EG.5.1

  • 文章类型: Journal Article
    最近更新的COVID-19mRNA疫苗编码omicron亚变体XBB.1.5的刺突蛋白,建议用于炎症性肠病(IBD)患者进行免疫抑制治疗。尽管如此,它们在IBD患者中针对快速扩增的病毒变体的免疫原性仍然未知.这项前瞻性多中心队列研究是首次研究XBB.1.5适应疫苗在IBD患者中的免疫原性。在用单价XBB.1.5-适应的mRNA疫苗接种之前和之后2至4周定量靶向omicron亚变体XBB.1.5、EG.5.1和BA.2.86的受体结合结构域(RBD)的系统性和粘膜抗体以及它们的中和。疫苗接种增加了血清抗RBDIgG靶向XBB.1.5,EG.5.1和BA.2.86的水平(1.9倍,1.8折,和2.6倍,分别)和增强相应的中和反应(2.3倍,3.1折,和3.5倍,分别)。接种疫苗后,与接受其他细胞靶标治疗的患者相比,接受抗TNF治疗的患者的病毒中和作用降低.11.1%和16.7%的患者缺乏EG.5.1和BA.2.86中和,分别;所有这些患者都接受了抗TNF治疗。在粘膜部位,疫苗接种诱导变体特异性抗RBDIgG,但未能诱导靶向RBD的IgA。我们的研究结果为未来的疫苗建议提供了基础,同时强调了频繁加强疫苗适应的重要性以及IBD患者对粘膜疫苗接种策略的需求。
    Recently updated COVID-19 mRNA vaccines encode the spike protein of the omicron subvariant XBB.1.5 and are recommended for patients with inflammatory bowel disease (IBD) on immunosuppressive treatment. Nonetheless, their immunogenicity in patients with IBD against rapidly expanding virus variants remains unknown. This prospective multicenter cohort study is the first study to investigate the immunogenicity of XBB.1.5-adapted vaccines in patients with IBD. Systemic and mucosal antibodies targeting the receptor-binding domains (RBDs) of the omicron subvariants XBB.1.5, EG.5.1, and BA.2.86, as well as their neutralization were quantified before and two to four weeks after vaccination with monovalent XBB.1.5-adapted mRNA vaccines. Vaccination increased levels of serum anti-RBD IgG targeting XBB.1.5, EG.5.1, and BA.2.86 (1.9-fold, 1.8-fold, and 2.6-fold, respectively) and enhanced corresponding neutralization responses (2.3-fold, 3.1-fold, and 3.5-fold, respectively). Following vaccination, anti-TNF-treated patients had reduced virus neutralization compared to patients on treatments with other cellular targets. 11.1% and 16.7% of patients lacked EG.5.1 and BA.2.86 neutralization, respectively; all these patients received anti-TNF treatment. At mucosal sites, vaccination induced variant-specific anti-RBD IgG but failed to induce RBD-targeting IgA. Our findings provide a basis for future vaccine recommendations while highlighting the importance of frequent booster vaccine adaptation and the need for mucosal vaccination strategies in patients with IBD.
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  • 文章类型: Journal Article
    最近出现的BA.2.86,JN.1,EG.5,EG.5和HV.1变体具有增长优势。在这项研究中,我们探索了OmicronBA.2.86,JN.1,EG.5,EG.5和HV.1亚变体的受体结合和免疫逃避的结构基础。我们的发现表明,BA.2.86表现出强的受体结合,而其JN.1亚谱系显示与人ACE2(hACE2)的结合亲和力降低。通过复杂的结构分析,我们观察到BA.2.86受体结合域(RBD)中R493Q的逆转在受体结合中起促进作用,而JN.1RBD中的L455S取代恢复了最佳亲和力。此外,与BA.2.86RBD复合的单克隆抗体(mAb)S309的结构突出了K356T突变的重要性,这带来了一个新的N-糖基化基序,改变由S309表示的属于RBD-5的mAb的结合模式。这些发现强调了密切监测BA.2.86及其亚谱系以防止另一波SARS-CoV-2感染的重要性。
    The recently emerged BA.2.86, JN.1, EG.5, EG.5.1, and HV.1 variants have a growth advantage. In this study, we explore the structural bases of receptor binding and immune evasion for the Omicron BA.2.86, JN.1, EG.5, EG.5.1, and HV.1 sub-variants. Our findings reveal that BA.2.86 exhibits strong receptor binding, whereas its JN.1 sub-lineage displays a decreased binding affinity to human ACE2 (hACE2). Through complex structure analyses, we observed that the reversion of R493Q in BA.2.86 receptor binding domain (RBD) plays a facilitating role in receptor binding, while the L455S substitution in JN.1 RBD restores optimal affinity. Furthermore, the structure of monoclonal antibody (mAb) S309 complexed with BA.2.86 RBD highlights the importance of the K356T mutation, which brings a new N-glycosylation motif, altering the binding pattern of mAbs belonging to RBD-5 represented by S309. These findings emphasize the importance of closely monitoring BA.2.86 and its sub-lineages to prevent another wave of SARS-CoV-2 infections.
