Why the study?
Clade 2.2.1 avian influenza viruses (H5N1) have caused the highest number of human cases worldwide, presenting a serious public health threat and potential for adaptation to human hosts.
Ongoing dissemination of clade 2.2.1 H5N1 viruses has driven PA mutations that enhance viral replication and host range expansion, increasing the public health risk for humans.
May increase H5N1 fitness in recent clades; leaves open human transmission risk.
Clade 2.2.1 avian influenza viruses (H5N1) are unique to Egypt and have caused the highest number of human H5N1 influenza cases worldwide, presenting a serious global public health threat. These viruses may have the greatest evolutionary potential for adaptation from avian hosts to human hosts. Using a comprehensive phylogenetic approach, we identified several novel clade 2.2.1 virus polymerase mutations that increased viral replication in vitro in human cells and in vivo in mice. These mutations were in the polymerase PA subunit and acted cooperatively with the E627K mutation in the PB2 polymerase subunit to provide higher replication in contemporary clade 2.2.1.2 viruses than in ancestral clade 2.2.1 viruses. These data indicated that ongoing clade 2.2.1 dissemination in the field has driven PA mutations to modify viral replication to enable host range expansion, with a higher public health risk for humans.
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Arai et al. (2020) studied this question.
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