Egypt is considered the best model site for vaccine trials because the prevalence of HCV infections is high and extreme heterogeneity of HCV found at all levels. The development of an effective vaccine is influenced by many factors like proper folding of structural proteins, the eliciting of a neutralizing immune response and more importantly the viral heterogeneity due to its great role in disease progression therapy. This leads us to study in this research the most mutation prone regions of the virus (E1 and E2) in different isolates of Egyptian patients. Within the infected host a single isolate comprises many millions of both different and closely related sequences called quasispecies that provided a large store of different viral variants that had significant clinical effects helping the virus to escape the immune mechanism (
11). The present work established that the heterogeneity of the quasispecies of our local strains of E1-E2 was high showing up to 15% diversity that might have important consequences during a transmission route depending on the number of transmitted viral RNA copies that might be limited and not representing the true complexity of the sequence diversity of the donor (
12). However, this bottleneck could also be interpreted as selection of the optimal strain in the new host during the earliest infection events (
13).
Accumulation of mutations during viral replication was either silent synonymous that had no effect on the sequence of the viral protein, but sometimes could affect the secondary structure of RNA. The other one was called non-synonymous mutations that caused changes in protein sequence that led to the production of different newly defective viral variants that could be lethal and aggressive (
14,
15). The presented data in this research were interesting in light of analyzing the substitution rates of synonymous and non-synonymous mutations of the HCV E1-E2 local strains as the average number of potential synonymous substitutions in the sequences of the local isolates were 150.7 while those of the potential non-synonymous substitutions were 515 (
Table 2).Thus, the number of non-synonymous mutations exceeded the number of synonymous mutations three times that warns us to the emergence of aggressive variants as these mutations led to the production of defective viral particles in the Egyptian population and could be lethal.
By having the sequencing data from the core gene of HCV genotype 4 of the Egyptian strains that had showed genetic relevance to HCV types 1 (
16), in addition to the high number of the non-synonymous mutations of E1-E2 found in this study, suggests that the evaluation of the genotype 4 could happen in the same patient through multiple mutational ways of type 4 into genotype 1 which is closely related to it. Moreover, this might explain why the majority of the Egyptians, about 70%, did not respond to interferon therapy. In accordance to (
17) who reported that genetic variations of NS5 and E2 proteins of HCV genotype 1 would inhibit the double stranded (ds) RNA–dependent protein kinase that is involved in the cellular antiviral response induced by interferon.
It was reported that N-linked glycans in viral envelope proteins could play a major role in the viral entry, or in modulating the response to treatment (
18,
19). In the present study, all of the 28 Egyptian isolates showed four different glycosylation sites at positions 418, 431, 477 and 534 with the exception of clone OW14 (HM623433) which lacked the glycosylation site at position 431 (
Table 1). Those glycans were found to play an important role in HCV entry and/or protein folding (
20). In this study, two of the glycans (477, 534) were in the HVR2 and in the binding site of CD81 indicating that these regions were major targets for neutralizing antibodies. Furthermore, those glycans on E2 that attached to the binding site of CD81 might reduce the sense of HCV pp (HCV pseudo-particles) to antibody neutralization and consequently reduce the access of CD81 to its E2 binding site (
21). On the other hand, (
22) found that the absence of glycans at positions: 196, 305, 556 or 623 strongly influences the incorporation of HCV glycoproteins into HCVpp (HCV pseudo-particles), suggesting that these glycans are essential for protein folding. This was long-established by our data, as it lacked these glycans, suggesting the effect of their absence in viral entry.
It was found that most of the induced antibodies had no antiviral activity. This was because they either targeted against useless epitopes that had no role in virus entry or they were produced by degraded intracellular proteins released from dying cells (
23). Only “neutralizing antibodies” succeeded in both targeting the exposed epitopes and neutralizing the viral infection by controlling or preventing it (
24). Also, it was known that identification of many CTL epitopes is required especially for the development of a successful immunogenic vaccine.
This work observed six classes of epitopes shown in the results section (
Table 3). The present data showed that the class (HLA-A*0201) exhibits three epitopes (
Table 3), two of them could be utilized as having score more than the prototype 4a. The first one at (aa 340-348) and the second one at (aa 348-356) where 23 clones had mutations of score 29 more than that prototype 4a which is of score 27 indicating decreasing affinity of binding. However, (
25) represented (HLA-A0201) an epitope that was not utilized because it did not have a proteasome cleavage site and had mutations that caused a decrease in the score. Also, two clones of the second class of epitope (HLA-A*26) (aa 371-379) had mutations and a score of 28 more than the prototype 4a and these could be used for synthetic HCV peptides. The fifth class (HLA-B*2705) (aa 455-463) has all the 28 Egyptian isolates had score of 24 higher than the score of prototype 4a (23) with the exception of clone (OW24 of score 25) (
Table 3). These epitopes could be targeted by neutralizing antibodies and could exhibit broad cross-neutralizing activity among all major genotypes of HCV pp (HCV pseudo-particles) entry (
26). Also, these epitopes could have a role in membrane fusion processes and could represent a target for monoclonal antibodies (
27,
28). The present work also showed the sixth class (H2-Kd nonamer) (aa 490-498) where all the 28 Egyptian isolates had score of 24 the same as the score of prototype 4a (
Table 3) and those epitopes are different from that shown before in former report (
25). Those epitopes could be essential for immunoreactivity as the binding site of E2 of CD81 located at aa480–493 and aa544–551 of E2 (
29).
Furthermore, our data showed that the secondary structures of the E1-E2 region of our Egyptian HCV strains are different from former report (
25). They have conformational and folding structure stronger than that of the prototype 4a. These secondary structures in this study might help the HCV polyprotein to undergo a series of cleavages to form functional viral proteins and guide HCV to hide their epitopes from the immune system and this coincides with former studies (
21,
30).
The results of this study demonstrated different spectra of viral strains of HCV E1-E2 isolates showing synonyms and non-synonyms substitutions, finding glycosylation sites and different epitope domains that could be used to produce monoclonal or polyclonal antibodies targeting both linear and conformational epitopes of envelope glycoprotein E2 that have been shown to inhibit cellular binding of HCV-LP (HCV- Leucoplasts), entry of HCVpp (HCV pseudo-particles) and infection of HCVcc (HCV cell culture).
In conclusion, this study is considered as an important research tool for the development of vaccine trials in Egypt and would help in explaining the existing intra-individual variations of patients in response to the existing drugs in the local market.