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  • 文章类型: Journal Article
    在2023年中后期,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)OmicronXBB的亚谱系,EG.1.1(XBB.1.9.2的后代),正在世界各地迅速传播。我们进行了多尺度调查,包括系统发育分析,流行病动力学建模,使用假病毒的感染实验,临床分离株,细胞培养和实验动物中的重组病毒,以及使用人类血清和抗病毒化合物,揭示新出现的EG.5.1变体的病毒学特征。我们的系统发育分析和流行动力学模型表明,EG.5.1,S:F456L和ORF9b:I5T的两个标志替换对于其增加的病毒适应性至关重要。生长动力学的实验研究,对临床可用的抗病毒药物的敏感性,致融合性,EG.5.1的致病性表明EG.5.1的病毒学特征与XBB.1.5相当。然而,低温电子显微镜显示EG.5.1和XBB.1.5的刺突蛋白之间的结构差异。我们进一步评估了ORF9b:I5T对病毒特征的影响,但在我们的实验设置中几乎可以忽略不计。我们的多尺度调查为理解新出现的致病病毒的进化特征提供了知识。包括EG.5.1,在人口中。
    In middle to late 2023, a sublineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB, EG.5.1 (a progeny of XBB.1.9.2), is spreading rapidly around the world. We performed multiscale investigations, including phylogenetic analysis, epidemic dynamics modeling, infection experiments using pseudoviruses, clinical isolates, and recombinant viruses in cell cultures and experimental animals, and the use of human sera and antiviral compounds, to reveal the virological features of the newly emerging EG.5.1 variant. Our phylogenetic analysis and epidemic dynamics modeling suggested that two hallmark substitutions of EG.5.1, S:F456L and ORF9b:I5T are critical to its increased viral fitness. Experimental investigations on the growth kinetics, sensitivity to clinically available antivirals, fusogenicity, and pathogenicity of EG.5.1 suggested that the virological features of EG.5.1 are comparable to those of XBB.1.5. However, cryo-electron microscopy revealed structural differences between the spike proteins of EG.5.1 and XBB.1.5. We further assessed the impact of ORF9b:I5T on viral features, but it was almost negligible in our experimental setup. Our multiscale investigations provide knowledge for understanding the evolutionary traits of newly emerging pathogenic viruses, including EG.5.1, in the human population.
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  • 文章类型: Journal Article
    目的:新的SARS-CoV-2变体的出现导致了Omicron靶向二价mRNA疫苗的开发。了解二价疫苗如何改善针对新变体的抗体反应至关重要。
    方法:总共107名参与者,谁有三个COVID-19WTmRNA疫苗剂量,被招募,并且给予单价(WT)或二价mRNA疫苗接种(Pfizer/BioNTech二价(WT和BA4/BA.5)或Moderna二价(WT和BA.1))。在加强之前和加强后28天采集血样。
    结果:我们发现,在二价加强组中,血清结合IgA对BA.1,BA.5和EG.5.1峰值的反应倍数变化显着降低,与单价(WT)加强组相比,接种疫苗后。然而,这仅在有既往感染的个体中观察到.在先前感染的二价加强疫苗接种者中,血清结合IgA反应的相对倍数变化更偏向WT变异体(BA.1,BA.5或EG.5.1)峰值,与以前感染的单价(WT)加强疫苗相比。
    结论:研究结果表明,抗体反应的印记是由第一次接种(WT尖峰)形成的。以前的感染也会影响后续疫苗接种的促进作用。需要进行研究,以了解如何诱导强大而持久的IgA免疫,以防止COVID-19感染。
    OBJECTIVE: The emergence of new SARS-CoV-2 variants has led to the development of Omicron-targeting bivalent mRNA vaccines. It is crucial to understand how bivalent vaccines may improve antibody responses against new variants.
