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Review
. 2021 Oct;49(5):855-876.
doi: 10.1007/s15010-021-01677-8. Epub 2021 Aug 2.

SARS-CoV-2 spike protein: pathogenesis, vaccines, and potential therapies

Ahmed M Almehdi  1 , Ghalia Khoder  2   3 , Aminah S Alchakee  2 , Azizeh T Alsayyid  2 , Nadin H Sarg  2 , Sameh S M Soliman  4   5
Affiliations
Review

SARS-CoV-2 spike protein: pathogenesis, vaccines, and potential therapies

Ahmed M Almehdi et al. Infection. 2021 Oct.

Abstract

Purpose: COVID-19 pandemic has emerged as a result of infection by the deadly pathogenic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing enormous threats to humans. Coronaviruses are distinguished by a clove-like spike (S) protein, which plays a key role in viral pathogenesis, evolutions, and transmission. The objectives of this study are to investigate the distinctive structural features of SARS-CoV-2 S protein, its essential role in pathogenesis, and its use in the development of potential therapies and vaccines.

Methodology: A literature review was conducted to summarize, analyze, and interpret the available scientific data related to SARS-CoV-2 S protein in terms of characteristics, vaccines development and potential therapies.

Results: The data indicate that S protein subunits and their variable conformational states significantly affect the virus pathogenesis, infectivity, and evolutionary mutation. A considerable number of potential natural and synthetic therapies were proposed based on S protein. Additionally, neutralizing antibodies were recently approved for emergency use. Furthermore, several vaccines utilizing the S protein were developed.

Conclusion: A better understanding of S protein features, structure and mutations facilitate the recognition of the importance of SARS-CoV-2 S protein in viral infection, as well as the development of therapies and vaccines. The efficacy and safety of these therapeutic compounds and vaccines are still controversial. However, they may potentially reduce or prevent SARS-CoV-2 infection, leading to a significant reduction of the global health burden of this pandemic.

Keywords: Mutations; Pathogenesis; SARS-CoV-2; Spike protein; Treatments; Vaccines.

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Conflict of interest statement

All authors declare there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Diagram showing the domain organization of the S protein of SARS-COV-2. NTD N-terminal domain, RBD receptor-binding domain, FP fusion peptide, HR1 heptad repeat 1, HR2 heptad repeat 2, TM transmembrane domain, CT cytoplasmic tail. S1/S2 and S2’: Cleavage sites of the S protein
Fig. 2
Fig. 2
Diagram showing the conformational changes of SARS-COV-2 S protein during the binding of ACE-2 receptor
Fig. 3
Fig. 3
Pulmonary pathogenesis mediated by SARS-CoV-2 S protein upon its fusion and entry, and its potential treatments and current vaccines
Fig. 4
Fig. 4
Future perspectives of SARS-CoV-2 S protein mutations and planning to identify and restrict the spread of potential new variants. A Tracking and analyzing the mutagenic pattern adopted by the SARS-CoV-2 S protein. B Factors that significantly contribute to infection range and protection
See this image and copyright information in PMC

References

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