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Furin Cleavage Site Is Key to SARS-CoV-2 Pathogenesis

Bryan A. Johnson, Xuping Xie, Birte Kalveram, Kumari G. Lokugamage, Antonio Muruato, Jing Zou, Xianwen Zhang, Terry Juelich, Jennifer K. Smith, Lihong Zhang, Nathen Bopp, Craig Schindewolf, Michelle Vu, Abigail Vanderheiden, Daniele Swetnam, Jessica A. Plante, Patricia Aguilar, Kenneth S. Plante, Benhur Lee, Scott C. Weaver, View ORCID ProfileMehul S. Suthar, View ORCID ProfileAndrew L. Routh, Ping Ren, Zhiqiang Ku, Zhiqiang An, Kari Debbink, Pei Yong Shi, Alexander N. Freiberg, Vineet D. Menachery
doi: https://doi.org/10.1101/2020.08.26.268854
Bryan A. Johnson
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Xuping Xie
2Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
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Birte Kalveram
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Kumari G. Lokugamage
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Antonio Muruato
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Jing Zou
2Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
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Xianwen Zhang
2Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
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Terry Juelich
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Jennifer K. Smith
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Lihong Zhang
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Nathen Bopp
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Craig Schindewolf
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Michelle Vu
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Abigail Vanderheiden
5Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
6Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
7Yerkes National Primate Research Center, Atlanta, GA, USA
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Daniele Swetnam
2Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
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Jessica A. Plante
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Patricia Aguilar
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Kenneth S. Plante
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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Benhur Lee
8Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Scott C. Weaver
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
4Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX, USA
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Mehul S. Suthar
5Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
6Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
7Yerkes National Primate Research Center, Atlanta, GA, USA
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  • ORCID record for Mehul S. Suthar
Andrew L. Routh
2Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
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  • ORCID record for Andrew L. Routh
Ping Ren
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Zhiqiang Ku
9Texas Therapeutics Institute, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, USA
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Zhiqiang An
9Texas Therapeutics Institute, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, USA
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Kari Debbink
10Bowie State University, Bowie, MD, USA
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Pei Yong Shi
2Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
4Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX, USA
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Alexander N. Freiberg
3Pathology, University of Texas Medical Branch, Galveston, TX, USA
4Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX, USA
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Vineet D. Menachery
1Departments of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
4Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX, USA
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  • For correspondence: Vimenach@utmb.edu
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Abstract

SARS-CoV-2 has resulted in a global pandemic and shutdown economies around the world. Sequence analysis indicates that the novel coronavirus (CoV) has an insertion of a furin cleavage site (PRRAR) in its spike protein. Absent in other group 2B CoVs, the insertion may be a key factor in the replication and virulence of SARS-CoV-2. To explore this question, we generated a SARS-CoV-2 mutant lacking the furin cleavage site (ΔPRRA) in the spike protein. This mutant virus replicated with faster kinetics and improved fitness in Vero E6 cells. The mutant virus also had reduced spike protein processing as compared to wild-type SARS-CoV-2. In contrast, the ΔPRRA had reduced replication in Calu3 cells, a human respiratory cell line, and had attenuated disease in a hamster pathogenesis model. Despite the reduced disease, the ΔPRRA mutant offered robust protection from SARS-CoV-2 rechallenge. Importantly, plaque reduction neutralization tests (PRNT50) with COVID-19 patient sera and monoclonal antibodies against the receptor-binding domain found a shift, with the mutant virus resulting in consistently reduced PRNT50 titers. Together, these results demonstrate a critical role for the furin cleavage site insertion in SARS-CoV-2 replication and pathogenesis. In addition, these findings illustrate the importance of this insertion in evaluating neutralization and other downstream SARS-CoV-2 assays.

Importance As COVID-19 has impacted the world, understanding how SARS-CoV-2 replicates and causes virulence offers potential pathways to disrupt its disease. By removing the furin cleavage site, we demonstrate the importance of this insertion to SARS-CoV-2 replication and pathogenesis. In addition, the findings with Vero cells indicate the likelihood of cell culture adaptations in virus stocks that can influence reagent generation and interpretation of a wide range of data including neutralization and drug efficacy. Overall, our work highlights the importance of this key motif in SARS-CoV-2 infection and pathogenesis.

Article Summary A deletion of the furin cleavage site in SARS-CoV-2 amplifies replication in Vero cells, but attenuates replication in respiratory cells and pathogenesis in vivo. Loss of the furin site also reduces susceptibility to neutralization in vitro.

Competing Interest Statement

X.X., V.D.M., and P.-Y.S. have filed a patent on the reverse genetic system and reporter SARS-CoV-2. Other authors declare no competing interests.

Footnotes

  • ↵# Co-senior authors

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted August 26, 2020.
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Furin Cleavage Site Is Key to SARS-CoV-2 Pathogenesis
Bryan A. Johnson, Xuping Xie, Birte Kalveram, Kumari G. Lokugamage, Antonio Muruato, Jing Zou, Xianwen Zhang, Terry Juelich, Jennifer K. Smith, Lihong Zhang, Nathen Bopp, Craig Schindewolf, Michelle Vu, Abigail Vanderheiden, Daniele Swetnam, Jessica A. Plante, Patricia Aguilar, Kenneth S. Plante, Benhur Lee, Scott C. Weaver, Mehul S. Suthar, Andrew L. Routh, Ping Ren, Zhiqiang Ku, Zhiqiang An, Kari Debbink, Pei Yong Shi, Alexander N. Freiberg, Vineet D. Menachery
bioRxiv 2020.08.26.268854; doi: https://doi.org/10.1101/2020.08.26.268854
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Furin Cleavage Site Is Key to SARS-CoV-2 Pathogenesis
Bryan A. Johnson, Xuping Xie, Birte Kalveram, Kumari G. Lokugamage, Antonio Muruato, Jing Zou, Xianwen Zhang, Terry Juelich, Jennifer K. Smith, Lihong Zhang, Nathen Bopp, Craig Schindewolf, Michelle Vu, Abigail Vanderheiden, Daniele Swetnam, Jessica A. Plante, Patricia Aguilar, Kenneth S. Plante, Benhur Lee, Scott C. Weaver, Mehul S. Suthar, Andrew L. Routh, Ping Ren, Zhiqiang Ku, Zhiqiang An, Kari Debbink, Pei Yong Shi, Alexander N. Freiberg, Vineet D. Menachery
bioRxiv 2020.08.26.268854; doi: https://doi.org/10.1101/2020.08.26.268854

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