The Middle East Respiratory Syndrome

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The Middle East respiratory syndrome coronavirus (MERS-CoV) is a positive-strand RNA virus belonging to the C lineage of the Betacoronavirus genus. Since its identification in 2012 in a patient from Saudi Arabia, there have been seven hundred one laboratory-confirmed cases of MERS-CoV in eight different countries, boasting an alarming thirty-five percent patient fatality rate. Both alphacoronaviruses (alphaCoVs) and betacoronaviruses (betaCoVs) have been known to cause human disease, but a majority of cases only cause common cold-like illnesses in health adults. Some betaCoVs, however, have the ability to cause severe life-threatening pandemics, such as the severe acute respiratory syndrome coronavirus pandemic (SARS-CoV). In 2003, SARS-CoV, a B lineage betaCoV, infected more than eight thousand people worldwide, more than eight hundred of which succumbed to the virus. The important question that needs to be answered to shed some light on its origin as well as potential therapeutic approaches is why are some species susceptible to MERS-CoV infection while others remain resistant? Initiation of viral infections begins with viral particles binding to host surface cellular receptors. It has recently been determined that MERS-CoV infection is initiated by the interaction of MERS-CoV’s spike protein with dipeptidyl peptidase 4 receptor (DPP4; also known as CD26) on the surface of the host cell. The region of the spike protein responsible for the recognition of DPP4 was
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