诺如病毒的致病机制及诊断

诺如病毒(Norovirus, NoV)是引起全人群急性胃肠炎暴发和流行的主要病原体,也是引起食源性疾病的最常见非细菌性病原体。由于缺少有效的小型动物及培养细胞研究模型,目前对NoV感染的致病机制尚不清楚。NoV实验室诊断技术发展成熟,尤其是近年来新技术的应用将进一步推动其诊断水平的提高,满足公共卫生和临床诊疗的新需求。     

急性胃肠炎暴发中GI.5[P4]型诺如病毒的遗传进化分析

近年来,南京市急性胃肠炎暴发呈上升趋势,主要是由GII型诺如病毒(norovirus,NoV)引起,GI型较为少见。本研究通过对南京市输入性病例和本地性暴发急性胃肠炎疫情中GI.5[P4]型NoV进行遗传进化分析,为本地疫情控制和处置提供科学依据。对两起暴发疫情采集的18份样本进行荧光定量RT-PCR检测,并对NoV阳性样本部分聚合酶区和衣壳蛋白区进行一步法RT-PCR扩增、测序,结合参考株进行序列比对和进化树分析。18份样本中,GI型NoV阳性5份,其中4份扩增出条带,其N/S区域序列与2016-2018年已公布的GI.5[P4]同源性高达99.0%以上。其部分聚合酶区同1987年之后检出的GI.P4进化距离较近,变异不大。部分衣壳蛋白区在2003-2013年发生较为明显的进化,形成新的簇,期间在2008年又继续进化,慢慢趋于稳定。这是南京市首次在输入性病例和本地暴发疫情中均检出同源性极高的GI.5[P4],该NoV虽然在聚合酶区和衣壳蛋白区并没有发生较大进化,但是通过重组已在亚洲地区人群特别是中国多个城市导致了急性胃肠炎流行。因此,该型病毒株将是本市今后监测的重点。     

急性胃肠炎暴发中GⅠ.5[P4]型诺如病毒的遗传进化分析

近年来,南京市急性胃肠炎暴发呈上升趋势,主要是由GⅡ型诺如病毒(norovirus,NoV)引起,GⅠ型较为少见.本研究通过对南京市输入性病例和本地性暴发急性胃肠炎疫情中GⅠ.5[P4]型NoV进行遗传进化分析,为本地疫情控制和处置提供科学依据.对两起暴发疫情采集的18份样本进行荧光定量RT-PCR检测,并对NoV阳性样本部分聚合酶区和衣壳蛋白区进行一步法RT-PCR扩增、测序,结合参考株进行序列比对和进化树分析.18份样本中,GⅠ型NoV阳性5份,其中4份扩增出条带,其N/S区域序列与2016-2018年已公布的GⅠ.5[P4]同源性高达99.0％以上.其部分聚合酶区同1987年之后检出的GⅠ.P4进化距离较近,变异不大.部分衣壳蛋白区在2003-2013年发生较为明显的进化,形成新的簇,期间在2008年又继续进化,慢慢趋于稳定.这是南京市首次在输入性病例和本地暴发疫情中均检出同源性极高的GⅠ.5[P4],该NoV虽然在聚合酶区和衣壳蛋白区并没有发生较大进化,但是通过重组已在亚洲地区人群特别是中国多个城市导致了急性胃肠炎流行.因此,该型病毒株将是本市今后监测的重点.     

GⅡ.17型诺如病毒样颗粒的制备及鉴定

[背景]诺如病毒(Norovirus,NoV)是引发全球人类急性胃肠炎的主要食源性致病原,具有广泛的遗传多样性,其中GⅡ.17型是亚洲地区的优势流行株,危害最为严重.研究表明,通过基因工程技术制备的诺如病毒样颗粒(virus-like particle,VLP)具有良好的免疫保护作用,是目前NoV疫苗研发的主要思路.[...     

