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Nat Rev Mol Cell Biol . Mechanisms of SARS-CoV-2 entry into cells

tetano

Editor, Senior Moderator
Nat Rev Mol Cell Biol


. 2021 Oct 5.
doi: 10.1038/s41580-021-00418-x. Online ahead of print.
Mechanisms of SARS-CoV-2 entry into cells


Cody B Jackson[SUP] 1 2 [/SUP], Michael Farzan[SUP] 1 [/SUP], Bing Chen[SUP] 3 4 [/SUP], Hyeryun Choe[SUP] 5 [/SUP]



Affiliations

Abstract

The unprecedented public health and economic impact of the COVID-19 pandemic caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been met with an equally unprecedented scientific response. Much of this response has focused, appropriately, on the mechanisms of SARS-CoV-2 entry into host cells, and in particular the binding of the spike (S) protein to its receptor, angiotensin-converting enzyme 2 (ACE2), and subsequent membrane fusion. This Review provides the structural and cellular foundations for understanding the multistep SARS-CoV-2 entry process, including S protein synthesis, S protein structure, conformational transitions necessary for association of the S protein with ACE2, engagement of the receptor-binding domain of the S protein with ACE2, proteolytic activation of the S protein, endocytosis and membrane fusion. We define the roles of furin-like proteases, transmembrane protease, serine 2 (TMPRSS2) and cathepsin L in these processes, and delineate the features of ACE2 orthologues in reservoir animal species and S protein adaptations that facilitate efficient human transmission. We also examine the utility of vaccines, antibodies and other potential therapeutics targeting SARS-CoV-2 entry mechanisms. Finally, we present key outstanding questions associated with this critical process.
 
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