscosity despite lower hematocrit than healthy individuals, as well as increased RBC aggregation. In-vitro experiments demonstrated a strong contribution of plasma fibrinogen in this RBC hyper-aggregation. RBC aggregation correlated positively with clot firmness, negatively with clot formation time, and positively with the length of hospitalization. Patients with oxygen supplementation had higher RBC aggregation and blood viscosity than those without, and patients with pulmonary lesions had higher RBC aggregation and enhanced coagulation than those without. This study is the first to demonstrate blood hyper-viscosity and RBC hyper-aggregation in a large cohort of patients with COVID-19 and describe associations with enhanced coagulation and clinical outcomes. © 2021 Wiley Periodicals LLC.

Veren viskositeetti vaikessa Covid-19:ssa

https://pubmed.ncbi.nlm.nih.gov/?term=blood+viscosity+in+severe+covid-1

Abstract

Background: Changes in blood viscoelastic properties have been proposed previously as etiopathogenesis for severe complications in COVID-19 and some cases of Sudden Deafness (SD). This is an attempt to verify if SD cases in patients admitted for SARS-Cov-2 infection can be correlated.

Patients and methods: A prospective follow-up was carried out with COVID-19 patients, monitoring their blood viscosity (BV) at high shear rate (300 s-1) and inquiring them periodically for eventual hearing loss. This measurement was extended to cases bearing of SD in 2019 and 2020 without infection and a control group of healthy normoacoustic subjects.

Results: The normality range was 4,16 ± 0,62 cps. 330 cases admitted for COVID-19 were evaluated from February 24th, 2020 to March 24th, 2021, 85 of them attended in ICU. After anamnesis and Audiometric Tone Thresholds developed as soon as possible, 9 SD were detected, all belonging to ICU group. The mean BV was 4,38 ± 0,43 cps in the ward group, 4,53 ± 0,39 cps in the ICU patients without SD, and 4,85 ± 0,52 cps in the cases with SD, with statistically significant differences. Highest BV elevations in the SD cases were detected between days 6 and 10 of hospital admission. In 2019 four cases consulted with SD, and another two did it in 2020 without a diagnosis of COVID-19, with normal BV values.

Conclusions: During SARS-Cov-2 infection, patients may show high BV and SS, although an inpatients control group and a larger sample volume are necessary to confirm the predisposition to hyperviscosity. The incidence of hearing damage is considerable if its possible appearance is taken into account, within the limitations of critical patients with COVID-19.

Keywords: Blood viscosity; COVID-19; Hipoacusia neurosensorial; SARS-Cov-2; Sensorineural hearingloss; Sordera súbita; Sudden deafness; Viscosidad sanguínea.


söndag 28 maj 2023

Suomen historian kulkutaudeista nettilinkki - virukset keksittiin myöhään

 https://kulkutaudit1.webnode.fi/

otetava huomioon että virusten havaitseminen tapahtui ihmiskuntahistoriassa myöhäisvaiheessa .

 

Mitä kirjoitti Tri Arno Forsius H1N1 pandemiasta aikanaan?

 https://yle.fi/a/3-5278543   Artikkeli on 13 vuoden takainen.

Terveys

Pandemiaan ei voi suhtautua olankohautuksella, muistuttaa lääketieteen tohtori Arno Forsius

Tiedot sikainfluenssasta (A H1N1)  vaihtelevat päivästä päivään. Nyt tauti on rantautunut Hämeeseen jo todenteolla, Lahdessa on yksi varma tartunta ja naapurimaakunnissa useita. Sikainfluenssaa ei voi ohittaa olankohautuksella. Pahin on edessä, tiesi edelliset pandemiat muistava professori Arno Forsius jo toukokuussa.

Moni vielä muistaa miten Suomessa raivosi sekä 1950- että 60-lukujen lopulla kaksi voimakasta influenssaa, tuolloin puhuttiin aasialaisesta ja hongkonglaisesta influenssasta.