诺如病毒疫苗研究概况

诺如病毒（norovirus,NoV）是引发急性胃肠炎疾病的主要病原体之一。NoV易发生突变产生多种毒株,对人类健康造成严重威胁。由于缺乏成功的动物模型,抗NoV药物和疫苗的后续评价受到了限制,目前尚没有上市的疫苗用于NoV的预防。对NoV疫苗的研究进展进行了综述,重点阐述了病毒样颗粒（virus like particles,VLP）疫苗、病毒载体疫苗和基于P颗粒疫苗的研究现状和发展前景,以期为NoV疫苗的研发提供新思路。     

环境污水中诺如、轮状、星状病毒的检测和分子流行病学研究

为分析城市污水中诺如病毒(Norovirus,NoV)、轮状病毒(Rotavirus,RV)、人类星状病毒(Human Astrovirus,HAstV)的分子流行病学特征,探索环境监测技术在病毒性胃肠炎疾病防控中的作用,本研究在山东省3个城市建立环境污水监测点,从7份分别采自2009~2015年的污水标本中提取RNA,通过逆转录-聚合酶链反应扩增其中的NoV、RV、HAstV的核酸片段,扩增产物通过TA克隆后转化大肠杆菌JM109并进行序列测定,根据获得的序列分析其型别构成和系统发生特征。共检测出特异性序列210条,分属于6个NoV I基因型、4个NoV II、3个RV G基因型、3个RV P基因型和4个HAstV血清型。GI.2、GII.4、G9、P[8]和HAstV-1是各病毒检测中最常见的基因型。系统发生分析显示GI.3、GI.6、GII.4、G9、P[8]、HAstV-1和HAstV-4基因型内又分为多个传播链。研究结果表明生活污水中含有多种多样的胃肠炎病毒信息,环境监测是监测病毒区域性流行的重要途径之一。     

基于生活污水监测的诺如病毒分子流行病学研究

为了解生活污水中诺如病毒(Norovirus,NoV)检出情况、基因型分布和分子流行病学特征,进一步探索环境监测技术用于研究病毒性胃肠炎病原区域性流行的必要性,本研究于2016年1～12月在山东省济南和临沂两地采集生活污水,通过阴离子膜吸附洗脱法对收集到的24份污水样品进行浓缩后,提取核酸,经过逆转录-聚合酶链反应扩增NoV VP1基因片段,经TA克隆后测序,进行分型和系统进化树分析。结果显示,监测地区生活污水标本中GⅠ的检出率为100%,GⅡ为95.8%。共获得412条NoV序列,分别属于6个GⅠ基因型和8个GⅡ基因型,其中GⅠ.6(32.3%,133/412)、GⅡ.3(14.1%,58/412)和GⅡ.17(25.7%,106/412)检出数量最多。GⅡ.17检出序列均属于Kawasaki 308变异株,而前些年大流行的GⅡ.4的检出序列占比仅1.0%,属于Sydney 2012变异株。本研究描述了2016年山东省本地流行的诺如病毒基因型分布和序列特征,证明了可以通过对城市污水进行监测来探索人群中循环的诺如病毒的遗传多样性。     

