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      Opinion: A call for an independent inquiry into the origin of the SARS-CoV-2 virus

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          Abstract

          Since the identification of theSARS-CoV-2 in Wuhan, China, in January 2020 (1), the origin of the virus has been a topic of intense scientific debate and public speculation. The two main hypotheses are that the virus emerged from human exposure to an infected animal [“zoonosis” (2)] or that it emerged in a research-related incident (3). The investigation into the origin of the virus has been made difficult by the lack of key evidence from the earliest days of the outbreak—there’s no doubt that greater transparency on the part of Chinese authorities would be enormously helpful. Nevertheless, we argue here that there is much important information that can be gleaned from US-based research institutions, information not yet made available for independent, transparent, and scientific scrutiny. When it comes to deciphering the origins of COVID-19, much important information can be gleaned from US-based research institutions—information that has yet to be made available for independent, transparent, and scientific scrutiny. Image credit: Dave Cutler (artist). The data available within the United States would explicitly include, but are not limited to, viral sequences gathered and held as part of the PREDICT project and other funded programs, as well as sequencing data and laboratory notebooks from US laboratories. We call on US government scientific agencies, most notably the NIH, to support a full, independent, and transparent investigation of the origins of SARS-CoV-2. This should take place, for example, within a tightly focused science-based bipartisan Congressional inquiry with full investigative powers, which would be able to ask important questions—but avoid misguided witch-hunts governed more by politics than by science. Essential US Investigations The US intelligence community (IC) was tasked, in 2021 by President Joe Biden (4), with investigating the origin of the virus. In their summary public statement, the IC writes that “all agencies assess that two hypotheses are plausible: natural exposure to an infected animal and a laboratory-associated incident” (4). The IC further writes that “China’s cooperation most likely would be needed to reach a conclusive assessment of the origins of COVID-19 [coronavirus disease 2019].” Of course, such cooperation is highly warranted and should be pursued by the US Government and the US scientific community. Yet, as outlined below, much could be learned by investigating US-supported and US-based work that was underway in collaboration with Wuhan-based institutions, including the Wuhan Institute of Virology (WIV), China. It is still not clear whether the IC investigated these US-supported and US-based activities. If it did, it has yet to make any of its findings available to the US scientific community for independent and transparent analysis and assessment. If, on the other hand, the IC did not investigate these US-supported and US-based activities, then it has fallen far short of conducting a comprehensive investigation. This lack of an independent and transparent US-based scientific investigation has had four highly adverse consequences. First, public trust in the ability of US scientific institutions to govern the activities of US science in a responsible manner has been shaken. Second, the investigation of the origin of SARS-CoV-2 has become politicized within the US Congress (5); as a result, the inception of an independent and transparent investigation has been obstructed and delayed. Third, US researchers with deep knowledge of the possibilities of a laboratory-associated incident have not been enabled to share their expertise effectively. Fourth, the failure of NIH, one of the main funders of the US–China collaborative work, to facilitate the investigation into the origins of SARS-CoV-2 (4) has fostered distrust regarding US biodefense research activities. Much of the work on SARS-like CoVs performed in Wuhan was part of an active and highly collaborative US–China scientific research program funded by the US Government (NIH, Defense Threat Reduction Agency [DTRA], and US Agency for International Development [USAID]), coordinated by researchers at EcoHealth Alliance (EHA), but involving researchers at several other US institutions. For this reason, it is important that US institutions be transparent about any knowledge of the detailed activities that were underway in Wuhan and in the United States. The evidence may also suggest that research institutions in other countries were involved, and those too should be asked to submit relevant information (e.g., with respect to unpublished sequences). Participating US institutions include the EHA, the University of North Carolina (UNC), the University of California at Davis (UCD), the NIH, and the USAID. Under a series of NIH grants and USAID contracts, EHA coordinated the collection of SARS-like bat CoVs from the field