    METHODS: A total of 107 participants, who had three COVID-19 WT mRNA vaccine doses, were recruited, and given either a monovalent (WT) or a bivalent mRNA vaccination (Pfizer/BioNTech Bivalent (WT and BA.4/BA.5) or Moderna Bivalent (WT and BA.1). Blood samples were taken before booster and at 28 days post-booster.
    RESULTS: We found significantly lower fold change in serum binding IgA responses against BA.1, BA.5 and EG.5.1 spike in the bivalent booster group, compared with the monovalent (WT) booster group, following vaccination. However, this was only observed in individuals with prior infection. The relative fold change in serum binding IgA response was more skewed towards WT over variant (BA.1, BA.5 or EG.5.1) spike in previously infected bivalent-booster-vaccinees, as compared with previously infected monovalent-(WT)-booster-vaccinees.
    CONCLUSIONS: The findings suggest imprinting of antibody responses that is shaped by the first vaccination (WT spike). Previous infection also affects the boosting effect of follow-up vaccination. Studies are needed to understand how to induce a robust and long-lasting IgA immunity for protection against COVID-19 infection.
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  • 文章类型: Journal Article
    SARS-CoV-2变体的持续出现对感染和疫苗接种诱导的免疫提出了挑战。我们对来自具有针对BA.5,XBB.1.5,EG.5.1和BA.2.86的六种不同疫苗接种和感染组合的个体的血清的抗体结合和中和进行了6个月的纵向评估。我们发现大多数个体在感染或接种疫苗2个月后产生针对BA.5、XBB.1.5、EG.5.1和BA.2.86的刺突结合IgG或中和抗体。然而,与祖先菌株和BA.5变体相比,XBB.1.5、EG.5.1和BA.2.86表现出相当但显著的免疫逃避。在没有额外抗原暴露的个体中,刺突结合IgG和中和抗体滴度降低,在6个月的随访期间,<50%的个体中和XBB.1.5、EG.5.1和BA.2.86。107名随访者中约有57%经历了额外的感染,导致针对这些变体的改善的结合IgG和中和抗体水平。这些发现提供了对SARS-CoV-2变体在重复暴露后对免疫的影响的见解。
    The ongoing emergence of SARS-CoV-2 variants poses challenges to the immunity induced by infections and vaccination. We conduct a 6-month longitudinal evaluation of antibody binding and neutralization of sera from individuals with six different combinations of vaccination and infection against BA.5, XBB.1.5, EG.5.1, and BA.2.86. We find that most individuals produce spike-binding IgG or neutralizing antibodies against BA.5, XBB.1.5, EG.5.1, and BA.2.86 2 months after infection or vaccination. However, compared to ancestral strain and BA.5 variant, XBB.1.5, EG.5.1, and BA.2.86 exhibit comparable but significant immune evasion. The spike-binding IgG and neutralizing antibody titers decrease in individuals without additional antigen exposure, and <50% of individuals neutralize XBB.1.5, EG.5.1, and BA.2.86 during the 6-month follow-up. Approximately 57% of the 107 followed up individuals experienced an additional infection, leading to improved binding IgG and neutralizing antibody levels against these variants. These findings provide insights into the impact of SARS-CoV-2 variants on immunity following repeated exposure.
