EV71抗病毒药物及疫苗研究进展

手足口病(hand-foot and mouth disease,HFMD)作为全球关注的公共卫生疾病,亚洲地区频发,危害不容小觑.其传播途径广、传染性强、易引起并发症,致病株多样且易变异等特点,均为手足口病的治疗与防控带来挑战.肠道病毒71型(human enterovirus 71,EV71)作为手足口病主要的病原...     

抗肠道病毒71型的药物研究进展

肠道病毒71型（Enterovirus 71,EV71）是引起重症手足口病（Hand,Foot and Mouth Disease,HFMD）的主要病原体。重症HFMD进展迅速,可表现为严重的神经系统并发症,甚至危及生命。目前临床上防治EV71感染缺乏特异、高效的药物,其残疾率和死亡率很高。随着研究的深入,已经发现了大量具有抗EV71能力的化合物,人们探索的药物机制和药物靶点各不相同。因此,本文从药物靶向病毒、宿主等角度出发,针对抗EV71感染的天然药物、合成药物及常见中药中活性成分作用机制的最新进展进行综述与讨论。此外,对抗病毒药物筛选技术进行简要概述,以期为抗EV71药物的筛选与研发设计等相关研究提供参考。     

肠道病毒71型及其疫苗的研究进展

肠道病毒71型(Enterovirus71,EV71)是手足口病的主要病原体,是一种具有较强传染性和致病性的病毒,其流行范围波及全世界,近年来在亚太地区尤其是在中国的流行日趋频繁。目前EV71病原学、流行病学以及动物模型的研究均取得了一定进展,为疫苗的研发奠定了相应的基础,中国三家公司的EV71灭活疫苗现已率先获得临床批件,有望成为预防手足口病的有效手段。     

以EV71 3Cpro为靶标的抗病毒药物筛选模型的建立及抗3Cpro化合物筛选

建立一种以EV71 3C蛋白酶为靶标的抗肠病毒药物筛选模型,并应用于小分子化合物库筛选具有抗EV71活性的化合物.从临床手足口病例标本中分离肠道病毒进行PCR鉴定及基因组测序.通过插入突变在黄色荧光YFP编码框合适位点处引入EV71 3C酶切位点,构建对3C蛋白酶敏感的报告质粒pc DNA3-m YFP,然后将其与表达3C的质粒共转293A细胞,在3C抑制剂Rupintrivir存在与否的情况下通过荧光显微镜和酶标仪检测Ex(500nm)/Em(535nm)荧光信号的变化,判断建模是否成功;利用建好的筛选模型在高通量药物筛选平台对小分子化合物库进行初筛和复筛;再利用空斑分析检测筛选出的活性化合物是否对临床分离的EV71毒株具有抑制作用.m YFP在293A细胞中表达良好,3C的表达使荧光信号下降80%,Rupintrivir的存在则几乎不影响荧光表达,说明以3C为靶位的筛选模型构建成功.经过高通量初筛和复筛从26 000多种小分子化合物中获得26种能够显著回复m YFP表达的活性化合物;空斑分析显示其中2种化合物具有较为明显的抑制EV71复制的活性.因此,我们所构建的3C-m YFP共表达系统是一种简便有效的、可用于高通量筛选抗EV71 3C~(pro)药物的筛选模型.     

肠道病毒EV71疫苗效力国家参考品的协作标定

目的建立肠道病毒71型(Enterovirus 71,EV71)疫苗效力参考品,用于EV71疫苗效力的小鼠ED50检测质量控制。方法选取经Ⅲ期临床试验验证具有良好保护效果的一批EV71疫苗作为候选参考品,采用EV71小鼠ED50检测方法,对候选参考品进行效力的协作标定及适用性研究。结果候选参考品在各实验室的ED50均值分别为9.5~51.0 U,CV为3.8%~18.7%;5个实验室总均值为23.5 U,CV为60.9%。各实验室检测结果均符合正态分布;3个EV71灭活疫苗与参考品均表现出了良好的剂量效应关系,中和抗体阳转率均随疫苗稀释度的增加而降低,下降曲线形态相近。当以候选参考品为标准,3个灭活疫苗的体内效价比均值分别为2.7倍、0.8倍和0.9倍;CV分别为5.5%、27.5%和11.2%。结论建立的EV71疫苗效力国家参考品(320 U/0.5 m L),可用于EV71疫苗效力的小鼠ED_(50)检测质量控制。     

肠道病毒71型的研究进展

肠道病毒71型(enterovirus71,EV71)是小RNA病毒科(Picornaviridae)肠道病毒属(Enterovirus)成员,其感染主要引起患者手足口病(hand-foot-and-mouth disease,HFMD).通常情况下,EV71感染引起的HFMD在临床症状等方面与柯萨奇病毒A16(Coxsackie A16,CA16)引起的手足口病难以区别,但EV71感染除了引起HFMD以外,还能够引起无菌性脑膜炎(aseptic meningitis)、脑干脑炎(brainstem encephalitis)和脊髓灰质炎样的麻痹(poliomyelitis-like paralysis)等多种与神经系统相关的疾病[1].自1974年首次报道[2]以来,EV71已在世界范围内引起十多次爆发与流行[3-6].近年来,EV71病毒的流行在亚太地区呈上升趋势[7-9].根据病毒衣壳蛋白VP1核苷酸序列的差异,可将EV71分为A、B、C 3个基因型,其中,B型和C型又进一步分为B1、B2、B3、B4以及C1和C2亚型[10-12].     

