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奥密克戎变异株的研究进展。

Advances in the Omicron variant development.

机构信息

Pharmaceutical Department, Usl Umbria 1, Perugia, Italy.

Pharmaceutical Department, Asl Napoli 3 Sud, Naples, Italy.

出版信息

J Intern Med. 2022 Jul;292(1):81-90. doi: 10.1111/joim.13478. Epub 2022 Mar 22.

Abstract

Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 has spread worldwide, leading the World Health Organization (WHO) to declare a pandemic, on 11 March 2020. Variants of concern have appeared at regular intervals-Alpha, Beta, Gamma, Delta, and now Omicron. Omicron variant, first identified in Botswana in November 2021, is rapidly becoming the dominant circulating variant. In this review, we provide an overview regarding the molecular profile of the Omicron variant, epidemiology, transmissibility, the impact on vaccines, as well as vaccine escape, and finally, we report the pharmacological agents able to block the endocellular entry of SARS-CoV-2 or to inhibit its viral replication. The Omicron has more than 50 mutations, of which the spike protein has 26-35 amino acids different from the original SARS-CoV-2 virus or the Delta, some of which are associated with humoral immune escape potential and greater transmissibility. Omicron has a significant growth advantage over Delta, leading to rapid spread with higher incidence levels. The disease so far has been mild compared to the Delta. The two vaccination doses offer little or no protection against Omicron infection while the booster doses provide significant protection against mild illness and likely offer even greater levels of protection against serious illness. Recently, new oral antiviral agents such as molnupiravir and paxlovid have been approved and represent important therapeutic alternatives to antiviral remdesivir. In addition, monoclonal antibodies such as casirivimab/imdevimab bind different epitopes of the spike protein receptor; is this class of drugs effective against the Omicron variant? However, more research is needed to define whether Omicron is indeed more infectious and whether the vaccines, monoclonal antibodies, and antivirals currently available are effective.

摘要

严重急性呼吸综合征冠状病毒(SARS-CoV-2)已在全球范围内传播,世界卫生组织(WHO)于 2020 年 3 月 11 日宣布大流行。关切变体定期出现-阿尔法,贝塔,伽马,三角洲,现在是奥密克戎。奥密克戎变体于 2021 年 11 月在博茨瓦纳首次被发现,正在迅速成为主要的循环变体。在这篇综述中,我们提供了奥密克戎变体的分子特征,流行病学,传染性,对疫苗的影响以及疫苗逃逸的概述,最后,我们报告了能够阻止 SARS-CoV-2 细胞内进入或抑制其病毒复制的药理制剂。奥密克戎有 50 多个突变,其中刺突蛋白与原始 SARS-CoV-2 病毒或三角洲有 26-35 个氨基酸不同,其中一些与体液免疫逃逸潜力和更高的传染性有关。奥密克戎对三角洲具有明显的生长优势,导致发病率水平更高的快速传播。到目前为止,这种疾病与三角洲相比较轻。两剂疫苗接种对奥密克戎感染几乎没有保护作用,而加强剂量对轻度疾病提供了显著的保护作用,并且可能对严重疾病提供更大的保护作用。最近,新的口服抗病毒药物如莫努匹韦和帕昔洛韦已获得批准,是抗病毒瑞德西韦的重要治疗替代药物。此外,单克隆抗体如 casirivimab/imdevimab 结合刺突蛋白受体的不同表位;这类药物对奥密克戎变体有效吗?然而,需要更多的研究来确定奥密克戎是否确实更具传染性,以及当前可用的疫苗、单克隆抗体和抗病毒药物是否有效。

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Advances in the Omicron variant development.奥密克戎变异株的研究进展。
J Intern Med. 2022 Jul;292(1):81-90. doi: 10.1111/joim.13478. Epub 2022 Mar 22.

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