Discussion: A meta-analysis of published data from 2009 to 2012 showed that there is a statistically significant association between the mutation D222G and severe disease and fatality.
Discussion: A(H1N1)pdm09 viruses with the D222G mutation in HA have a preferential affinity for SA-alpha-2,3 receptors.
Discussion: Also, the D222G mutation was more common than D222N in samples from fatal cases in other studies.
Discussion: An increase in the frequency of D222G/N mutations was found in the lungs compared to the upper parts of the respiratory system (Table 5).
Discussion: Analysis of the presence of major and minor virus variants with the mutations also revealed the coexistence of two mutations D222G and PMID: 33408229
2021
mSphere
Abstract: However, the D222G/N substitution in hemagglutinin (HA) protein was the only amino acid substitution common to multiple patients.
Abstract: Therefore, it is important to investigate influenza A(H1N1)pdm09 virus populations using multiple paired samples from the upper and lower respiratory tract to avoid overlooking potentially important substitutions, especially in patients with severe disease.IMPORTANCE The D222G/N substitution in the hemagglutinin (HA) protein of influenza A(H1N1)pdm09 virus has been reported to be associated with disease severity and mortality in numerous previous studies.
Discussion: Conversely, previous studies have identified that the HA-D222G/N and othe
Laninamivir-Interferon Lambda 1 Combination Treatment Promotes Resistance by Influenza A Virus More Rapidly than Laninamivir Alone.
PMID: 32393488
2020
Antimicrobial agents and chemotherapy
Abstract: Moreover, the E119G NA mutation emerged together with concomitant hemagglutinin (HA) mutations (T197A and D222G), which were selected more rapidly by combination treatment with laninamivir plus IFN-lambda1 (passages 2 and 3, respectively) than by laninamivir alone (passage 10).
Epidemic of influenza A(H1N1)pdm09 analyzed by full genome sequences and the first case of oseltamivir-resistant strain in Myanmar 2017.
Result: We did not find the D222G mutation commonly associated with increased virulence.
Genetic diversity of influenza A viruses circulating in Bulgaria during the 2018-2019 winter season.
PMID: 32459617
2020
Journal of medical microbiology
Discussion: D222G/N polymorphism has been reported in recently circulating viruses and two of the recent Bulgarian viruses (A/Bulgaria/013/2019 and A/Bulgaria/043/2019) carried D222N substitution.
Discussion: A(H1N1)pdm09 HA1 D222G/N/S or Q293H substitutions have been associated with cases of severe disease and fatalities earlier in the pandemic period.
Discussion: The D222G substitution was shown to cause a shift from alpha2,6-sialic acid receptor specificity to mixed alpha2,3/alpha2,6-sialic acid receptor specificity, adduced thereby to facilitate lung infection.
Genetic sequencing of influenza A (H1N1) pdm09 isolates from South India, collected between 2011 and 2015 to detect mutations affecting virulence and resistance to oseltamivir.
PMID: 33154243
2020
Indian journal of medical microbiology
Abstract: Two samples collected from expired patients had D239N (D222G or D225G) mutation in HA.
Amino acid changes in HA and determinants of pathogenicity associated with influenza virus A H1N1pdm09 during the winter seasons 2015-2016 and 2016-2017 in Mexico.
Abstract: We also found the D222 G substitution, which has been associated with a higher tropism towards the lower respiratory tract, and a non-reported insertion of one Ile in NS1 (Ile113).
Severe cases of seasonal influenza in Russia in 2017-2018.
Abstract: This study demonstrated the importance of monitoring D222G/N polymorphism, including detection of minor viral variants with the mutations, in the hemagglutinin gene of A(H1N1)pdm09 for epidemiological surveillance.
Discussion
Discussion: Analysis of the presence of minor variants of the mutations revealed simultaneous presence of the virus variants with D222G and D222N mutations in three of the six cases examined (Table 2).
Discussion: Considering demonstrated genetic stability of the viral isolates after the first passage on MDCK cells, the presence of D222G/N mutations in major proportion in viral isolates obtained after one passage on MDCK cells, as was observed in our study, is indicative of the presence of the mutations in the original specimens, possibly in smaller proportions.
Serial Section Array Scanning Electron Microscopy Analysis of Cells from Lung Autopsy Specimens following Fatal A/H1N1 2009 Pandemic Influenza Virus Infection.
Abstract: A/H1N1/pdm09 harboring the D222G substitution has a receptor-binding preference for alpha-2,3-linked sialic acids expressed on human AECs and infects them in the same way as H5N1 and H7N9 avian IAVs.
Abstract: This was because the majority of A/H1N1/pdm09 in the lung tissue harbored an aspartic acid-to-glycine substitution at position 222 (D222G) of the hemagglutinin protein.
Introduction: Since the first appearance of A/H1N1/pdm09, an amino acid substitution from aspartic acid to glycine at position 222 (D222G) in the HA protein has been identified sporadically
Discussion: A/H1N1/pdm09-D222G proliferated in the lung, and many viral antigens and much viral RNA were detected in AEC-IIs.
IV mutation literature information.
PMID: 
2021
PloS one
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