Nyt maailmassa on vuosikymmeniin ensimmäinen pandemiaksi eli maailmanlaajuiseksi epidemiaksi luokiteltu influenssa. H1N1-taudista alettiin puhua keväällä ja nyt Suomessakin tulee uusia tartuntatapauksia päivittäin.

- Toisaalta näyttää siltä, että tauti ei välttämättä olisi kovin vakava, mutta toisaalta on vielä aivan liian aikaista sanoa, miten tilanne tulee kehittymään.

Edelliset influenssa olivat hieman toisenlaiseen maailmanaikaan, mutta tarttuivat nyt nähtyä herkemmin.

- Molemmat taudit tarttuivat herkästi ja pahimmillaan saattoi jopa 40 prosenttia väestöstä olla taudin kourissa, muistelee Forsius.

Kulkutaudit ovat muutenkin olleet osa ihmiskunnan historiaa. Suomessa kulkutautien historia ulottuu 1500-luvun lopulle.

- Pandemioita ja epidemioita on aina esiintynyt säännöllisin väliajoin, muistuttaa Forsius.

 

lördag 27 maj 2023

GITHUB uutiset: Jatkoselvittelyä XBB.1.11.1 linjan alalinjalle , jonka tapaisia on diversiteettinä ehkä runsaasti Indonesiassa

 https://github.com/cov-lineages/pango-designation/issues/2021

 9 h ago

XBB.1.11.1 (S:S486P) Sublineage with S:K478R (87 seq, May 20)—first proposed by @FedeGueli #2021

transferred from pre-Proposal page Issue 66 sars-cov-2-variants/lineage-proposals#66

Note: A sub-branch of this lineage was previously proposed by @FedeGueli, but after a subsequent rearrangement of the Usher tree, I made the following proposal, not realizing it contained within it the branch proposed earlier.

Description
Sub-lineage of: XBB.1.11.1
Earliest sequence: 2023-2-2, Indonesia — EPI_ISL_17012209
Most recent sequence: 2023-5-2, Indonesia — EPI_ISL_17655098
Countries circulating: Indonesia (29), Malaysia (7), England (3) South Korea (1), Australia (1), Spain (1), Japan (1)
Number of Sequences: 43
GISAID Nucleotide Query: C13968A, G16377A, C22995G, T23018C
CovSpectrum Query: Nextcladepangolineage:XBB.1.11.1* & S:K478R
Substitutions on top of XBB.1.11.1:
Spike: K478R
Nucleotide: A22995G

USHER Tree (The tree below excludes several sequences with multiple artifactual reversions, so all the longer branches below consist of real mutations.) (Figure)

 Evidence
This lineages seems to be most in Indonesia, a country of about 275 million people from which we don't get very many sequences. It is also prominent in Malaysia. The base lineage can't be growing particularly fast or it would be more widespread internationally by now, but there's a great deal of diversity here, including a sizable branch with S:F186S and four additional AA mutations. This branch includes the most recently collected sequence (May 2) and first appeared on March 10 in Indonesia.

@ryhisner i think now that thing has been resolved with the saltation sublineage being moved to another tree:
(see my pango proposal:
#2012)

(Figure)

In the same tree your one is the one in the middle coloured for F/R

fredag 26 maj 2023

GITHUB uutiset : EG.5.1 saanut alalinjan.

 https://github.com/cov-lineages/pango-designation/issues/2020

EG.5.1 with orf1b:D54N in China, USA, Canada (97 seq) #2020
12 h ago 
"EG" Alias XBB.1.9.2 
 
 


 