食源性诺如病毒在果蔬农产品中的污染及检测研究

本文综述了食源性致病微生物-诺如病毒(Norovirus,NoV)在果蔬农产品中的来源和分布、在果蔬农产品中的富集情况、与果蔬农产品相关的食源性NoV暴发情况以及在农产品中的检测方法等内容。近30年来,与农产品相关的食源性NoV暴发数目持续增长。这主要与NoV的传播特性(强传染性、低感染剂量和对环境的较强抗性)以及近15年食品中NoV检测方法的显著发展有关。生鲜农产品作为高风险的食品,通常不经烹饪直接生食,在供应链中不同环节都容易被污染,如人类粪便污染的灌溉用水、肥料、食物处理用水、食物处理者的不卫生操作、交叉污染等。NoV在果蔬农产品中的结合主要与病毒颗粒的理化性质及农产品对NoV的吸附和可能的内在化途径有关。根据欧美国家与果蔬农产品有关的食源性NoV暴发的最新数据统计分析,在欧洲大规模食源性暴发主要由被NoV污染的覆盆子和生菜导致,在美国主要由被NoV污染的生菜导致。在国内,由于尚无农产品中食源性NoV检测的相关研究,缺乏与农产品相关NoV暴发的相关数据,因此无法对国内农产品中NoV的污染情况进行具体分析。农产品中NoV具有含量低且分布不均匀的特点,针对不同样品,需要采用合理的采样方法、病毒核糖核酸(Ribonucleic acid,RNA)提取方法以及实时荧光定量PCR(Real-time quantitative polymerase chain reaction,RT-qPCR)方法对其进行检测。根据NoV外壳蛋白的物化特性,高pH值和高离子强度的洗脱溶液(如碱性甘氨酸缓冲液等)可提高NoV的回收率;对于酸性水果中的病毒洗脱,加入三羟甲基氨基甲烷-盐酸(Tris(hydroxymethyl)aminomethane-HCl,Tris-HCl)可以提高回收率;莓果类中含有的果胶,可在中性条件下用果胶酶去除。本文还论述了食品中食源性NoV检测的国际标准ISO/TS 15216:2013、果蔬农产品中NoV检测方法的汇总以及检测NoV的最新方法(原位杂交RT-qPCR方法),为开展农产品中NoV检测的研究提供部分参考,从而建立和发展农产品中NoV的检测方法,针对不同果蔬产品对NoV的吸附特性,配套相应NoV的提取方法,建立多种农产品中NoV常规分子检测方法,以利于对农产品安全的源头监控。     

抗GⅡ.3型诺如病毒阻断型单克隆抗体的制备和鉴定

诺如病毒(norovirus,NoV)是引起非细菌性急性肠胃炎的主要病原体之一。目前国内外还没有关于抗GⅡ.3NoV组织血型抗原(histo-blood group antigens,HBGAs)阻断型单克隆抗体(monoclonal antibody,mAb)的报道,本研究制备了抗GⅡ.3型NoV HBGA阻断型mAbs,并对这些抗体特性进行了初步的鉴定。采用纯化的GⅡ.3型(GenBank登录号:KY767665)NoV病毒样颗粒(virus-like particles,VLPs)免疫BALB/c小鼠。将GⅡ.3,GⅡ.4(GenBank登录号,KF306214),GⅡ.3S/GⅡ.6P,GⅡ.6S/GⅡ.3P,GⅡ.4-VP1/GⅡ.3-P2主要衣壳蛋白(VP1)抗原或嵌合抗原作为包被抗原采用间接ELISA方法分别对细胞克隆株进行筛选,采用体外HBGA-VLP结合阻断实验对筛选的mAbs进行阻断活性鉴定,利用基于涵盖GⅡ.3突环区(protruding domain,P区)的重叠多肽ELISA和western blot(WB)对阻断抗体结合位点进行特性分析。体外HBGA-VLPs阻断实验显示三株细胞分泌抗体具有阻断活性。挑选目标株制备腹水并对mAbs进行纯化。WB结果显示三株HBGA阻断型mAbs只识别非变性的GⅡ.3 VP1蛋白;基于GⅡ.3 P区重叠多肽的间接ELISA结果显示三株HBGA阻断型mAbs与被检测多肽无结合活性。本研究制备了具有HBGAs阻断活性的GⅡ.3 NoV特异性mAbs,全部只识别非变性的GⅡ.3 VP1蛋白,且结合位点位于GⅡ.3 VP1 P2区。抗GⅡ.3 NoV HBGAs阻断型mAbs的获得为后续研究GⅡ.3 NoV的进化、感染机制和HBGAs结合位点提供了原材料。     

诺如病毒和肠道菌群的互作关系及机制研究进展

诺如病毒(Norovirus,NoV)是全球流行性、非细菌性胃肠炎暴发的主要原因之一.研究表明,肠道菌群能与诺如病毒互作并调控其在肠道中的感染和复制过程,但关于两者之间的互作关系及机制研究目前还处于初步探索阶段.本文通过综述国内外最新研究,系统全面地阐述了肠道菌群通过稳定病毒结构、增强病毒与靶细胞的结合,调节宿主先天免疫应答等多种途径促进诺如病毒感染的作用和可能机制,对于更进一步了解和研究诺如病毒感染和发病机制提供新思路和视角.     

