浙江省登革热暴发疫情的病原学和分子生物学研究

2004年浙江省慈溪市发生了由输入病例引起的登革热暴发,共报告病例113例。为查明病因,从分子水平分析流行毒株的生物学特征,对疑似患者血清测定了登革病毒IgM和IgG抗体,并用C6/36和BHK-21细胞分离登革病毒。同时采用RT-PCR方法扩增病毒E基因和NS1基因后又分别进行序列测定,并与不同国家和地区的登革热毒株进行同源性和进化树分析。结果表明,从患者血清中检测到登革病毒IgM和IgG抗体及登革I型病毒核酸;从18份疑似患者血清中分离到10株登革I型病毒;浙江登革I型分离株(ZJ/07/04)与登革I型夏威夷株、广东株和泰国株的E基因氨基酸同源性分别为96.3%、98.8%和99.2%,而与登革Ⅱ、Ⅲ、Ⅳ型毒株相同区域氨基酸同源性分别为68.3%、77.5%和62.8%。基因进化树显示浙江省登革病毒分离株与泰国株亲缘关系最近,在进化树的同一分支上。从病原学、血清学和分子生物学特征上均证实该次疫情的病因为由泰国输入的登革I型病毒。     

登革2型PrM基因的重组病毒对不同型别登革病毒复制的阻断作用

观察登革 2型PrM基因的pSFV重组甲病毒抗该型病毒的作用 ,进一步探讨登革 2型PrM基因的这种重组病毒对其它 3个血清型登革病毒复制的阻断作用 .采用体外转录和电穿孔 ,分别将构建的含正、反义PrM基因的重组质粒DNA和辅助载体DNA转录成RNA ,然后将这两种RNA共转染BHK细胞 ,进而包装成重组病毒颗粒 .再将激活的重组病毒感染细胞 ,分别用不同型病毒进行攻击 .然后通过免疫荧光法 ,观察对登革病毒复制的阻断作用 .结果表明 ,含登革 2型PrM基因的重组病毒不仅可阻断登革 2型病毒的复制 ,同样具有抑制其他 3个型病毒复制的能力 ,且抗登革 1、4型病毒的复制作用强于抗登革 3型病毒的作用 .用 10 3 TCID50 剂量的登革病毒攻击 ,含反义PrM基因的重组病毒可完全阻断登革 1、3、4型病毒的复制 .但含正义PrM基因的重组病毒对登革 3型病毒的复制不能完全阻断 .为探讨登革病毒防治新途径奠定了基础     

Ⅲ型登革病毒在THP-1细胞上的ADE模型建立

登革热(dengue fever,DF)是由Ⅰ、Ⅱ、Ⅲ和Ⅳ型登革病毒(dengue virus,DENV)引起的急性传染病,抗体依赖增强感染(antibody-dependent enhancement,ADE)是自限性的登革热以及危及生命的登革出血热(dengue hemorrhagic fever,DHF)或登革休克综合症(dengue shock syndrome,DSS)等重症的主要原因。采用不同稀释度的Ⅱ型登革病毒prM前膜抗体与分离自云南西双版纳重症病人的Ⅲ型登革病毒复合感染THP-1细胞,通过实时荧光定量PCR发现亚中和浓度prM前膜抗体诱发THP-1细胞液中更高浓度的病毒载量。在THP-1细胞系上的研究可为后续研究登革病毒ADE打下坚实的基础。     

登革病毒流行株的分离鉴定及其毒力位点变异研究

目的:从登革热患者血清中分离登革病毒,鉴定流行株的血清型及其毒力。对其中两分离株E基因进行序列测定,分析其可能的毒力位点变异。方法:采集临床诊断为登革热患者急性期血清91份,接种于C6/36细胞分离病毒,应用间接免疫荧光法鉴定及分型。并通过乳鼠脑内接种和空斑试验,测定分离株的毒力。扩增2株分离株E基因,克隆到pGEM-T载体进行序列测定,分析变异位点。结果:在91份血清中经2~3次传代分离出8株病毒,鉴定为登革1型病毒。在E蛋白影响毒力的3个区段中,两分离株有3处存在变异。结论:推测此次广州地区流行登革热可能由DEN 1型病毒感染引起,流行株的毒力较弱。毒力减弱可能和其基因位点变异有关。     