Metallomics tietoa sars-cov-2 viruksen sinkkiproteomista

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314716/

Etsin tietoa intravirionaalisesta sinkin sijoituksesta  Ennen kun virion on aloittanut  infektiota ihmiseen.  miten sinkki sijoitautuu intravirionaalisesti  Rdp partikkelin ja nukleokapsidin  ja virionin sisäpinnan suheen tässä C-terminaali-trimeerissä, joka on IDP luonteinen. .  mutta omaa  runsasti cystein aminohappoa, joka voi sitoa sinkkejä. fysiologisissa oloissa.  Viimeiset Sars-cov-2 versiot eivät kirjoita ORF 7 tai ORF8:aa proteiineiksi ja näsitä ,mainitaan  tässä sitaatissa. sinkkiä sitovina.

https://www.frontiersin.org/articles/10.3389/fmolb.2020.00222/full

BRIEF RESEARCH REPORT article

Front. Mol. Biosci., 17 September 2020
Sec. Biophysics
Volume 7 - 2020 | https://doi.org/10.3389/fmolb.2020.00222

SARS-CoV-2 Virion Stabilization by Zn Binding

Zinc plays a crucial role in the process of virion maturation inside the host cell. The accessory Cys-rich proteins expressed in SARS-CoV-2 by genes ORF7a and ORF8 are likely involved in zinc binding and in interactions with cellular antigens activated by extensive disulfide bonds. In this report we provide a proof of concept for the feasibility of a structural study of orf7a and orf8 proteins. A conceivable hypothesis is that lack of cellular zinc, or substitution thereof, might lead to a significant slowing down of viral maturation.

. Introduction

The SARS-CoV-2 open reading frames ORF7a and ORF8 code for virion non-structural, called accessory (Coffin et al., 1997), proteins of yet unknown function (orf7a and orf8, respectively, hereafter). The protein orf7a is common to all SARS-CoV type coronaviruses and highly conserved (Wu A. et al., 2020), while orf8 is remarkably different from proteins coded by genes ORF8 and ORF8b of human SARS-CoV (Xu et al., 2020).

The orf7a protein of SARS-CoV-1 has been shown to interact with several host proteins (Vasilenko et al., 2010). An analogous situation occurs in the case of the very similar SARS-CoV-2 orf7a protein (Gordon et al., 2020). The most supported hypothesis proposed for orf7a protein function is the interference with virion budding tethering (Bonifacino and Glick, 2004) operated by cellular antigens (Taylor et al., 2015). Indeed, orf7a is expressed in the host cell to inhibit the intracellular (at endoplasmic membrane) process of virion immobilization before and after virion vesiculation. On the basis of structural similarities (Swiecki et al., 2013) we argue that also protein orf8 can be involved in the same inhibition process, strengthening the inhibition of virion immobilization. This conjecture is in agreement with Gordon et al. (2020) where it is suggested that orf8 plays a role in vesicle trafficking and in endoplasmic reticulum protein quality control, thus favoring the reconfiguration of ER/Golgi trafficking during coronavirus infection.

Virion tethering is mainly due to proteins of the tetherin family, also known as bone marrow stromal antigen 2 (BST2) or cluster of differentiation 317 (CD317). BST2 is expressed in many cells in the interferon-dependent antiviral response pathway. The mechanism of tethering involves tetherin protein dimerization via formation of extended disulfide bonds within the coiled coil region (Le Tortorec et al., 2011). This step is known to be strongly influenced by divalent cations involved in Cys binding. Among these ions, the most available in cells is Zn2+.

A timely computational search for therapeutic targets of SARS-CoV-2 found the orf7a-BST2 complex as a potential target to be addressed with structural studies (Wu C. et al., 2020).

The orf7a and orf8 protein sequences (both 121 amino acids long) hint at a high Zn binding propensity, as they display 6 Cys/3 His and 7 Cys/4 His side-chains, respectively, with motifs that are able to bind Zn, thus forming multiple zinc finger (ZF) domains. 

 The relevance of Zn in the viral replication process has been widely investigated (Chaturvedi and Shrivastava, 2005; Chasapis, 2018) and, indeed, two ZF domains have been discovered in the nucleocapsid protein of HIV-1 (Ncp7) (Morellet et al., 1998; Guo et al., 2000). Two such similar Zn domains have been also identified (Kirchdoerfer and Ward, 2019) along the highly conserved, within the SARS-CoV family (Xu et al., 2020), nsp12 polymerase.