in southwest China and southeast Asia, the sequencing of these viruses, the archiving of these sequences (involving UCD), and the analysis and manipulation of these viruses (notably at UNC). A broad spectrum of coronavirus research work was done not only in Wuhan (including groups at Wuhan University and the Wuhan CDC, as well as WIV) but also in the United States. The exact details of the fieldwork and laboratory work of the EHA-WIV-UNC partnership, and the engagement of other institutions in the United States and China, has not been disclosed for independent analysis. The precise nature of the experiments that were conducted, including the full array of viruses collected from the field and the subsequent sequencing and manipulation of those viruses, remains unknown. EHA, UNC, NIH, USAID, and other research partners have failed to disclose their activities to the US scientific community and the US public, instead declaring that they were not involved in any experiments that could have resulted in the emergence of SARS-CoV-2. The NIH has specifically stated (6) that there is a significant evolutionary distance between the published viral sequences and that of SARS-CoV-2 and that the pandemic virus could not have resulted from the work sponsored by NIH. Of course, this statement is only as good as the limited data on which it is based, and verification of this claim is dependent on gaining access to any other unpublished viral sequences that are deposited in relevant US and Chinese databases (7,8). On May 11, 2022, Acting NIH Director Lawrence Tabak testified before Congress that several such sequences in a US database were removed from public view, and that this was done at the request of both Chinese and US investigators. Blanket denials from the NIH are no longer good enough. Although the NIH and USAID have strenuously resisted full disclosure of the details of the EHA-WIV-UNC work program, several documents leaked to the public or released through the Freedom of Information Act (FOIA) have raised concerns. These research proposals make clear that the EHA-WIV-UNC collaboration was involved in the collection of a large number of so-far undocumented SARS-like viruses and was engaged in their manipulation within biological safety level (BSL)-2 and BSL-3 laboratory facilities, raising concerns that an airborne virus might have infected a laboratory worker (9). A variety of scenarios have been discussed by others, including an infection that involved a natural virus collected from the field or perhaps an engineered virus manipulated in one of the laboratories (3). Overlooked Details Special concerns surround the presence of an unusual furin cleavage site (FCS) in SARS-CoV-2 (10) that augments the pathogenicity and transmissibility of the virus relative to related viruses like SARS-CoV-1 (11, 12). SARS-CoV-2 is, to date, the only identified member of the subgenus sarbecovirus that contains an FCS, although these are present in other coronaviruses (13, 14). A portion of the sequence of the spike protein of some of these viruses is illustrated in the alignment shown in Fig. 1, illustrating the unusual nature of the FCS and its apparent insertion in SARS-CoV-2 (15). From the first weeks after the genome sequence of SARS-CoV-2 became available, researchers have commented on the unexpected presence of the FCS within SARS-CoV-2—the implication being that SARS-CoV-2 might be a product of laboratory manipulation. In a review piece arguing against this possibility, it was asserted that the amino acid sequence of the FCS in SARS-CoV-2 is an unusual, nonstandard sequence for an FCS and that nobody in a laboratory would design such a novel FCS (13). Fig. 1. This alignment of the amino acid sequences of coronavirus spike proteins, in the region of the S1/S2 junction, illustrates the sequence of SARS-CoV-2 (Wuhan-Hu-1) and some of its closest relatives. The furin cleavage site (FCS) is indicated (PRRAR'SVAS), and furin cuts the spike protein between R and S, as indicated by the red arrowhead. Adapted from Chan & Zhan (15). In fact, the assertion that the FCS in SARS-CoV-2 has an unusual, nonstandard amino acid sequence is false. The amino acid sequence of the FCS in SARS-CoV-2 also exists in the human ENaC α subunit (16), where it is known to be functional and has been extensively studied (17, 18). The FCS of human ENaC α has the amino acid sequence RRAR'SVAS (Fig. 2), an eight–amino-acid sequence that is perfectly identical with the FCS of SARS-CoV-2 (16). ENaC is an epithelial sodium channel, expressed on the apical surface of epithelial cells in the kidney, colon, and airways (19, 20), that plays a critical role in controlling fluid exchange. The ENaC α subunit has a functional FCS (17, 18) that is essential for ion channel function (19) and has been characterized in a variety of species. The FCS sequence of human ENaC α (20) is identical in chimpanzee, bonobo, orangutan, and gorilla ( SI Appendix, Fig. 1), but diverges in all other species, even primates, except one. (The one non-human non-great ape species with the same sequence is