Viruses and amyloids-a vicious liaison

The crosstalk between viral infections, amyloid formation and neurodegeneration has been discussed with varying intensity since the last century. Several viral proteins are known to be amyloidogenic. Post-acute sequalae (PAS) of viral infections is known for several viruses. SARS-CoV-2 and COVID-19 implicate connections between amyloid formation and severe outcomes in the acute infection, PAS and neurodegenerative diseases. Is the amyloid connection causation or just correlation? In this review we highlight several aspects where amyloids and viruses meet. The evolutionary driving forces that dictate protein amyloid formation propensity are different for viruses compared to prokaryotes and eukaryotes, while posttranslational endoproteolysis appears to be a common mechanism leading up to amyloid formation for both viral and human proteins. Not only do human and viral proteins form amyloid irrespective of each other but there are also several examples of co-operativity between amyloids, viruses and the inter-, and intra-host spread of the respective entity. Abnormal blood clotting in severe and long COVID and as a side effect in some vaccine recipients has been connected to amyloid formation of both the human fibrin and the viral Spike-protein. We conclude that there are many intersects between viruses and amyloids and, consequently, amyloid and virus research need to join forces here. We emphasize the need to accelerate development and implementation in clinical practice of antiviral drugs to preclude PAS and downstream neurological damage. There is also an ample need for retake on suitable antigen targets for the further development of next generation of vaccines against the current and coming pandemics.

Automated summary

The interaction between viral infections, amyloid formation, and neurodegeneration has been a topic of discussion for a long time. Viral proteins can form amyloids, and post-acute sequalae (PAS) after viral infections have been observed. SARS-CoV-2 and COVID-19 have shown a connection between amyloid formation and severe outcomes in the acute infection, PAS, and neurodegenerative diseases. Various intersecting aspects of viruses and amyloids are highlighted, including evolutionary driving forces, protein endoproteolysis, and co-operativity between amyloids and viruses. The abnormal blood clotting in severe and long COVID, as well as the side effects of some vaccines, is linked to amyloid formation. Antiviral drug development, implementation, and the identification of suitable antigen targets for future vaccines are emphasized.