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Review
. 2016 Sep;15(9):1123-34.
doi: 10.1586/14760584.2016.1167603. Epub 2016 Apr 6.

Vaccines for the prevention against the threat of MERS-CoV

Affiliations
Review

Vaccines for the prevention against the threat of MERS-CoV

Lanying Du et al. Expert Rev Vaccines. 2016 Sep.

Abstract

First identified in 2012, Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) is listed as a new Category C Priority Pathogen. While the high mortality of MERS-CoV infection is further intensified by potential human-to-human transmissibility, no MERS vaccines are available for human use. This review explains immune responses resulting from MERS-CoV infection, describes MERS vaccine criteria, and presents available small animal models to evaluate the efficacy of MERS vaccines. Current advances in vaccine development are summarized, focusing on specific applications and limitations of each vaccine category. Taken together, this review provides valuable guidelines toward the development of an effective and safe MERS vaccine. This article is written for a Special Focus Issue of Expert Review of Vaccines on 'Vaccines for Biodefence'.

Keywords: Animal models; MERS; MERS-CoV; immune responses; neutralizing antibody; protection; spike protein; vaccines.

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Conflict of interest statement

Declaration of Interests The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1.
Figure 1.
Potential MERS-CoV transmission routes and MERS-CoV-infection hosts. Bats are the most likely natural reservoir of MERS-CoV, and dromedary camels are potential intermediate hosts. Human-to-human transmission of MERS-CoV may easily occur through healthcare facilities or within family clusters.
Figure 2.
Figure 2.
Classification of coronavirus genera. The four coronavirus genera are α, β, γ, and δ coronaviruses. Each coronavirus genus contains different subclasses. Letters in blue indicate coronaviruses that have caused human infection.
Figure 3.
Figure 3.
MERS-CoV genome and schematic structure of viral proteins. (A) The MERS-CoV genome consists of 2 partially overlapping replicase open reading frames (OFR1a and 1b) and several downstream ORFs that encode viral functional structural proteins and other proteins with unknown function. (B) Schematic structure of major MERS-CoV structural proteins. (C) Schematic structure of MERS-CoV S protein. SP, signal peptide; RBD, receptor-binding domain; RBM, receptor-binding motif; FP, fusion peptide; HR1 and HR2, heptad repeat 1 and 2; TM, transmembrane domain; CP, cytoplasmic tail.
Figure 4.
Figure 4.
Schematic diagram of MERS vaccine-induced immune responses and neutralization. Immunization of MERS vaccines may activate naïve B cells to differentiate into plasma cells and produce serum IgG, IgA, and/or secretory immunoglobulin A (sIgA) antibodies to bind MERS-CoV. Antibodies with neutralizing activity will block binding between MERS-CoV and its receptor dipeptidyl peptidase-4 (DPP4) at the cell surface, thus inhibiting virus entry into target cells. Naïve CD4+ and CD8+ T cells can also be activated to produce cytokines and/or function as cytotoxic T lymphocytes (CTLs) to destroy MERS-CoV-infected target cells. Some memory B (Bm) and T (Tm) cells may be activated after further stimulation or boost vaccination, and play a role in humoral and cellular immune responses.

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