SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway.

Brian J Willett ORCID logo; Joe Grove ORCID logo; Oscar A MacLean; Craig Wilkie ORCID logo; Giuditta De Lorenzo ORCID logo; Wilhelm Furnon ORCID logo; Diego Cantoni; Sam Scott ORCID logo; Nicola Logan; Shirin Ashraf ORCID logo; +33 more... Maria Manali; Agnieszka Szemiel; Vanessa Cowton ORCID logo; Elen Vink ORCID logo; William T Harvey; Chris Davis; Patawee Asamaphan; Katherine Smollett; Lily Tong ORCID logo; Richard Orton; Joseph Hughes ORCID logo; Poppy Holland ORCID logo; Vanessa Silva; David J Pascall ORCID logo; Kathryn Puxty ORCID logo; Ana da Silva Filipe ORCID logo; Gonzalo Yebra ORCID logo; Sharif Shaaban; Matthew TG Holden; Rute Maria Pinto; Rory Gunson; Kate Templeton; Pablo R Murcia ORCID logo; Arvind H Patel ORCID logo; Paul Klenerman; Susanna Dunachie ORCID logo; PITCH Consortium; COVID-19 Genomics UK (COG-UK) Consortium; John Haughney; David L Robertson ORCID logo; Massimo Palmarini; Surajit Ray ORCID logo; Emma C Thomson ORCID logo; (2022) SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway. Nature Microbiology, 7 (8). pp. 1161-1179. ISSN 2058-5276 DOI: 10.1038/s41564-022-01143-7
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Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant.


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