原型（祖先）森林登革病毒与外溢感染

摘要：登革病毒是蚊源性病原,保持于森林（非人灵长类/森林蚊子）和地方性流行（人类/城市/家周蚊子）循环中。由蚊媒介的人?人的传播在亚洲和美洲是病毒循环的通用方式,而在西非森林循环占优势。登革病毒的地方性流行方式源于森林登革病毒对家周/城市蚊子的适应。在2004?2007年,马来西亚在登革1型流行中分离到1株原型森林登革1型病毒。该病毒与哨猴株间外膜基因序列——核苷酸序列相似性>99%,氨基酸序列相似性99%。在55位点上仅有1个氨基酸差异,猴株是缬氨酸,人株是异白氨酸。病毒能被流行登革病毒1型感染的患者血清中和。该病毒的罕见分离表明来自只限于森林循环的一种有限的外溢感染。估计患者株序列进化率是5.2×10-4取代/位点/年。1965年在尼日利亚从发热患者分离到3株森林病毒,遗传发生树表明不同于地方流行登革病毒并均在森林登革病毒区块内,表明外溢流行。埃及伊蚊在西非森林中表现偏动物倾向,在登革病毒森林扩大循环中的作用有限。     

原型(祖先)森林登革病毒与外溢感染CSCD

登革病毒是蚊源性病原,保持于森林(非人灵长类/森林蚊子)和地方性流行(人类/城市/家周蚊子)循环中。由蚊媒介的人-人的传播在亚洲和美洲是病毒循环的通用方式,而在西非森林循环占优势。登革病毒的地方性流行方式源于森林登革病毒对家周/城市蚊子的适应。在2004-2007年,马来西亚在登革1型流行中分离到1株原型森林登革1型病毒。该病毒与哨猴株间外膜基因序列——核苷酸序列相似性>97%,氨基酸序列相似性99%。在55位点上仅有1个氨基酸差异,猴株是缬氨酸,人株是异白氨酸。病毒能被流行登革病毒1型感染的患者血清中和。该病毒的罕见分离表明来自只限于森林循环的一种有限的外溢感染。估计患者株序列进化率是5.2×10-4取代/位点/年。尼日利亚1965年从发热患者分离到3株森林病毒,遗传发生树表明不同于地方流行登革病毒并均在森林登革病毒区块内,表明外溢流行。埃及伊蚊在西非森林中表现偏动物倾向,在登革病毒森林扩大循环中的作用有限。     

原型(祖先)森林登革病毒与外溢感染

登革病毒是蚊源性病原,保持于森林(非人灵长类/森林蚊子)和地方性流行(人类/城市/家周蚊子)循环中。由蚊媒介的人-人的传播在亚洲和美洲是病毒循环的通用方式,而在西非森林循环占优势。登革病毒的地方性流行方式源于森林登革病毒对家周/城市蚊子的适应。在2004-2007年,马来西亚在登革1型流行中分离到1株原型森林登革1型病毒。该病毒与哨猴株间外膜基因序列——核苷酸序列相似性97%,氨基酸序列相似性99%。在55位点上仅有1个氨基酸差异,猴株是缬氨酸,人株是异白氨酸。病毒能被流行登革病毒1型感染的患者血清中和。该病毒的罕见分离表明来自只限于森林循环的一种有限的外溢感染。估计患者株序列进化率是5.2×10-4取代/位点/年。尼日利亚1965年从发热患者分离到3株森林病毒,遗传发生树表明不同于地方流行登革病毒并均在森林登革病毒区块内,表明外溢流行。埃及伊蚊在西非森林中表现偏动物倾向,在登革病毒森林扩大循环中的作用有限。     