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  • 文章类型: Journal Article
    随着SARS-CoV-2继续传播和变异,跟踪病毒的进化轨迹和了解其突变的功能后果仍然至关重要。这里,我们表征了抗体逃避,ACE2受体接合,高度突变的SARS-CoV-2Omicron亚变体BA.2.87.1的病毒感染性。与其他Omicron亚变体相比,包括EG.5.1和当前主要的JN.1,BA.2.87.1表现出较少的免疫逃避,减少病毒受体参与,在Calu-3肺细胞中具有相当的感染性。有趣的是,刺突蛋白的N末端结构域(NTD)中的两个大缺失(Δ15-26和Δ136-146)促进了抗体逃避的微妙增加,但显着降低了病毒的感染性。总的来说,我们的数据支持美国疾病预防控制中心的声明,即BA.2.87.1造成的公共卫生风险似乎很低。
    As SARS-CoV-2 continues to spread and mutate, tracking the viral evolutionary trajectory and understanding the functional consequences of its mutations remain crucial. Here, we characterized the antibody evasion, ACE2 receptor engagement, and viral infectivity of the highly mutated SARS-CoV-2 Omicron subvariant BA.2.87.1. Compared with other Omicron subvariants, including EG.5.1 and the current predominant JN.1, BA.2.87.1 exhibits less immune evasion, reduced viral receptor engagement, and comparable infectivity in Calu-3 lung cells. Intriguingly, two large deletions (Δ15-26 and Δ136-146) in the N-terminal domain (NTD) of the spike protein facilitate subtly increased antibody evasion but significantly diminish viral infectivity. Collectively, our data support the announcement by the USA CDC that the public health risk posed by BA.2.87.1 appears to be low.
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  • 文章类型: Journal Article
    背景:与BA.2或XBB.1.5相比,最近流行的Omicron变体BA.2.86和JN.1在刺突蛋白上有30多个氨基酸变化。本研究旨在全面评估BA.2.86、JN.1、EG.5和EG.5.1的免疫逃逸潜力。
    方法:我们收集了人和鼠血清以评估血清学中和活性。参与者接受了三剂2019冠状病毒病(COVID-19)疫苗或加强剂量的ZF2022-A疫苗(Delta-BA.5受体结合域[RBD]-异二聚体免疫原)或经历了突破性感染(BTI)。ZF2202-A疫苗正在进行临床试验研究(ClinicalTrials.gov:NCT05850507)。BALB/c小鼠接种一组严重急性呼吸综合征冠状病毒2RBD-二聚体蛋白。用靶向8个RBD表位的41种代表性人单克隆抗体分析这些变体的抗体逃避性质。
    结果:我们发现,在人类中,BA.2.86比EG.5和EG.5.1具有更少的中和逃避。ZF2202-A加强剂诱导的中和滴度显著高于BTI。此外,BA.2.86和JN.1在RBD-4和RBD-5表位上表现出比EG.5和EG.5.1更强的抗体逃避。与BA.2.86相比,JN.1进一步丧失了与几种RBD-1单克隆抗体结合的能力,并显示出进一步的免疫逃逸。
    结论:我们的数据显示,目前占主导地位的亚变体,与BA.2.86和EG.5.1相比,JN.1显示出增强的免疫逃避,这是高度关注的。这项研究为感兴趣的亚变体提供了及时的风险评估,并为更新COVID-19疫苗提供了基础。
    背景:这项工作由中国国家重点研发计划资助,国家自然科学基金,北京生命科学研究院,比尔和梅林达·盖茨基金会,和中国博士后科学基金会(CPSF)博士后奖学金计划。
    BACKGROUND: The recently circulating Omicron variants BA.2.86 and JN.1 were identified with more than 30 amino acid changes on the spike protein compared to BA.2 or XBB.1.5. This study aimed to comprehensively assess the immune escape potential of BA.2.86, JN.1, EG.5, and EG.5.1.
    METHODS: We collected human and murine sera to evaluate serological neutralization activities. The participants received three doses of coronavirus disease 2019 (COVID-19) vaccines or a booster dose of the ZF2022-A vaccine (Delta-BA.5 receptor-binding domain [RBD]-heterodimer immunogen) or experienced a breakthrough infection (BTI). The ZF2202-A vaccine is under clinical trial study (ClinicalTrials.gov: NCT05850507). BALB/c mice were vaccinated with a panel of severe acute respiratory syndrome coronavirus 2 RBD-dimer proteins. The antibody evasion properties of these variants were analyzed with 41 representative human monoclonal antibodies targeting the eight RBD epitopes.
    RESULTS: We found that BA.2.86 had less neutralization evasion than EG.5 and EG.5.1 in humans. The ZF2202-A booster induced significantly higher neutralizing titers than BTI. Furthermore, BA.2.86 and JN.1 exhibited stronger antibody evasion than EG.5 and EG.5.1 on RBD-4 and RBD-5 epitopes. Compared to BA.2.86, JN.1 further lost the ability to bind to several RBD-1 monoclonal antibodies and displayed further immune escape.