 

 

 

Ajatuksia tänään. minkäläinen konformaatio on Sars-Cov-2 spikproteiinilla intrvirionaalisessa tilasa sen klmessa C-terminaalipeptidissä?

 Asia on aiemmin ajateltu:Viime vuoden tammikuulta on artikkeli netissä. Siinä on isoloidusti tutkittu yhden C-terminaalisen monomeerin ominaisuudet- jolloin  se osoitautuu IDP-tyyppiseksi mitä  suurimamssa määrin eli fysiologisissa oloissa  saattaa  muodostaa  minkä tahansa struktuurin interaktioproteiininsa kanssa.  siis  siinä piilee  monia resursseja toimia  viruksen elinsyklin eduksi. Otan aika laajasti sitaattia.

https://www.sciencedirect.com/science/article/pii/S0042682221002300

Microsecond simulations and CD spectroscopy reveals the intrinsically disordered nature of SARS-CoV-2 spike-C-terminal cytoplasmic tail (residues 1242–1273) in isolation

All available SARS-CoV-2 spike protein crystal and cryo-EM structures have shown missing electron densities for cytosolic C-terminal regions (CTR). Generally, the missing electron densities point towards the intrinsically disordered nature of the protein region (IDPR). This curiosity has led us to investigate the cytosolic CTR of the spike glycoprotein of SARS-CoV-2 in isolation. The spike CTR is supposed to be from 1235 to 1273 residues or 1242–1273 residues based on our used prediction. Therefore, we have demonstrated the structural conformation of cytosolic region and its dynamics through computer simulations up to microsecond timescale using OPLS and CHARMM forcefields. The simulations have revealed the unstructured conformation of cytosolic region. Further, we have validated our computational observations with circular dichroism (CD) spectroscopy-based experiments and found its signature spectra at 198 nm. We believe that our findings will surely help in understanding the structure-function relationship of the spike protein's cytosolic region.

  1. Download : Download high-res image (351KB)
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, ,
CD Circular Dichroism
cryo-EM  Cryo-electron microscopy
CTR    C-terminal Region
DTT    Dithiothreitol
IDPR   Intrinsically disordered protein region
MD     Molecular Dynamics
PEG   Polyethylene glycol
REMD Replica-Exchange Molecular Dynamics
SDS     Sodium Dodecyl Sulfate
TFE   2,2,2-Trifluoroethanol
 Keywords
Spike
Cytosolic domain
Conformational dynamics
Secondary structure
SARS-CoV-2
 1. Introduction

The importance of coronavirus spike protein is apparent from it surface-exposed location, suggesting it is a prime target after viral infection for cell-mediated and humoral immune responses as well as artificially designed vaccines and antiviral therapeutics. The SARS-CoV-2 homo-trimeric spike glycoprotein consists of an extracellular unit anchored by a transmembrane (TM) domain in viral membrane and a cytoplasmic domain (Walls et al., 2020). It is secreted as monomeric 1273 amino acid long protein from endoplasmic reticulum (ER) shortly after which it trimerizes to facilitate the transport to the Golgi complex (Duan et al., 2020; Walls et al., 2020). Moreover, N-linked high mannose oligosaccharide side chains that are added to spike monomer in ER are further modified in Golgi compartments (Duan et al., 2020).

Spike is one of the most extensively studied protein among all of SARS-CoV-2 proteome. So far, based on Uniprot database, approximately two hundred structures have been reported using X-ray crystallography and cryo-electron microscopy techniques. However, these structures consist of S1 subunit of spike but lacks the transmembrane and cytoplasmic C-terminal regions present in S2 subunit or with missing electron densities in cytoplasmic region.