Pipistrellus kuhlii, a bat species found in Europe and Western Asia; other bat species, including Rhinolophus ferrumequinem, have a different FCS sequence in ENaC α [RKAR'SAAS]). Fig. 2. Amino acid alignment of the furin cleavage sites of SARS-CoV-2 spike protein with (Top) the spike proteins of other viruses that lack the furin cleavage site and (Bottom) the furin cleavage sites present in the α subunits of human and mouse ENaC. Adapted from Anand et al. (16). One consequence of this “molecular mimicry” between the FCS of SARS CoV-2 spike and the FCS of human ENaC is competition for host furin in the lumen of the Golgi apparatus, where the SARS-CoV-2 spike is processed. This results in a decrease in human ENaC expression (21). A decrease in human ENaC expression compromises airway function and has been implicated as a contributing factor in the pathogenesis of COVID-19 (22). Another consequence of this astonishing molecular mimicry is evidenced by apparent cross-reactivity with human ENaC of antibodies from COVID-19 patients, with the highest levels of cross-reacting antibodies directed against this epitope being associated with most severe disease (23). We do not know whether the insertion of the FCS was the result of natural evolution (2, 13)—perhaps via a recombination event in an intermediate mammal or a human (13, 24)—or was the result of a deliberate introduction of the FCS into a SARS-like virus as part of a laboratory experiment. We do know that the insertion of such FCS sequences into SARS-like viruses was a specific goal of work proposed by the EHA-WIV-UNC partnership within a 2018 grant proposal (“DEFUSE”) that was submitted to the US Defense Advanced Research Projects Agency (DARPA) (25). The 2018 proposal to DARPA was not funded, but we do not know whether some of the proposed work was subsequently carried out in 2018 or 2019, perhaps using another source of funding. We also know that that this research team would be familiar with several previous experiments involving the successful insertion of an FCS sequence into SARS-CoV-1 (26) and other coronaviruses, and they had a lot of experience in construction of chimeric SARS-like viruses (27 –29). In addition, the research team would also have some familiarity with the FCS sequence and the FCS-dependent activation mechanism of human ENaC α (19), which was extensively characterized at UNC (17, 18). For a research team assessing the pandemic potential of SARS-related coronaviruses, the FCS of human ENaC—an FCS known to be efficiently cleaved by host furin present in the target location (epithelial cells) of an important target organ (lung), of the target organism (human)—might be a rational, if not obvious, choice of FCS to introduce into a virus to alter its infectivity, in line with other work performed previously. Of course, the molecular mimicry of ENaC within the SARS-CoV-2 spike protein might be a mere coincidence, although one with a very low probability. The exact FCS sequence present in SARS-CoV-2 has recently been introduced into the spike protein of SARS-CoV-1 in the laboratory, in an elegant series of experiments (12, 30), with predictable consequences in terms of enhanced viral transmissibility and pathogenicity. Obviously, the creation of such SARS-1/2 “chimeras” is an area of some concern for those responsible for present and future regulation of this area of biology. [Note that these experiments in ref. 30 were done in the context of a safe “pseudotyped” virus and thus posed no danger of producing or releasing a novel pathogen.] These simple experiments show that the introduction of the 12 nucleotides that constitute the FCS insertion in SARS-CoV-2 would not be difficult to achieve in a lab. It would therefore seem reasonable to ask that electronic communications and other relevant data from US groups should be made available for scrutiny. Seeking Transparency To date, the federal government, including the NIH, has not done enough to promote public trust and transparency in the science surrounding SARS-CoV-2. A steady trickle of disquieting information has cast a darkening cloud over the agency. The NIH could say more about the possible role of its grantees in the emergence of SARS-CoV-2, yet the agency has failed to reveal to the public the possibility that SARS-CoV-2 emerged from a research-associated event, even though several researchers raised that concern on February 1, 2020, in a phone conversation that was documented by email (5). Those emails were released to the public only through FOIA, and they suggest that the NIH leadership took an early and active role in promoting the “zoonotic hypothesis” and the rejection of the laboratory-associated hypothesis (5). The NIH has resisted the release of important evidence, such as the grant proposals and project reports of EHA, and has continued to redact materials released under FOIA, including a remarkable 290-page redaction in a recent FOIA release. Information now held by the research team headed by EHA (7), as well as the communications of that research team with US research funding agencies, including