    CONCLUSIONS: Our data showed that the currently dominating sub-variant, JN.1, showed increased immune evasion compared to BA.2.86 and EG.5.1, which is highly concerning. This study provides a timely risk assessment of the interested sub-variants and the basis for updating COVID-19 vaccines.
    BACKGROUND: This work was funded by the National Key R&D Program of China, the National Natural Science Foundation of China, the Beijing Life Science Academy, the Bill & Melinda Gates Foundation, and the Postdoctoral Fellowship Program of China Postdoctoral Science Foundation (CPSF).
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  • 文章类型: Journal Article
    最近出现的SARS-CoV-2Omicron亚谱系,包括BA.2衍生的XBB.1.5(Kraken),XBB.1.16(Arcturus),EG.5.1(Eris),积累了几个可能增加免疫逃逸的尖峰突变,影响疫苗的有效性。老年人是一个研究不足的群体,患严重COVID-19的风险显着增加。在这里,我们报告了来自59名老年人的177份血清样本的中和活性,62-97岁,在第4剂ChAdOx1-S(牛津/阿斯利康)接种后1和4个月,以及第5剂Comirnaty二价原始/OmicronBA.4/BA.5疫苗(Pfizer-BioNTech)接种后3个月。ChAdOx1-S疫苗接种诱导的抗体有效地中和了祖先D614G和BA4/5变体,但XBB.1.5、XBB.1.16和EG.5.1变体的程度要小得多。结果显示XBB.1.16和EG.5.1之间的中和滴度相似,并且与XBB.1.5相比更低。用二价mRNA疫苗加强的同一个体的血清含有较高的中和抗体滴度,为OmicronXBB.1.5、XBB.1.16和EG.1.1变体提供更好的交叉保护。在BA.1/BA.2和BA.4/BA.5的流行病学波中,先前的感染史,血清样品对XBBs和EG.5.1变体的中和活性增强不良。我们的数据强调了最近Omicron亚变体的持续免疫逃避,并支持BA4/5二价疫苗的加强给药,作为更新未来疫苗加强剂量以匹配新出现的SARS-CoV-2变种的持续策略。
    The recently emerged SARS-CoV-2 Omicron sublineages, including the BA.2-derived XBB.1.5 (Kraken), XBB.1.16 (Arcturus), and EG.5.1 (Eris), have accumulated several spike mutations that may increase immune escape, affecting vaccine effectiveness. Older adults are an understudied group at significantly increased risk of severe COVID-19. Here we report the neutralizing activities of 177 sera samples from 59 older adults, aged 62-97 years, 1 and 4 months after vaccination with a 4th dose of ChAdOx1-S (Oxford/AstraZeneca) and 3 months after a 5th dose of Comirnaty Bivalent Original/Omicron BA.4/BA.5 vaccine (Pfizer-BioNTech). The ChAdOx1-S vaccination-induced antibodies neutralized efficiently the ancestral D614G and BA.4/5 variants, but to a much lesser extent the XBB.1.5, XBB.1.16, and EG.5.1 variants. The results showed similar neutralization titers between XBB.1.16 and EG.5.1 and were lower compared to XBB.1.5. Sera from the same individuals boosted with the bivalent mRNA vaccine contained higher neutralizing antibody titers, providing a better cross-protection against Omicron XBB.1.5, XBB.1.16 and EG.5.1 variants. Previous history of infection during the epidemiological waves of BA.1/BA.2 and BA.4/BA.5, poorly enhanced neutralization activity of serum samples against XBBs and EG.5.1 variants. Our data highlight the continued immune evasion of recent Omicron subvariants and support the booster administration of BA.4/5 bivalent vaccine, as a continuous strategy of updating future vaccine booster doses to match newly emerged SARS-CoV-2 variants.