High-pressure inactivation of human norovirus virus-like particles provides evidence that the capsid of human norovirus is highly pressure resistant

Human norovirus (NoV) is the leading cause of nonbacterial acute gastroenteritis epidemics worldwide. High-pressure processing (HPP) has been considered a promising nonthermal processing technology to inactivate food- and waterborne viral pathogens. Due to the lack of an effective cell culture method for human NoV, the effectiveness of HPP in inactivating human NoV remains poorly understood. In this study, we evaluated the effectiveness of HPP in disrupting the capsid of human NoV based on the structural and functional integrity of virus-like particles (VLPs) and histo-blood group antigen (HBGA) receptor binding assays. We found that pressurization at 500 to 600 MPa for 2 min, a pressure level that completely inactivates murine norovirus and feline calicivirus, was not sufficient to disrupt the structure and function of human NoV VLPs, even with a holding time of 60 min. Degradation of VLPs increased commensurate with increasing pressure levels more than increasing time. The times required for complete disruption of human NoV VLPs at 700, 800, and 900 MPa were 45, 15, and 2 min, respectively. Human NoV VLPs were more resistant to HPP in their ability to bind type A than type B and O HBGAs. Additionally, the 23-nm VLPs appeared to be much more stable than the 38-nm VLPs. Taken together, our results demonstrated that the human NoV capsid is highly resistant to HPP. While human NoV VLPs may not be fully representative of viable human NoV, destruction of the VLP capsid is highly suggestive of a typical response for viable human NoV.     

Discovery and genomic characterization of noroviruses from a gastroenteritis outbreak in domestic cats in the US

Norovirus (NoV) RNA was detected in the stools of 6 out 14 (42.8%) 8-12-week-old cats with enteritis from a feline shelter, in New York State. Upon sequence analysis of the complete capsid, the six NoVs were found to be identical, suggesting the spread of a unique NoV strain in the shelter. The full-length genomic sequence (7839 nt) of one feline NoV, CU081210E/2010/US, was determined. In the capsid protein VP1 region, the virus displayed the highest amino acid identity to animal genogroup IV genotype 2 (GIV.2) NoVs: lion/Pistoia-387/06/IT (97.9%) and dog/Bari-170/07/IT (90.4%). These findings document the discovery of a novel feline calicivirus, different from vesiviruses, and extend the spectrum of NoV host range. Epidemiological studies using feline NoV-specific diagnostic tools and experimental infection of cats are required to understand whether NoVs have a pathogenic role in this species.     

Genetic diversity of noroviruses in Brazil

Norovirus (NoV) infections are a major cause of acute gastroenteritis outbreaks around the world. In Brazil, the surveillance system for acute diarrhoea does not include the diagnosis of NoV, precluding the ability to assess its impact on public health. The present study assessed the circulation of NoV genotypes in different Brazilian states by partial nucleotide sequencing analysis of the genomic region coding for the major capsid viral protein. NoV genogroup II genotype 4 (GII.4) was the prevalent (78%) followed by GII.6, GII.7, GII.12, GII.16 and GII.17, demonstrating the great diversity of NoV genotypes circulating in Brazil. Thus, this paper highlights the importance of a virological surveillance system to detect and characterize emerging strains of NoV and their spreading potential.     

Nodamura virus RNA replication in Saccharomyces cerevisiae: heterologous gene expression allows replication-dependent colony formation

