Influenza A virus hemagglutinin mutations associated with use of neuraminidase inhibitors correlate with decreased inhib
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RESEARCH
Open Access
Influenza A virus hemagglutinin mutations associated with use of neuraminidase inhibitors correlate with decreased inhibition by anti-influenza antibodies Natalia A. Ilyushina1* , Takashi E. Komatsu2, William L. Ince2, Eric F. Donaldson2, Nicolette Lee1, Julian J. O’Rear2 and Raymond P. Donnelly1
Abstract Background: Vaccination and the use of neuraminidase inhibitors (NAIs) are currently the front lines of defense against seasonal influenza. The activity of influenza vaccines and antivirals drugs such as the NAIs can be affected by mutations in the influenza hemagglutinin (HA) protein. Numerous HA substitutions have been identified in nonclinical NAI resistance-selection experiments as well as in clinical specimens from NAI treatment or surveillance studies. These mutations are listed in the prescribing information (package inserts) for FDA-approved NAIs, including oseltamivir, zanamivir, and peramivir. Methods: NAI treatment-emergent H1 HA mutations were mapped onto the H1N1 HA1 trimeric crystal structure and most of them localized to the HA antigenic sites predicted to be important for anti-influenza immunity. Recombinant A/California/04/09 (H1N1)-like viruses carrying HA V152I, G155E, S162 N, S183P, and D222G mutations were generated. We then evaluated the impact of these mutations on the immune reactivity and replication potential of the recombinant viruses in a human respiratory epithelial cell line, Calu− 3. Results: We found that the G155E and D222G mutations significantly increased viral titers ~ 13-fold compared to the wild-type virus. The hemagglutination and microneutralization activity of goat and ferret antisera, monoclonal antibodies, and human serum samples raised against pandemic A(H1N1)pdm09 viruses was ~ 100-fold lower against mutants carrying G155E or D222G compared to the wild-type virus. Conclusions: Although the mechanism by which HA mutations emerge during NAI treatment is uncertain, some NAI treatment-emergent HA mutations correlate with decreased immunity to influenza virus. Keywords: Hemagglutinin (HA), Neuraminidase (NA), Neuraminidase inhibitors (NAI), Influenza A virus, Antiviral resistance
Background Influenza virus continues to have a major impact on global health and is responsible for millions of cases of respiratory illness and hundreds of thousands of hospitalizations annually in the United States alone [1]. The envelope glycoproteins, hemagglutinin (HA) and * Correspondence: [email protected] 1 Division of Biotechnology Review and Research II, Food and Drug Administration CDER, WO Bldg. 52/72, Room 2105, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA Full list of author information is available at the end of the article
neuraminidase (NA), mediate host cell attachment and release, respectively, and are the primary targets of the protective antibody-mediated immune response. HA has functionally defined immunodominant antigenic sites that primarily map to the globular domain of the glycoprotein and surround the receptor binding site
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