The current 2019-nCoV outbreak has the potential to become a global pandemic. Our previous decade-long structural studies on SARS-CoV have established receptor recognition as one of the most important determinants of SARS-CoV infectivity, pathogenesis, and host range 15,23. Based on the newly discovered structural basis for receptor recognition by 2019-nCoV presented here, we discuss some of the most pressing questions regarding the virus.
Why is 2019-nCoV more damaging than SARS-CoV? Our study found that compared with SARS-CoV, structural changes in the hACE2-binding ridge in 2019- nCoV RBM cause the ridge to become more compact, get closer to hACE2, and form better contact with hACE2. Moreover, both of the virus-binding hotspots on hACE2 have become more stabilized through interactions with 2019-nCoV RBM. Our biochemical data confirm that 2019-nCoV RBD has significantly higher hACE2-binding affinity than SARS-CoV RBD. Thus, both of the structural and biochemical data reveal that 2019- nCoV recognizes hACE2 better than SARS-CoV does, suggesting more efficient cell infectivity, higher human infectivity, and wider spread of 2019-nCoV.
How did 2019-nCoV transmit from bats to humans? First, like 2019-nCoV, bat RaTG13 RBM contains a similar four-residue motif in the ACE2-binding ridge (Fig. 3C), supporting RaTG13 as the original source for 2019-nCoV. As this study shows, the four- residue motif is correlated with better receptor usage; RaTG13 likely evolved this motif as an adaptation to bat infections (Fig. 4). Second, because residue 329 in bat ACE2 is an asparagine (Fig. 3D), it cannot form a salt bridge with Arg426 from the RBM, allowing this RBM residue to evolve to other residues, first to a lysine in Bat RaTG13 and then to an asparagine in 2019-nCoV. Thus, Asn439 is a viral adaptation to bat ACE2 (Fig. 4).
Third, Gln493 in 2019-nCoV RBM plays a critical role in stabilizing hotspot-31. It is better suited for hACE2 binding than the other residues in the same position in other viral RBMs (Fig. 3C). Hence Gln493 is a viral adaption to hACE2 (Fig. 4). It is worth noting that a lysine-to-asparagine mutation in this same position allowed SARS-CoV to get into human populations 20. Overall, the combinations of the above critical receptor-binding features of 2019-nCoV may have facilitated 2019-nCoV to transmit from bats to humans, either directly or through an intermediate host (Fig. 4).
Could 2019-nCoV evolve further in the future to become even more dangerous for humans? The chimeric RBD used for crystallization shows that an N439R mutation in 2019-nCoV RBM significantly enhances hACE2 recognition by 2019-nCoV. This mutation may occur as the virus further adapts to human infections, and hence should be closely monitored as an important part of epidemic surveillance.
What does our study inform on intervention strategies? First, neutralizing monoclonal antibodies targeting 2019-nCoV RBM can prevent the virus from binding to ACE2, and hence are promising antiviral drugs. However, the strong binding between 2019-nCoV RBD and human ACE2 suggests that antibody drugs will have a worse chance to outcompete ACE2 for the binding site on the RBD, making this antiviral approach more challenging. Second, the RBD itself can function as a subunit vaccine17,18. Our study has identified all of the functionally important epitopes in 2019-nCoV RBM, and hence vaccine design can focus on these epitopes. Moreover, we previously developed a structure-based strategy to improve the efficacy of coronavirus RBD vaccines. This strategy may be helpful in designing 2019-nCoV RBD vaccines 27.
Finally, antibody-dependent enhancement (ADE) of 2019-nCoV infection should be carefully monitored for secondary 2019-nCoV infections, for antibody-based drug therapy, and for vaccinations. The molecular mechanism of ADE that we recently identified for other coronaviruses may apply to 2019-nCoV 28. Overall, our study can guide structure-based intervention strategies that target receptor recognition by 2019- nCoV.