哈尔滨地区发热患者风疹病毒的分离鉴定

目的 为了明确哈尔滨地区风疹病毒（Rubella virus,RV）的流行情况,对2003年上半年采集的部分发热患者血清及血细胞进行筛选、鉴定、比较,进行血清学和病原学研究。同时从风疹病毒IgM抗体阳性患者血中分离病毒,对疑似风疹病毒的分离株进行鉴定。方法 采用酶联免疫吸附试验（ELISA）对159例发热患者血清中的风疹病毒IgM进行测定;采用BHK21细胞培养法对风疹病毒IgM抗体阳性患者血标本进行风疹病毒分离,并用RT—PCR、细胞生长曲线、电镜观察、免疫组化等方法对可疑风疹病毒株进行鉴定。结果 风疹病毒IgM抗体阳性为22例,占13．83％;经RT—PCR、细胞生长曲线、电镜观察、免疫组化等方法初步鉴定从血液标本中获得的病毒分离株是风疹病毒。结论 采用FTISA决对该地区159例发热患者血清风疹病毒IgM进行检测,阳性率为13．83％;获得了1株风疹病毒分离株。     

我国登革2/4型病毒株Pr-M-E基因的双表达质粒构建及在真核细胞中的共表达

将我国登革 2、4型病毒分离株PrM E基因通过RT PCR以病毒RNA为模板扩增我国登革 2型 4 3株和 4型B5株的PrM E基因 .并分别克隆至pGEM TEasy载体 ,然后亚克隆至双顺反子表达质粒的两个多克隆位点 ,获得同时含有登革 2型 4 3株和 4型B5株PrM E基因的双顺反子重组表达质粒pIDME2 4 .在用该重组质粒转染的BHK2 1细胞中 ,不但可检测到PrM E基因的转录产物 ,而且采用间接免疫荧光法还可观察到针对登革 2型 4型病毒的特异荧光 .研究结果表明 ,重组的双顺反子表达质粒在真核细胞中可共表达登革两个血清型PrM E基因 ,为双价登革核酸疫苗的研究奠定基础     

海南岛125株登革病毒的分离与鉴定

1985年9月儋县发生一次由Ⅱ型登革病毒引起的登革热和登革出血热的爆发流行,至1986年10月疫情已由儋县波及本岛十县二市。根据记载,国外登革热流行期间,常伴多个型别登革病毒同时传播。为掌握本岛此次登革热流行时除Ⅱ型病毒外,是否尚有其他型别流行,于1986年1月至10月登革热流行期间,取十县二市278例急性期病人血清,接种C6/36白纹伊蚊细胞系,进行病毒分离,共获得125株病毒。均用抗登革     

Immunodiagnosis of Dengue Virus Infection Using Saliva

Keeping in view the complications and the case fatality associated with dengue virus, several serologic tests have been developed. However, the major drawback of these serologic tests is the need for a venous blood sample obtained by invasive venipuncture. As a noninvasive alternative, saliva provides a body fluid that contains antibodies of diagnostic importance. Hence, the detection of DEN-specific IgM and IgG antibodies in serum and saliva from 80 patients was compared. Salivary IgM antibodies were detected in 100% of the serum IgM-positive samples and in 30% of the serum samples that were negative for IgM antibodies. Salivary IgG antibodies were detected in 93.3% of the serum samples that were positive for anti-dengue IgG antibodies and in none of the serum IgG-negative cases. None of the specimens from the healthy controls showed the presence of IgM or IgG antibodies. The detection of both IgG and IgM antibodies in saliva correlated well with the serum IgG and IgM detection by the ELISA test (r = 0.6322 and r = 0.4227). Detection of salivary IgM antibodies by ELISA showed 100% sensitivity, 70% specificity, 90.9% positive predictive value, and 100% negative predictive value. The detection of IgG in saliva proved to be a promising tool as the sensitivity, specificity, positive predictive value, and negative predictive value were found out to be 93.3%, 100%, 100%, and 83.3%, respectively. Thus, from this study we conclude that the detection of DEN-specific salivary IgG and IgM antibodies are useful markers for dengue infection.     