Nodamura virus (NoV) and Flock House virus (FHV) are members of the family Nodaviridae. The nodavirus genome is composed of two positive-sense RNA segments: RNA1 encodes the viral RNA-dependent RNA polymerase and RNA2 encodes the capsid protein precursor. A small subgenomic RNA3, which encodes nonstructural proteins B1 and B2, is transcribed from RNA1 during RNA replication. Previously, FHV was shown to replicate both of its genomic RNAs and to transcribe RNA3 in transiently transfected yeast cells. FHV RNAs and their derivatives could also be expressed from plasmids containing RNA polymerase II promoters. Here we show that all of these features can be recapitulated for NoV, the only nodavirus that productively infects mammals. Inducible plasmid-based systems were used to characterize the RNA replication requirements for NoV RNA1 and RNA2 in Saccharomyces cerevisiae. Induced NoV RNA1 replication was robust. Three previously described NoV RNA1 mutants behaved in yeast as they had in mammalian cells. Yeast colonies were selected from cells expressing NoV RNA1, and RNA2 replicons that encoded yeast nutritional markers, from plasmids. Unexpectedly, these NoV RNA replication-dependent yeast colonies were recovered at frequencies 10(4)-fold lower than in the analogous FHV system. Molecular analysis revealed that some of the NoV RNA replication-dependent colonies contained mutations in the NoV B2 open reading frame in the replicating viral RNA. In addition, we found that NoV RNA1 could support limited replication of a deletion derivative of the heterologous FHV RNA2 that expressed the yeast HIS3 selectable marker, resulting in formation of HIS+ colonies.     

Genetic analysis of the capsid gene of genotype GII.2 noroviruses

Noroviruses (NoVs) are considered to be a major cause of acute nonbacterial gastroenteritis in humans. The NoV genus is genetically diverse, and genotype GII.4 has been most commonly identified worldwide in recent years. In this study we analyzed the complete capsid gene of NoV strains belonging to the less prevalent genotype GII.2. We compared a total of 36 complete capsid sequences of GII.2 sequences obtained from the GenBank (n = 5) and from outbreaks or sporadic cases that occurred in The Netherlands (n = 10) and in Osaka City, Japan (n = 21), between 1976 and 2005. Alignment of all capsid sequences did not show fixation of amino acid substitutions over time as an indication for genetic drift. In contrast, when strains previously recognized as recombinants were excluded from the alignment, genetic drift was observed. Substitutions were found at five informative sites (two in the P1 subdomain and three in the P2 subdomain), segregating strains into five genetic groups (1994 to 1997, 1999 to 2000, 2001 to 2003, 2004, and 2005). Only one amino acid position changed consistently between each group (position 345). Homology modeling of the GII.2 capsid protein showed that the five amino acids were located on the surface of the capsid and close to each other at the interface of two monomers. The data suggest that these changes were induced by selective pressure, driving virus evolution. Remarkably, this was observed only for nonrecombinant genomes, suggesting differences in behavior with recombinant strains.     

Identification of monomorphic and divergent haplotypes in the 2006-2007 norovirus GII/4 epidemic population by genomewide tracing of evolutionary history

Our norovirus (NoV) surveillance group reported a >4-fold increase in NoV infection in Japan during the winter of 2006-2007 compared to the previous winter. Because the increase was not linked to changes in the surveillance system, we suspected the emergence of new NoV GII/4 epidemic variants. To obtain information on viral changes, we conducted full-length genomic analysis. Stool specimens from 55 acute gastroenteritis patients of various ages were collected at 11 sites in Japan between May 2006 and January 2007. Direct sequencing of long PCR products revealed 37 GII/4 genome sequences. Phylogenetic study of viral genome and partial sequences showed that the two new GII/4 variants in Europe, termed 2006a and 2006b, initially coexisted as minorities in early 2006 in Japan and that 2006b alone had dominated over the resident GII/4 variants during 2006. A combination of phylogenetic and entropy analyses revealed for the first time the unique amino acid substitutions in all eight proteins of the new epidemic strains. These data and computer-assisted structural study of the NoV capsid protein are compatible with a model of antigenic drift with tuning of the structure and functions of multiple proteins for the global outgrowth of new GII/4 variants. The availability of comprehensive information on genome sequences and unique protein changes of the recent global epidemic variants will allow studies of diagnostic assays, molecular epidemiology, molecular biology, and adaptive changes of NoV in nature.     