NIH, USAID, DARPA, DTRA, and the Department of Homeland Security, could shed considerable light on the experiments undertaken by the US-funded research team and on the possible relationship, if any, between those experiments and the emergence of SARS-CoV-2. We do not assert that laboratory manipulation was involved in the emergence of SARS-CoV-2, although it is apparent that it could have been. However, we do assert that there has been no independent and transparent scientific scrutiny to date of the full scope of the US-based evidence. The relevant US-based evidence would include the following information: laboratory notebooks, virus databases, electronic media (emails, other communications), biological samples, viral sequences gathered and held as part of the PREDICT project (7) and other funded programs, and interviews of the EHA-led research team by independent researchers, together with a full record of US agency involvement in funding the research on SARS-like viruses, especially with regard to projects in collaboration with Wuhan-based institutions. We suggest that a bipartisan inquiry should also follow up on the tentative conclusion of the IC (4) that the initial outbreak in Wuhan may have occurred no later than November 2019 and that therefore the virus was circulating before the cluster of known clinical cases in December. The IC did not reveal the evidence for this statement, nor when parts of the US Government or US-based researchers first became aware of a potential new outbreak. Any available information and knowledge of the earliest days of the outbreak, including viral sequences (8), could shed considerable light on the origins question. We continue to recognize the tremendous value of US–China cooperation in ongoing efforts to uncover the proximal origins of the pandemic. Much vital information still resides in China, in the laboratories, hospital samples, and early epidemiological information not yet available to the scientific community. Yet a US-based investigation need not wait—there is much to learn from the US institutions that were extensively involved in research that may have contributed to, or documented the emergence of, the SARS-CoV-2 virus. Only an independent and transparent investigation, perhaps as a bipartisan Congressional inquiry, will reveal the information that is needed to enable a thorough scientific process of scrutiny and evaluation. Supplementary Material Supplementary File

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          A pneumonia outbreak associated with a new coronavirus of probable bat origin

          Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats 1–4 . Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans 5–7 . Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV.
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            The proximal origin of SARS-CoV-2

            To the Editor — Since the first reports of novel pneumonia (COVID-19) in Wuhan, Hubei province, China 1,2 , there has been considerable discussion on the origin of the causative virus, SARS-CoV-2 3 (also referred to as HCoV-19) 4 . Infections with SARS-CoV-2 are now widespread, and as of 11 March 2020, 121,564 cases have been confirmed in more than 110 countries, with 4,373 deaths 5 . SARS-CoV-2 is the seventh coronavirus known to infect humans; SARS-CoV, MERS-CoV and SARS-CoV-2 can cause severe disease, whereas HKU1, NL63, OC43 and 229E are associated with mild symptoms 6 . Here we review what can be deduced about the origin of SARS-CoV-2 from comparative analysis of genomic data. We offer a perspective on the notable features of the SARS-CoV-2 genome and discuss scenarios by which they could have arisen. Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus. Notable features of the SARS-CoV-2 genome Our comparison of alpha- and betacoronaviruses identifies two notable genomic features of SARS-CoV-2: (i) on the basis of structural studies 7–9 and biochemical experiments 1,9,10 , SARS-CoV-2 appears to be optimized for binding to the human receptor ACE2; and (ii) the spike protein of SARS-CoV-2 has a functional polybasic (furin) cleavage site at the S1–S2 boundary through the insertion of 12 nucleotides 8 , which additionally led to the predicted acquisition of three O-linked glycans around the site. 1. Mutations in the receptor-binding domain of SARS-CoV-2 The receptor-binding domain (RBD) in the spike protein is the most variable part of the coronavirus genome 1,2 . Six RBD amino acids have been shown to be critical for binding to ACE2 receptors and for determining the host range of SARS-CoV-like viruses 7 . With coordinates based on SARS-CoV, they are Y442, L472, N479, D480, T487 and Y4911, which correspond to L455, F486, Q493, S494, N501 and Y505 in SARS-CoV-2 7 . Five of these six residues differ between SARS-CoV-2 and SARS-CoV (Fig. 1a). On the basis of structural studies 7–9 and biochemical experiments 1,9,10 , SARS-CoV-2 seems to have an RBD that binds with high affinity to ACE2 from humans, ferrets, cats and other species with high receptor homology 7 . Fig. 1 Features