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by dnautics 1976 days ago
re: E484K

1) it's in the spike protein. I think it's in the area that typically elicits antigen response. That's super bad news. If you look carefully, it's near the cleft of a representative antibody (fig 1a), and the buried surface area is high across the board on (clinically?) sampled antibodies (fig 1e), suggesting its importance.

2) it's a mutation that changes the charge state of one of the amino acid residues. E->K, changes a negative charge to a positive charge, potentially very bad if typically antibodies have a positive surface charge to interact with it, now they will be repelled. Since individual humans make random antibodies, even if there is no charge interaction, K amino acid is bigger than E, and so there is likely a shape interaction that could get disrupted by the "new bump" in the spike.

Is it a serious cause for concern? Yeah, almost certainly. The current round of vaccinations will probably be rendered inactive.

IMO the fastest way around this is to quickly approve a reformulation of the moderna/pfizer vaccines that encode for the new amino acid, or better yet, a cocktail of both.

For the more traditional protein-based vaccines, it could be more challenging, because the gut feeling is that an amino acid change like this could pose more of a risk to the effectiveness of the formulation for delivery of the vaccine (mrna is more "neutral" information medium that typically exerts less of a chemical change to the delivered product when altered).

In any case this emergent phenomenon will be certainly challenging to the regulatory landscape around vaccination.

disclaimer: I own MRNA stock.

1 comments

But CAN you safely reformulate vaccines to include this new protein and introduce it widely into the population without knowing if this protein's antigen is already present in the body and might cause severe side effects?

I think you can't. It's famously difficult to anticipate off-target effects of any novel antigen target. This can't be tested in-vitro. You have to repeat the full range of clinical trials with each reformulation that targets a new antigen.

> You have to repeat the full range of clinical trials with each reformulation that targets a new antigen.

Are you sure? I don't think we do this with the seasonal flu vaccine in general. It certainly wasn't a consideration in the CDC pandemic flu response fire drill (sequence antigen -> manufactured vaccine in ~2 weeks) that I got a sideline seat on.