Reactivity of serum samples from patients with a flavivirus infection measured by immunofluorescence assay and ELISA

Flavivirus infections are a significant public health problem, since several members of the Flaviviridae family are highly pathogenic to humans. Accurate diagnosis and differentiation of the infecting virus is important, especially in areas where many flaviviruses are circulating. In this study we evaluated a newly developed commercially available immunofluorescence assay (IFA) (INDX, Baltimore, MD, USA) for the detection of IgM and IgG antibodies against dengue virus, yellow fever virus, Japanese encephalitis virus and West Nile virus. IFA was compared with standard diagnostic enzyme immunoassays (EIAs) specific for the detection of IgM and IgG antibodies against these viruses. Forty-seven serum samples from patients with a defined flavivirus infection were tested. As controls, serum samples from individuals with antibodies against tick-borne encephalitis virus and hepatitis C virus as well as healthy individuals were included. The results obtained from this study indicate that IFA showed a significantly better discrimination for flavivirus specific IgM antibodies than did the standard IgM specific EIAs (the overall cross-reactivity varied between 4 and 10% by IFA and 30-44% by EIA for the respective viruses). In contrast, the detection of flavivirus specific IgG antibodies showed high cross-reactions in both IFA and EIAs (overall cross-reactivity 16-71 and 62-84%, respectively). This study clearly stated the complexity of flavivirus diagnosis, showing that one cannot rely on one assay or search for one virus only. The flavivirus IFA is a useful tool for the identification of flavivirus infections during the acute stage of disease. In particular, IFA can be an important diagnostic tool for testing samples from travellers who have been accidentally exposed to these viruses.     

Development,Characterization and Application of Monoclonal Antibodies against Brazilian Dengue Virus Isolates

Dengue is the most prevalent human arboviral disease. The morbidity related to dengue infection supports the need for an early, quick and effective diagnostic test. Brazil is a hotspot for dengue, but no serological diagnostic test has been produced using Brazilian dengue virus isolates. This study aims to improve the development of immunodiagnostic methods for dengue virus (DENV) detection through the production and characterization of 22 monoclonal antibodies (mAbs) against Brazilian isolates of DENV-1, -2 and -3. The mAbs include IgG2bκ, IgG2aκ and IgG1κ isotypes, and most were raised against the envelope or the pre-membrane proteins of DENV. When the antibodies were tested against the four DENV serotypes, different reactivity patterns were identified: group-specific, subcomplex specific (DENV-1, -3 and -4 and DENV-2 and -3) and dengue serotype-specific (DENV-2 or -3). Additionally, some mAbs cross-reacted with yellow fever virus (YFV), West Nile virus (WNV) and Saint Louis encephalitis virus (SLEV). None of the mAbs recognized the alphavirus Venezuelan equine encephalitis virus (VEEV). Furthermore, mAbs D3 424/8G, D1 606/A12/B9 and D1 695/12C/2H were used to develop a capture enzyme-linked immunosorbent assay (ELISA) for anti-dengue IgM detection in sera from patients with acute dengue. To our knowledge, these are the first monoclonal antibodies raised against Brazilian DENV isolates, and they may be of special interest in the development of diagnostic assays, as well as for basic research.     

The diagnostic sensitivity of dengue rapid test assays is significantly enhanced by using a combined antigen and antibody testing approach

Background

Serological tests for IgM and IgG are routinely used in clinical laboratories for the rapid diagnosis of dengue and can differentiate between primary and secondary infections. Dengue virus non-structural protein 1 (NS1) has been identified as an early marker for acute dengue, and is typically present between days 1–9 post-onset of illness but following seroconversion it can be difficult to detect in serum.

Aims

To evaluate the performance of a newly developed Panbio® Dengue Early Rapid test for NS1 and determine if it can improve diagnostic sensitivity when used in combination with a commercial IgM/IgG rapid test.

Methodology

The clinical performance of the Dengue Early Rapid was evaluated in a retrospective study in Vietnam with 198 acute laboratory-confirmed positive and 100 negative samples. The performance of the Dengue Early Rapid in combination with the IgM/IgG Rapid test was also evaluated in Malaysia with 263 laboratory-confirmed positive and 30 negative samples.