of the spike protein in human SARS-CoV-2 and related coronaviruses. a, Mutations in contact residues of the SARS-CoV-2 spike protein. The spike protein of SARS-CoV-2 (red bar at top) was aligned against the most closely related SARS-CoV-like coronaviruses and SARS-CoV itself. Key residues in the spike protein that make contact to the ACE2 receptor are marked with blue boxes in both SARS-CoV-2 and related viruses, including SARS-CoV (Urbani strain). b, Acquisition of polybasic cleavage site and O-linked glycans. Both the polybasic cleavage site and the three adjacent predicted O-linked glycans are unique to SARS-CoV-2 and were not previously seen in lineage B betacoronaviruses. Sequences shown are from NCBI GenBank, accession codes MN908947, MN996532, AY278741, KY417146 and MK211376. The pangolin coronavirus sequences are a consensus generated from SRR10168377 and SRR10168378 (NCBI BioProject PRJNA573298) 29,30 . While the analyses above suggest that SARS-CoV-2 may bind human ACE2 with high affinity, computational analyses predict that the interaction is not ideal 7 and that the RBD sequence is different from those shown in SARS-CoV to be optimal for receptor binding 7,11 . Thus, the high-affinity binding of the SARS-CoV-2 spike protein to human ACE2 is most likely the result of natural selection on a human or human-like ACE2 that permits another optimal binding solution to arise. This is strong evidence that SARS-CoV-2 is not the product of purposeful manipulation. 2. Polybasic furin cleavage site and O-linked glycans The second notable feature of SARS-CoV-2 is a polybasic cleavage site (RRAR) at the junction of S1 and S2, the two subunits of the spike 8 (Fig. 1b). This allows effective cleavage by furin and other proteases and has a role in determining viral infectivity and host range 12 . In addition, a leading proline is also inserted at this site in SARS-CoV-2; thus, the inserted sequence is PRRA (Fig. 1b). The turn created by the proline is predicted to result in the addition of O-linked glycans to S673, T678 and S686, which flank the cleavage site and are unique to SARS-CoV-2 (Fig. 1b). Polybasic cleavage sites have not been observed in related ‘lineage B’ betacoronaviruses, although other human betacoronaviruses, including HKU1 (lineage A), have those sites and predicted O-linked glycans 13 . Given the level of genetic variation in the spike, it is likely that SARS-CoV-2-like viruses with partial or full polybasic cleavage sites will be discovered in other species. The functional consequence of the polybasic cleavage site in SARS-CoV-2 is unknown, and it will be important to determine its impact on transmissibility and pathogenesis in animal models. Experiments with SARS-CoV have shown that insertion of a furin cleavage site at the S1–S2 junction enhances cell–cell fusion without affecting viral entry 14 . In addition, efficient cleavage of the MERS-CoV spike enables MERS-like coronaviruses from bats to infect human cells 15 . In avian influenza viruses, rapid replication and transmission in highly dense chicken populations selects for the acquisition of polybasic cleavage sites in the hemagglutinin (HA) protein 16 , which serves a function similar to that of the coronavirus spike protein. Acquisition of polybasic cleavage sites in HA, by insertion or recombination, converts low-pathogenicity avian influenza viruses into highly pathogenic forms 16 . The acquisition of polybasic cleavage sites by HA has also been observed after repeated passage in cell culture or through animals 17 . The function of the predicted O-linked glycans is unclear, but they could create a ‘mucin-like domain’ that shields epitopes or key residues on the SARS-CoV-2 spike protein 18 . Several viruses utilize mucin-like domains as glycan shields involved immunoevasion 18 . Although prediction of O-linked glycosylation is robust, experimental studies are needed to determine if these sites are used in SARS-CoV-2. Theories of SARS-CoV-2 origins It is improbable that SARS-CoV-2 emerged through laboratory manipulation of a related SARS-CoV-like coronavirus. As noted above, the RBD of SARS-CoV-2 is optimized for binding to human ACE2 with an efficient solution different from those previously predicted 7,11 . Furthermore, if genetic manipulation had been performed, one of the several reverse-genetic systems available for betacoronaviruses would probably have been used 19 . However, the genetic data irrefutably show that SARS-CoV-2 is not derived from any previously used virus backbone 20 . Instead, we propose two scenarios that can plausibly explain the origin of SARS-CoV-2: (i) natural selection in an animal host before zoonotic transfer; and (ii) natural selection in humans following zoonotic transfer. We also discuss whether selection during passage could have given rise to SARS-CoV-2. 