INTRODUCTION
Since the summer of 2012, a novel coronavirus, Middle East respiratory syndrome coronavirus (MERS-CoV), has emerged from the Middle East and spread to parts of Europe. MERS-CoV infection often leads to acute pneumonia and renal failure, and the human fatality rate is more than 50% (
1,
2). To date, MERS-CoV has infected at least 77 people and was able to be transmitted from human to human. The genomic sequence of MERS-CoV is closely related to the sequences of certain bat coronaviruses (
3–5), raising concerns over persistent bat-to-human cross-species transmission of the virus. The clinical signs and epidemic patterns of MERS-CoV are reminiscent of the severe acute respiratory syndrome coronavirus (SARS-CoV), the etiological agent of the worldwide SARS epidemic in 2002-2003 that infected more than 8,000 people with a ∼10% fatality rate (
6,
7). MERS-CoV poses a significant threat to global health and economy.
Coronaviruses are enveloped and positive-stranded RNA viruses and can be divided into three major genera, α, β, and γ (
8). They mainly cause respiratory, gastrointestinal, and central nervous system diseases in mammals and birds. Coronaviruses recognize a variety of host receptors. Human NL63 respiratory coronavirus (HCoV-NL63) from α-genus and SARS-CoV from β-genus both recognize angiotensin-converting enzyme 2 (ACE2) as their host receptor (
9,
10). Porcine respiratory coronavirus (PRCV) and some other coronaviruses from α-genus recognize aminopeptidase N (APN) (
11,
12). Mouse hepatitis coronavirus (MHV) from β-genus recognizes carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) (
13,
14), although certain MHV strains also recognize heparan sulfate (
15,
16). Some coronaviruses from each of the three genera recognize sugars (
17–20). MERS-CoV belongs to the β-genus and uses human dipeptidyl peptidase 4 (DPP4) as its host receptor (
21). Receptor recognition is a major determinant of coronavirus host range and tropism.
An envelope-anchored trimeric spike protein is responsible for coronavirus entry into host cells via binding to the host receptor and subsequently fusing viral and host membranes (
22). The spike protein consists of a receptor-binding S1 subunit and a membrane fusion S2 subunit. The S1 subunit contains two independent domains, an N-terminal domain (NTD) and a C-domain, both of which can potentially function as receptor-binding domains (RBD) (
Fig. 1A) (
23). Specifically, coronavirus S1 C-domains can function as ACE2-, APN-, or heparan sulfate-binding RBDs, whereas S1 NTDs can function as CEACAM1- or sugar-binding RBDs. To date, crystal structures have been determined for a number of coronavirus RBDs by themselves or in complex with their host receptors, revealing how coronaviruses have evolved to recognize host receptors and thereby traffic between different species (
24–28). It is not known which one of MERS-CoV S1 domains is the DPP4-binding RBD or how the tertiary structure of MERS-CoV RBD fits into the landscape of coronavirus evolution.
Here we have identified the MERS-CoV S1 C-domain as the RBD, characterized its interaction with human DPP4, and determined its crystal structure. This study provides structural insights into the evolution and receptor recognition of MERS-CoV. The identified MERS-CoV RBD also has therapeutic implications.
ADDENDUM
During the submission and review of the present study, two other studies independently mapped the MERS-CoV RBD fragments (residues 358 to 588 and 377 to 662), both of which are similar to the one identified in the present study (residues 367 to 588) (
42,
43). These studies also showed that the RBD efficiently elicits neutralizing antibodies, confirming that the crystal structure of MERS-CoV can be useful in structure-based vaccine design.
In addition, two other studies independently determined the crystal structure of MERS-CoV RBD (residues 367 to 606) complexed with human DPP4 (
44,
45). These studies delineated the molecular interactions between the MERS-CoV RBD and its receptor and confirmed that the accessory subdomain in the MERS-CoV RBD is the DPP4-binding RBM. The structures of the MERS-CoV RBD as determined in these studies are a good match with the structure reported in the present study (e.g., MERS-CoV RBD in PDB 4KR0 can be superimposed onto the current structure with a root mean square deviation [RMSD] of 0.82 Å). Although these recently published studies are in general agreement with the present study, this study is unique in that it focuses on (i) the evolution of MERS-CoV and other coronavirus RBDs and (ii) the therapeutic implications of MERS-CoV RBD. Both of these issues are critical for understanding and controlling MERS-CoV.