 The distal S1 subunit (residues 14–685) contains a N-terminal domain, a C-terminal domain, and two subdomains (Fig. 1). The C-terminal domain of S1 is the receptor-binding domain or RBD, has a receptor-binding motif (RBM) which interacts with human angiotensin converting enzyme 2 (ACE2), chief target receptor of SARS-CoV-2 on human cells (Lan et al., 2020). RBM is present as an extended loop insertion which binds to bottom side of the small lobe of ACE2 receptor.

 The S2 subunit (residues 686–1273) has a hydrophobic fusion peptide, two heptad repeats, a transmembrane domain, and a cytoplasmic C-terminal tail (Fig. 1).

Fig. 1. Domain architecture of spike Glycoprotein: depiction of available structures in open and closed states, transmembrane domain, and cytoplasmic C-terminal tail. Based on prediction of transmembrane region in the spike protein by CCTOP, a consensus-based predictor, the boundaries of all domains have been defined. As per CCTOP prediction, the transmembrane region of spike lies within the residues 1216–1241, and so, the cytoplasmic region of spike has been used in this study with the residues 1242–1273.

As of yet, cytoplasmic domain of spike protein is the least explored region despite of such extensive research in pandemic times. It is of particular importance as it contains a conserved ER retrieval signal (KKXX) (Lontok et al., 2004). 

 In SARS-CoV and SARS-CoV-2 spike proteins, a novel dibasic KLHYT (KXHXX) motif present at extreme ends of the C-terminus plays a crucial role in its subcellular localization (Giri et al., 2020; McBride et al., 2007; Sadasivan et al., 2017).

 Also, deletions in cytoplasmic domain of coronavirus spike are implicated in viral infection in recent reports (Bosch et al., 2005; Dieterle et al., 2020; Ou et al., 2020; Ujike et al., 2016). SARS-CoV and SARS-CoV-2 spike having a deletion of last ∼20 residues displayed increased infectivity of single-cycle vesicular stomatitis virus (VSV)–S pseudotypes (Dieterle et al., 2020; Ou et al., 2020).

 Contrarily, short truncations of cytoplasmic domain of Mouse Hepatitis Virus (MHV) spike protein (△12 and △25) had limited effect on viral infectivity while the long truncation of 35 residues interfered with both viral-host cell membrane fusion and assembly.

 Importantly, it is also shown to interact with the membrane protein inside host cells (Bosch et al., 2005). In our previous report, the cytoplasmic tail is predicted to be a MoRF (Molecular Recognition Feature) region (residues 1265–1273) by a predictor MoRFchibi (Giri et al., 2020). The MoRF regions in proteins are disorder-based binding regions that contribute the binding to DNA, RNA, and other proteins. In the same report, it is also found to contain many DNA and RNA binding residues (Giri et al., 2020).

Despite of availability of several structures of spike protein using advanced techniques like cryo-EM, the structure of cytoplasmic domain is not yet clear due to its ‘missing electron density’. Generally, intrinsically disordered proteins show such characteristic of missing electron density and lacks a well-defined three-dimensional structure (Uversky, 2020).

Additionally, the consensus-based disorder prediction by MobiDB has shown this region to be disordered (Piovesan et al., 2021). Considering these arguments, we aimed to understand the cytoplasmic domain of the SARS-CoV-2 spike protein to gain further insights. To this end, we computationally analyzed its behavioural dynamics using molecular dynamic (MD) simulations up to 1 microsecond (μs) and validated it with CD spectroscopy based experiments. This report's outcomes will help to understand this domain's structure and function and provide knowledge to explore the interaction of spike protein with other viral and host proteins.

2. Material and methods

 Fig. 2. Transmembrane region prediction from five web servers: A. CCTOP, B. PSIPRED, C. SPLIT, D. TMHMM, and E. TMPred. F. Table showing predicted transmembrane residues. All predictors work as standalone except CCTOP which works based on consensus from multiple predictors. Considering this, the cytoplasmic region of spike is chosen from residues 1242–1273 as CCTOP has predicted residues 1216–1241 in transmembrane region.