1. Natural selection in an animal host before zoonotic transfer As many early cases of COVID-19 were linked to the Huanan market in Wuhan 1,2 , it is possible that an animal source was present at this location. Given the similarity of SARS-CoV-2 to bat SARS-CoV-like coronaviruses 2 , it is likely that bats serve as reservoir hosts for its progenitor. Although RaTG13, sampled from a Rhinolophus affinis bat 1 , is ~96% identical overall to SARS-CoV-2, its spike diverges in the RBD, which suggests that it may not bind efficiently to human ACE2 7 (Fig. 1a). Malayan pangolins (Manis javanica) illegally imported into Guangdong province contain coronaviruses similar to SARS-CoV-2 21 . Although the RaTG13 bat virus remains the closest to SARS-CoV-2 across the genome 1 , some pangolin coronaviruses exhibit strong similarity to SARS-CoV-2 in the RBD, including all six key RBD residues 21 (Fig. 1). This clearly shows that the SARS-CoV-2 spike protein optimized for binding to human-like ACE2 is the result of natural selection. Neither the bat betacoronaviruses nor the pangolin betacoronaviruses sampled thus far have polybasic cleavage sites. Although no animal coronavirus has been identified that is sufficiently similar to have served as the direct progenitor of SARS-CoV-2, the diversity of coronaviruses in bats and other species is massively undersampled. Mutations, insertions and deletions can occur near the S1–S2 junction of coronaviruses 22 , which shows that the polybasic cleavage site can arise by a natural evolutionary process. For a precursor virus to acquire both the polybasic cleavage site and mutations in the spike protein suitable for binding to human ACE2, an animal host would probably have to have a high population density (to allow natural selection to proceed efficiently) and an ACE2-encoding gene that is similar to the human ortholog. 2. Natural selection in humans following zoonotic transfer It is possible that a progenitor of SARS-CoV-2 jumped into humans, acquiring the genomic features described above through adaptation during undetected human-to-human transmission. Once acquired, these adaptations would enable the pandemic to take off and produce a sufficiently large cluster of cases to trigger the surveillance system that detected it 1,2 . All SARS-CoV-2 genomes sequenced so far have the genomic features described above and are thus derived from a common ancestor that had them too. The presence in pangolins of an RBD very similar to that of SARS-CoV-2 means that we can infer this was also probably in the virus that jumped to humans. This leaves the insertion of polybasic cleavage site to occur during human-to-human transmission. Estimates of the timing of the most recent common ancestor of SARS-CoV-2 made with current sequence data point to emergence of the virus in late November 2019 to early December 2019 23 , compatible with the earliest retrospectively confirmed cases 24 . Hence, this scenario presumes a period of unrecognized transmission in humans between the initial zoonotic event and the acquisition of the polybasic cleavage site. Sufficient opportunity could have arisen if there had been many prior zoonotic events that produced short chains of human-to-human transmission over an extended period. This is essentially the situation for MERS-CoV, for which all human cases are the result of repeated jumps of the virus from dromedary camels, producing single infections or short transmission chains that eventually resolve, with no adaptation to sustained transmission 25 . Studies of banked human samples could provide information on whether such cryptic spread has occurred. Retrospective serological studies could also be informative, and a few such studies have been conducted showing low-level exposures to SARS-CoV-like coronaviruses in certain areas of China 26 . Critically, however, these studies could not have distinguished whether exposures were due to prior infections with SARS-CoV, SARS-CoV-2 or other SARS-CoV-like coronaviruses. Further serological studies should be conducted to determine the extent of prior human exposure to SARS-CoV-2. 3. Selection during passage Basic research involving passage of bat SARS-CoV-like coronaviruses in cell culture and/or animal models has been ongoing for many years in biosafety level 2 laboratories across the world 27 , and there are documented instances of laboratory escapes of SARS-CoV 28 . We must therefore examine the possibility of an inadvertent laboratory release of SARS-CoV-2. In theory, it is possible that SARS-CoV-2 acquired RBD mutations (Fig. 1a) during adaptation to passage in cell culture, as has been observed in studies of SARS-CoV 11 . The finding of SARS-CoV-like coronaviruses from pangolins with nearly identical RBDs, however, provides a much stronger and more parsimonious explanation of how SARS-CoV-2 acquired these via recombination or mutation 19 . The acquisition of both the polybasic cleavage site and predicted O-linked glycans also argues against culture-based scenarios. New polybasic cleavage sites have been observed only after prolonged passage of low-pathogenicity avian influenza virus in vitro or in vivo 17 . Furthermore, a hypothetical generation of SARS-CoV-2 by cell culture or animal passage would have required prior isolation of a progenitor virus with very high genetic similarity, which has not been