Molecular Evolution of GII-4 Norovirus Strains

BACKGROUND: Human Noroviruses (NoV) are the major cause of acute nonbacterial gastroenteritis and the leading cause of outbreaks of gastroenteritis worldwide. Genotype II-4 (GII-4) NoV has been shown to spread rapidly and is the most commonly detected strain worldwide, particularly in association with outbreaks. Previously, we have shown that circulating GII-4 NoV strains exist as populations of selectively neutral variants, and that the emergence of epidemic GII-4 NoV strains correlated with mutations in at least two key sites (Sites A and B) within the P2 domain of the surface exposed major capsid protein (VP1). METHODOLOGY: We developed a rapid pyrosequencing method for screening of the two Sites A and B and a homology based modelling system was used to predict the effects of amino acid substitutions at these sites on the antigenic properties of the virus (defined as surface motif types). PRINCIPLE FINDING/CONCLUSION: Here, we describe the characterisation of amino acid diversity at Sites A and B for 1062 GII-4 NoV strains from clinical specimen associated with outbreak of gastroenteritis (2000-2011) and 250 GII-4 NoV sequences from Genbank. Our data identified a high diversity of different Site A and B site combinations at amino acid level and amino acid diversity was higher at Site B than Site A. Site A motifs could be grouped into 3 clusters based on similar surface motif types. We predict that Site A is a major epitope on the virus surface, responsible for defining the antigenic profile, and a more subtle role for Site B, maintaining minor antigenic variation within the virus population.     

Viral gastroenteritis associated with genogroup II norovirus among U.S. military personnel in Turkey, 2009

The present study demonstrates that multiple NoV genotypes belonging to genogroup II contributed to an acute gastroenteritis outbreak at a US military facility in Turkey that was associated with significant negative operational impact. Norovirus (NoV) is an important pathogen associated with acute gastroenteritis among military populations. We describe the genotypes of NoV outbreak occurred at a United States military facility in Turkey. Stool samples were collected from 37 out of 97 patients presenting to the clinic on base with acute gastroenteritis and evaluated for bacterial and viral pathogens. NoV genogroup II (GII) was identified by RT-PCR in 43% (16/37) stool samples. Phylogenetic analysis of a 260 base pair fragment of the NoV capsid gene from ten stool samples indicated the circulation of multiple and rare genotypes of GII NoV during the outbreak. We detected four GII.8 isolates, three GII.15, two GII.9 and a sole GII.10 NoV. Viral sequences could be grouped into four clusters, three of which have not been previously reported in Turkey. The fact that current NoV outbreak was caused by rare genotypes highlights the importance of norovirus strain typing. While NoV genogroup II is recognized as causative agent of outbreak, circulation of current genotypes has been rarely observed in large number of outbreaks.     

Absolute Humidity Influences the Seasonal Persistence and Infectivity of Human Norovirus

Norovirus (NoV) is one of the main causative agents of acute gastroenteritis worldwide. In temperate climates, outbreaks peak during the winter season. The mechanism by which climatic factors influence the occurrence of NoV outbreaks is unknown. We hypothesized that humidity is linked to NoV seasonality. Human NoV is not cultivatable, so we used cultivatable murine norovirus (MNV) as a surrogate to study its persistence when exposed to various levels of relative humidity (RH) from low (10% RH) to saturated (100% RH) conditions at 9 and 25°C. In addition, we conducted similar experiments with virus-like particles (VLPs) from the predominant GII-4 norovirus and studied changes in binding patterns to A, B, and O group carbohydrates that might reflect capsid alterations. The responses of MNV and VLP to humidity were somewhat similar, with 10 and 100% RH exhibiting a strong conserving effect for both models, whereas 50% RH was detrimental for MNV infectivity and VLP binding capacity. The data analysis suggested that absolute humidity (AH) rather than RH is the critical factor for keeping NoV infectious, with an AH below 0.007 kg water/kg air being favorable to NoV survival. Retrospective surveys of the meteorological data in Paris for the last 14 years showed that AH average values have almost always been below 0.007 kg water/kg air during the winter (i.e., 0.0046 ± 0.0014 kg water/kg air), and this finding supports the fact that low AH provides an ideal condition for NoV persistence and transmission during cold months.