3.1.1. Disorder prediction

In our recent study, we have identified the disordered and disorder-based binding regions in SARS-CoV-2 where the cytoplasmic domain at C-terminal of spike protein is found to be disordered (Giri et al., 2020). Again, we analyzed the disorderedness in selected cytoplasmic region using multiple predictors, including PONDR family, IUPred2A (redox state), and PrDOS predictors. Out of six predictors, three predictors from PONDR family have predicted it as highly disordered, PrDOS has predicted it as moderately disordered, and PONDR FIT has predicted it as least disordered. Additionally, IUPred2A has been used with its redox-state calculation function due to high number of cysteine residues present in the peptide (Fig. 3). As per calculations, the redox minus (where all cysteines are replaced by serine) state has shown high disorder propensity while redox plus has shown least propensity.

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 Fig. 4. Structure models of spike full-length and C-terminal cytoplasmic domain (1242–1273 residues): A. Full-length spike protein model using AlphaFold2, B. Modelled structure through PEP-FOLD web server, visualized in Maestro, and C. Secondary structure analysis using PSIPRED web server.

3.1.3. Simulation with OPLS 2005

In the last three decades, many advancements have been made in forcefields and hardware related to MD simulation to match the experimental events. Long MD simulations up to microseconds or milliseconds are incredibly insightful to study structural conformations occurring at the nanoscale level. We have recently explored various regions of different SARS-CoV-2 proteins through computational simulations and experimental techniques that are very well correlated (Gadhave et al., 2020a, 2020b, 2020a). This study performed 1 μs MD simulations of C-terminal cytoplasmic domain of spike protein (1242–1273 residues) to understand its dynamic nature. As obtained from structure modelling through PEP-FOLD, the model contains one small helix at C-terminal with residues 1265LKGV1268 (Fig. 4B). According to 2struc webserver (Klose et al., 2010), the total helix propensity contribute approximately 12.5% of total secondary structure while rest of the region is constituted by turns and extended coils. The secondary structure prediction of spike C-terminal tail region contains a β-strand of five residues 1262EPVLK1266, as predicted by PSIPRED webserver (Buchan and Jones, 2019) (Fig. 4C).

After analyzing the disorder propensity and secondary structure composition, we performed a rigorous simulation of cytoplasmic region (residues 1242–1273) to understand its atomic movement and structural integrity. A total of 1 μs simulation was done after 50,000 steps of steepest descent method-based energy minimization. It has been observed that the structure of spike C-terminal cytoplasmic region remains to be unstructured throughout the simulation. Based on mean distance analysis, the peptide simulation setup showed massive deviations up to 7.5 Å which does not attain any stable state (Fig. 5A). As shown in Fig. 5B, mean fluctuation in residues is observed to be within the range of 1.6–6.4 Å. The intramolecular hydrogen bond analysis demonstrates the highly fluctuating trend portraying no stable helical or beta sheet conformation adoption by the residues (Fig. 5E). The secondary structure timeline (Fig. 5C & D) also reveals the disordered state of spike C-terminal cytoplasmic region during the 1 μs simulation time (none of the frames captured α-helix or β-sheets) which is further depicted in the snapshot of 1 μs frame in Fig. 5F and the trajectory movie up to 1 μs (supplementary movie 1).