described. Subsequent generation of a polybasic cleavage site would have then required repeated passage in cell culture or animals with ACE2 receptors similar to those of humans, but such work has also not previously been described. Finally, the generation of the predicted O-linked glycans is also unlikely to have occurred due to cell-culture passage, as such features suggest the involvement of an immune system 18 . Conclusions In the midst of the global COVID-19 public-health emergency, it is reasonable to wonder why the origins of the pandemic matter. Detailed understanding of how an animal virus jumped species boundaries to infect humans so productively will help in the prevention of future zoonotic events. For example, if SARS-CoV-2 pre-adapted in another animal species, then there is the risk of future re-emergence events. In contrast, if the adaptive process occurred in humans, then even if repeated zoonotic transfers occur, they are unlikely to take off without the same series of mutations. In addition, identifying the closest viral relatives of SARS-CoV-2 circulating in animals will greatly assist studies of viral function. Indeed, the availability of the RaTG13 bat sequence helped reveal key RBD mutations and the polybasic cleavage site. The genomic features described here may explain in part the infectiousness and transmissibility of SARS-CoV-2 in humans. Although the evidence shows that SARS-CoV-2 is not a purposefully manipulated virus, it is currently impossible to prove or disprove the other theories of its origin described here. However, since we observed all notable SARS-CoV-2 features, including the optimized RBD and polybasic cleavage site, in related coronaviruses in nature, we do not believe that any type of laboratory-based scenario is plausible. More scientific data could swing the balance of evidence to favor one hypothesis over another. Obtaining related viral sequences from animal sources would be the most definitive way of revealing viral origins. For example, a future observation of an intermediate or fully formed polybasic cleavage site in a SARS-CoV-2-like virus from animals would lend even further support to the natural-selection hypotheses. It would also be helpful to obtain more genetic and functional data about SARS-CoV-2, including animal studies. The identification of a potential intermediate host of SARS-CoV-2, as well as sequencing of the virus from very early cases, would similarly be highly informative. Irrespective of the exact mechanisms by which SARS-CoV-2 originated via natural selection, the ongoing surveillance of pneumonia in humans and other animals is clearly of utmost importance.
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              A Multibasic Cleavage Site in the Spike Protein of SARS-CoV-2 Is Essential for Infection of Human Lung Cells

              Summary The pandemic coronavirus SARS-CoV-2 threatens public health worldwide. The viral spike protein mediates SARS-CoV-2 entry into host cells and harbors a S1/S2 cleavage site containing multiple arginine residues (multibasic) not found in closely related animal coronaviruses. However, the role of this multibasic cleavage site in SARS-CoV-2 infection is unknown. Here, we report that the cellular protease furin cleaves the spike protein at the S1/S2 site and that cleavage is essential for S-protein-mediated cell-cell fusion and entry into human lung cells. Moreover, optimizing the S1/S2 site increased cell-cell, but not virus-cell, fusion, suggesting that the corresponding viral variants might exhibit increased cell-cell spread and potentially altered virulence. Our results suggest that acquisition of a S1/S2 multibasic cleavage site was essential for SARS-CoV-2 infection of humans and identify furin as a potential target for therapeutic intervention.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc Natl Acad Sci U S A
                pnas
                pnas
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                19 May 2022
                24 May 2022
                19 May 2022
                : 119
                : 21
                : e2202769119
                Affiliations
                [1] aDepartment of Anesthesiology, Columbia University , New York, NY 10032;
                [2] bDepartment of Molecular Pharmacology and Therapeutics, Columbia University , New York, NY 10032;
                [3] cCenter for Sustainable Development, Columbia University , New York, NY 10032
                Author notes
                1To whom correspondence may be addressed. Email: nh2298@ 123456columbia.edu or sachs@ 123456ei.columbia.edu .

                Author contributions: N.L.H. and J.D.S. wrote the paper.

                Article
                202202769
                10.1073/pnas.2202769119
                9173817
                35588448
                69889df4-663e-447b-9d38-8de5c981a998
                Copyright © 2022 the Author(s). Published by PNAS.

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                May 23, 2022

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