Nikhil Prasad Fact checked by:Thailand Medical News Team Dec 01, 2024 11 hours, 40 minutes ago
Medical News: Influenza, a persistent global health concern, primarily affects humans through types A and B of the virus. Among its key components, the neuraminidase (NA) protein plays a critical role in spreading the virus by aiding its release from infected cells. This
Medical News report dives into new findings related to mutations in NA and their implications on drug resistance, presenting crucial insights from a recent study.
Influenza Mutations and Drug Resistance in Focus
The study, conducted by researchers from the College of Pharmacy at Shenzhen Technology University and the School of Pharmaceutical Sciences at Shenzhen University in China, sheds light on the challenges posed by drug-resistant influenza strains. Neuraminidase inhibitors (NAIs), such as oseltamivir and zanamivir, are vital in treating influenza, but mutations in the NA protein can compromise their effectiveness. This study explores the intricacies of these mutations and their global implications.
Key Findings of the Study
The research team examined influenza outbreaks worldwide and analyzed mutations that confer resistance to NAIs. Their study identified three primary mechanisms driving resistance:
-Catalytic Site Mutations: Changes in amino acid sequences at the active sites of NA disrupt the binding of drugs like oseltamivir and zanamivir. For example, the H274Y mutation significantly reduces the drug's efficacy, particularly in N1 subtypes.
-Structural Hindrance: Mutations such as H274Y in N1 can alter the spatial configuration of NA, reducing the effectiveness of drugs that rely on hydrophobic interactions.
-Monomer Stability Changes: Mutations at specific points can destabilize the tetramer structure of NA, further complicating drug efficacy.
Global Patterns of Resistance
Analyzing data from 2016 to 2024, the researchers discovered that drug resistance among influenza strains remains relatively stable globally, at around 1%. However, sporadic occurrences of resistant strains with mutations like H274Y pose a growing threat. Notably, this mutation, found predominantly in the H1N1 subtype, has been linked to resistance to oseltamivir and peramivir.
From 2005 to 2008, the H274Y mutation's prevalence surged globally, especially in regions like Japan and the United States. By 2009, this mutation had integrated into the A(H1N1) pdm09 virus, contributing to the 2009 pandemic. Despite its reduced prevalence in recent years, the mutation continues to challenge public health responses due to its potential for rapid spread and resistance development.
Emerging Trends and New Mutations
The study identified newer mutations in NA that exacerbate resistance. These include combinations like H274Y and G147R, which drastically increase resistance levels. Additionally, mutations such as S246G and I222V in the N1 subtype further reduce drug efficacy, creat
ing a pressing need for updated surveillance and treatment protocols.
Interestingly, while some mutations produce synergistic effects, others can antagonize resistance to certain drugs. For example, a mutation like D151N, when combined with others, might reduce resistance to zanamivir while enhancing resistance to oseltamivir and peramivir.
The Way Forward
Understanding the dynamics of these mutations underscores the importance of global influenza surveillance systems. By closely monitoring the evolution of drug-resistant strains, public health authorities can better anticipate and mitigate potential outbreaks.
Moreover, the development of new antiviral drugs targeting resistant strains is crucial. Enhanced vaccine coverage, prudent use of existing antivirals, and the exploration of broad-spectrum treatments are essential strategies to curb the spread of resistant influenza viruses.
Conclusions
The fight against influenza is far from over. Drug-resistant strains, driven by mutations in the neuraminidase protein, highlight the need for constant vigilance. While current resistance rates remain low, the potential for rapid escalation, especially with mutations like H274Y, demands proactive measures.
Strengthening global surveillance, investing in innovative treatments, and adopting comprehensive public health policies are critical steps to ensure preparedness against future outbreaks.
Ultimately, this research provides a roadmap for addressing the challenges of influenza drug resistance, emphasizing the need for continued collaboration among scientists, healthcare professionals, and policymakers. By staying ahead of the virus's evolution, we can protect vulnerable populations and reduce the burden of influenza worldwide.
The study findings were published in the peer-reviewed journal: Emerging Microbes and Infections.
https://www.tandfonline.com/doi/full/10.1080/22221751.2024.2429627
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Medical News.
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https://www.thailandmedical.news/articles/influenza-or-flu
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