Key Results

In Vietnam the sensitivity and specificity of the test was 69.2% (95% CI: 62.8% to 75.6%) and 96% (95% CI: 92.2% to 99.8) respectively. In Malaysia the performance was similar with 68.9% sensitivity (95% CI: 61.8% to 76.1%) and 96.7% specificity (95% CI: 82.8% to 99.9%) compared to RT-PCR. Importantly, when the Dengue Early Rapid test was used in combination with the IgM/IgG test the sensitivity increased to 93.0%. When the two tests were compared at each day post-onset of illness there was clear differentiation between the antigen and antibody markers.

Conclusions

This study highlights that using dengue NS1 antigen detection in combination with anti-glycoprotein E IgM and IgG serology can significantly increase the sensitivity of acute dengue diagnosis and extends the possible window of detection to include very early acute samples and enhances the clinical utility of rapid immunochromatographic testing for dengue.     

The performance of the SD BIOLINE Dengue DUO? rapid immunochromatographic test kit for the detection of NS1 antigen,IgM and IgG antibodies during a dengue type 1 epidemic in Jamaica

Background

Dengue is an important mosquito-borne viral infection that affects millions of persons worldwide. Early diagnosis is necessary to effect appropriate management and decrease mortality. Immunochromatographic tests are advantageous in producing dengue test results within 30 min but these results should be sensitive and specific. In this study we evaluated the diagnostic performance of the SD BIOLINE Dengue DUO® rapid immunochromatographic test kit. A panel of 309 dengue and 30 non-dengue single serum samples characterized by using reference enzyme-linked immunosorbent assays (ELISAs) was used. These samples were received in the virology laboratory for routine testing during a dengue type 1 outbreak between October to December, 2012.

Results

The overall diagnostic sensitivities of the SD BIOLINE Dengue DUO® rapid testfor IgM, IgG and NSI were 49.3 % (95 % CI: 41.3-57.4), 39.1 % (95 % CI: 33.3-45.2) and 90 % (95 % CI: 82.1-94.7), respectively. The IgM and IgG detection rates were significantly lower than that of the NSI (p < 0.001). However the combination of the IgM detection with NS1 detection or both NS1 and IgG resulted in a significant (p < 0.001) increase in sensitivity to 97.5 % (95 % CI: 92.9-99.2) and 98.9 % (95 % CI: 96.0-99.7), respectively. These higher sensitivities were achieved without any decrease in specificities.

Conclusions

This study revealed that combining two or more parameters of the SD BIOLINE Dengue DUO® rapid kit significantly improved the sensitivity of diagnosis of dengue virus infection and supports its usefulness in the Jamaican setting.     

Study of interaction between IgG and IgM antibodies against rubella virus by the immunofluorescence method.

In immunoglobulin fractions or after elimination of IgG by absorption the immunofluorescence test for rubella IgM antibodies is more sensitive than in whole serum. Blocking of IgM activity by IgG antibodies was eliminated when the time of incubation of the serum with virus antigen was prolonged. After prolonged incubation higher titres of rubella antibodies were also obtained in the IgM immunoglobulin fractions. Protein A in Staphylococcus aureus suspension effectively absorbs antibodies of IgG class. The IgM antibody titres in absorbed sera of patients infected with rubella were in some cases 2 to 4 times higher than in unabsorbed sera.     

登革病毒2型全长cDNA感染性转录体的构建和鉴定

为构建登革病毒感染性克隆, 针对登革病毒2型基因组全长cDNA的体外转录方法及感染性转录体进行研究。采用长链RT-PCR技术, 扩增DEN2 NGC株全长基因组cDNA, 以之为模板, 用SP6 RNA聚合酶系统制备体外转录RNA转录体, 分别经乳鼠脑内接种及电穿孔转染BHK-21细胞, 观察其感染效应。并从受染鼠脑和病变细胞中提取总RNA, 进行RT-PCR扩增、克隆测序以及电镜观察。结果发现, 从感染鼠脑和细胞中经RT-PCR均可扩增出病毒特异的基因片段, 大小与预期一致; 并从乳鼠脑组织和BHK-21细胞中观察到恢复病毒颗粒。上述结果表明本文成功构建的DEN2 NGC株病毒全长cDNA的体外转录体具有感染性, 乳鼠脑内接种途径与电穿孔转染细胞一样可成为体外转录体感染宿主细胞、获得恢复病毒的方法。