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  • 文章类型: Journal Article
    EG.5.1是严重急性呼吸综合征冠状病毒2(SARS-CoV-2)OmicronXBB变体的亚变体,在全球范围内流行迅速增加。然而,致病性,可传播性,EG.5.1分离株的免疫逃避特性在很大程度上是未知的。这里,我们表明,仓鼠的EG.5.1和XBB.1.5之间的生长能力和致病性没有明显差异。我们还证明,与XBB.1.5一样,EG.1.1在仓鼠之间的传输效率更高,BA.2.相比之下,与XBB.1.5不同,我们在六只暴露的仓鼠中的四只的肺部检测到EG.5.1,这表明EG.5.1的病毒特性与XBB.1.5不同。最后,我们发现,来自恢复期个体的血浆对EG.5.1的中和活性是轻微的,但重要的是,低于XBB.1.5或XBB.1.9.2。我们的数据表明,传播后的不同病毒特性和EG.5.1的抗原性改变可能会促使其在人类中的流行率超过XBB.1.5。
    EG.5.1 is a subvariant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB variant that is rapidly increasing in prevalence worldwide. However, the pathogenicity, transmissibility, and immune evasion properties of isolates of EG.5.1 are largely unknown. Here, we show that there are no obvious differences in growth ability and pathogenicity between EG.5.1 and XBB.1.5 in hamsters. We also demonstrate that, like XBB.1.5, EG.5.1 is transmitted more efficiently between hamsters compared to its predecessor, BA.2. In contrast, unlike XBB.1.5, we detect EG.5.1 in the lungs of four of six exposed hamsters, suggesting that the virus properties of EG.5.1 are different from those of XBB.1.5. Finally, we find that the neutralizing activity of plasma from convalescent individuals against EG.5.1 was slightly, but significantly, lower than that against XBB.1.5 or XBB.1.9.2. Our data suggest that the different virus properties after transmission and the altered antigenicity of EG.5.1 may be driving its increasing prevalence over XBB.1.5 in humans.
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  • 文章类型: Journal Article
    SARS-CoV-2的免疫逃避与单价mRNA疫苗的免疫印迹配对,导致针对Omicron亚变体的中和抗体应答减弱。在这项研究中,我们表征了在循环中上升的两个新的XBB变体-EG.5.1和XBB.2.3,因为它们具有中和和合胞体形成的能力。我们确定了接受二价mRNA疫苗加强剂的个体血清中的中和抗体,BA.4/5波感染,或XBB.1.5波感染。二价疫苗接种诱导的抗体有效中和祖先D614G,但程度要小得多,两个新的EG.5.1和XBB.2.3变体。事实上,EG.5.1增强的中和逃逸似乎是由其关键定义突变XBB.1.5-F456L驱动的。值得注意的是,BA4/5或XBB.1.5的感染很少,如果有的话,对EG.5.1,XBB.2.3和以前的XBB变体的中和-特别是在未接种疫苗的个体中,平均中和抗体滴度接近检测限。此外,我们调查了传染性,融合活动,并在HEK293T-ACE2和CaLu-3细胞中处理EG.5.1和XBB.2.3的变体尖峰,但与早期的XBB变体相比没有显着差异。总的来说,我们的发现强调了新的Omicron亚变体的持续免疫逃避,更重要的是,需要重新配制mRNA疫苗以包括XBB尖峰以获得更好的保护。
    Immune evasion by SARS-CoV-2 paired with immune imprinting from monovalent mRNA vaccines has resulted in attenuated neutralizing antibody responses against Omicron subvariants. In this study, we characterized two new XBB variants rising in circulation - EG.5.1 and XBB.2.3, for their neutralization and syncytia formation. We determined the neutralizing antibody titers in sera of individuals that received a bivalent mRNA vaccine booster, BA.4/5-wave infection, or XBB.1.5-wave infection. Bivalent vaccination-induced antibodies neutralized ancestral D614G efficiently, but to a much less extent, two new EG.5.1 and XBB.2.3 variants. In fact, the enhanced neutralization escape of EG.5.1 appeared to be driven by its key defining mutation XBB.1.5-F456L. Notably, infection by BA.4/5 or XBB.1.5 afforded little, if any, neutralization against EG.5.1, XBB.2.3 and previous XBB variants - especially in unvaccinated individuals, with average neutralizing antibody titers near the limit of detection. Additionally, we investigated the infectivity, fusion activity, and processing of variant spikes for EG.5.1 and XBB.2.3 in HEK293T-ACE2 and CaLu-3 cells but found no significant differences compared to earlier XBB variants. Overall, our findings highlight the continued immune evasion of new Omicron subvariants and, more importantly, the need to reformulate mRNA vaccines to include XBB spikes for better protection.
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