 We have also modelled the cytosolic part of Spike protein from 1235 to 1273 residues as defined in Uniprot database and two predictors (TMPred: 1216–1235, and TMHMM: 1214–1236) used in this study. In modelled structure, the helical propensity in cytosolic region was shown by 1237–1245 residues. Using above described OPLS 2005 forcefield parameters, the all-atoms explicit solvent MD simulation was carried out for 1 μs. The trajectory analysis has been shown in Supplementary Fig. 1, the cytosolic region has revealed majorly unstructured region along with a small β-strand of two residues 1258FD1259 after 1 μs. The upward trend of RMSD values illustrates the highly deviating atomic positions and fluctuating RMSF shows the change in structural property of residues (Supplementary Figs. 1A and 1B). Also, the decreasing number of hydrogen bonds demonstrates the breaking of helices in the structure (Supplementary Fig. 1C). The time-dependent secondary structure element analysis illustrates that a total of 15% secondary structure was formed that includes mainly alpha helix and small percentage of beta strands (Supplementary Figs. 1D and 1E; red: alpha helix and blue: beta strands). After huge structural transitions, the structural composition of last frame of simulation is shown with a small beta strand of two residues and other regions to be disordered (Supplementary Fig. 1F). The snapshots at every 100 ns till 1 μs show the structural transitions in Spike cytoplasmic region (Supplementary Fig. 2).

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Fig. 6. Depiction of representative from top 10 clusters from 1 μs simulation trajectory. Size of each cluster is shown which represent the total number of frames in the trajectory based on RMSD calculated with reference structure (frame 1). The protein backbone of all frames is shown as superimposition. The N- to C-terminal protein structures are colored from red to blue, respectively.

-----. However, we also tried to get the synthesized peptide of residues 1235–1273 of spike but due to multiple cysteine residues it was not feasible.

Further, it was of utmost importance to validate MD simulation outcomes using experimental techniques. The water-soluble peptide of spike residues 1242–1273 at 25 μM concentration exhibits a prominent negative peak at approximately 198 nm in far-UV CD spectra which defines the unstructured nature of a protein. Infact, we have also checked the secondary structure state in presence of a reducing agent, DTT, then also, the peptide is observed to be disordered with significant negative ellipticity. Further, in presence of helix inducer solvent, TFE, the peptide adopts helical structure. However, SDS micelles in surroundings of peptide generates little changes in the peptide structure which may signify its inability to gain structure. Also, in presence of sucrose, the CD spectra of peptide corresponds to the disordered conformation. Under the influence of crowding agents like Dextran-70 and PEG (8000), conservation of disordered structure indicates that no -intra chain forces are acting in between the residues. Based on this combination of facts, we have interpreted that spike C-terminal cytosolic tail (residues 1242–1273) as an intrinsically disordered region. Generally, an IDPR gains any structure upon interacting with its interacting partner or in physiological conditions (Wright and Dyson, 1999). In its unstructured state, it may function as a MoRF to bind with COP1 coated transporting vesicles which localizes the Spike protein into ER. As described earlier, the interaction of C-terminal domain of Spike protein is reported with other structural proteins like M which is highly likely to occur in its disordered form with extended radius.

5. Conclusion

The cytoplasmic region of spike glycoprotein of SARS-CoV-2 has not been studied yet. Given its extreme importance in functioning of spike protein, the structure and its dynamics has been investigated here. The advancement in computational powers and excessive improvements in forcefields have empowered structural biology. Newly developed algorithms and their user-friendly approach allow correlating the outcomes with experimental observations. In this article, we have identified the transmembrane region in spike protein by employing distinguished web predictors. This cleared the composition of amino acids forming cytoplasmic domain. Further, the secondary structure and disorder predisposition analysis demonstrated it to be highly disordered. We have demonstrated the structural conformation of cytoplasmic domain (1242–1273 residues) of spike protein at a microsecond timescale using computational simulations. As revealed, this domain is purely unstructured or disordered after 1 μs and have not gained any structural conformation throughout the simulation period. Experimental outcomes also confirm the intrinsic disordered state of cytoplasmic domain of spike. The intrinsic disordered nature of peptide is shown in presence of macromolecular crowders. Based on our previous study (Giri et al., 2020), cytoplasmic tail of spike glycoprotein has molecular recognition features therein which needs to be explored further. The disordered nature of cytosolic region may possibly have implications to interact with other viral proteins during virion assembly as well as host proteins and transporting vesicles during localization in ERs. In this study, the multiple conformations during the simulation process adds up to even more interesting speculations.

 

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