肠道病毒71型疫苗质量控制研究进展

手足口病(Hand foot and mouth disease,HFMD)已成为西太平洋区严重的公共卫生问题之一,肠道病毒71型(Enterovirus 71,EV71)是引起HFMD的主要病原体,研发疫苗是控制HFMD流行的有效手段。目前世界范围已有5个EV71全病毒灭活疫苗进入临床试验,其中中国研制的3种EV71疫苗已分别完成III期临床试验,结果表明3种疫苗都具有良好的安全性和保护效果。在EV71疫苗研发中,抗原质控的方法和标准是研发的瓶颈,其中抗原活性测定是工序工艺优化、免疫原性评价和剂量确定的关键指标。综述了EV71疫苗抗原质控的研究进展。     

肠道病毒71型研究进展

肠道病毒71型是一种具有较强致病性的肠道病毒,主要引起患者手足口病(Hand,foot and mouth disease,HFMD)。已在世界多个地区爆发和流行,主要症状是手、足、口、臀等部位皮疹或疱疹,少数患儿可以并发无菌性脑膜炎、脑炎、急性弛缓性麻痹等严重神经系统并发症,呼吸道感染和心肌炎等,可致残、致死。2007—2008年中国多个地区均有较大规模流行,危害十分严重。近四十年的多次流行中,EV71病毒的基因不断进化,研究其基因变化特点对早期诊断、分型以及了解基因与流行、致病的关系等有着重要的意义。对EV71感染尚缺乏有效的抗病毒药物,研制有效的预防性疫苗迫在眉睫,目前有灭活疫苗、减毒疫苗、多肽或蛋白疫苗、DNA疫苗等多种尝试,但至今尚无EV71疫苗上市。本文对EV71基因、实验室诊断和疫苗方面的研究进展进行了综述。     

EV-A71感染导致的重症手足口病的机制及防控研究进展

手足口病(Hand,foot and mouth disease,HFMD)是一种具有高度传染性的病毒性传染病,通常夏秋季高发于幼儿和儿童;若患儿并发呼吸和循环功能障碍、神经系统受累等临床症状称为重症HFMD。少数重症病例可出现肺水肿、脑炎和急性弛缓性麻痹等罕见的神经或循环系统并发症,甚至导致患儿死亡。引起HFMD最常见的病原是肠道病毒A71型(EV-A71)和柯萨奇病毒A16型(CV-A16),而EV-A71是引起重症HFMD的主要病原体。EV-A71导致的重症HFMD已成为全球重要的公共卫生问题,减少EV-A71流行范围和预防EV-A71重症HFMD非常重要。EV-A71疫苗是目前最有效的预防重症HFMD发生的措施;中国已经批准了三个厂家的灭活EV-A71疫苗上市并已开展适龄儿童接种,以期预防EV-A71感染引起的重症HFMD,但这种疫苗不能预防其它肠道病毒如CV-A16,CV-A6和CV-A10等引起的HFMD。据文献报道,小分子抑制剂芦平曲韦可以通过阻止EV-A71的3C pro蛋白活性来抑制EV-A71复制;小干扰RNA和单克隆抗体也可抑制EV-A71复制。研制EV-A71和CVA16双价灭活疫苗是防控HFMD的策略之一,而小分子抑制剂、小干扰RNA和单克隆抗体的研制和应用等也是临床防治HFMD的探索。     

肠道病毒71型感染机制研究进展

重症手足口病及其死亡病例多由肠道病毒71型(Enterovirus A71,EV-A71)感染引起,且近年来在亚太地区广泛流行。由于EV-A71具有严格的宿主细胞寄生性,需依赖细胞的能量和代谢系统完成其复制过程。因此研究该病毒在进入、脱衣壳等感染早期过程中病毒与宿主相互作用的机制,不仅有助于理解其致病机理,同时可为建立相应预防和治疗的策略提供科学依据。为此,就EV-A71感染早期的致病机制的研究进展进行了综述。     

肠道病毒71型基因组中小干扰RNA的靶位点预测

肠道病毒71型（EV71）已经在世界范围内有过十多次大的爆发与流行,近年来EV71病毒的流行在亚洲逐渐呈上升的趋势,但是目前尚无有效的治疗措施,因此迫切需要一种治疗EV71的有效药物。本文采用生物信息学的方法,对人类EV71病毒三个不同株型（SHZH03,SHZH98和MS）RNA序列的局域二级结构进行了预测,并从这些病毒株的基因组中分别得到了长度在21～25nt的小干扰RNA靶序列碱基片段。这一结果将有助于治疗EV71药物的开发研究,对预防和控制EV71的爆发和流行也会有重要意义。     

Toll样受体对肠道病毒71型基因组RNA的识别分析

目的分析Toll样受体(TLRs)对肠道病毒71型(EV71)基因组RNA的识别。方法用荧光定量RT-PCR方法检测与EV71基因组RNA作用24、48和72 h后人结肠癌SW620细胞的TLR3、TLR7和白细胞介素-6(IL-6)、IL-8、IL-12 m RNA表达。结果细胞的TLR3、TLR7 m RNA和IL-6、IL-12 m RNA在作用72 h后表达增加,IL-8 m RNA各时间点表达无变化。结论 TLR3、TLR7可与EV71基因组RNA识别,并诱导细胞因子IL-6、IL-12活化表达。     

肠道病毒71型分子生物学研究进展

肠道病毒7l 型( EV71) 是导致手足口病的主要病原体之一, 常引起多种与神经系统相关的严重疾病。自1969 年首次分离以来, 其感染已在世界范围内引起数次暴发与流行, 尤其是近几年在亚太地区呈上升趋势, 且出现越来越严重的神经系统症状。目前, 对于EV71 病毒结构及其所致严重神经系统症状的机制, 以及疫苗的开发等已进行了大量和深入的研究。     

Engineering a novel IgG-like bispecific antibody against enterovirus A71

Frequent outbreaks of enterovirus A71 (EVA71) occur in the Asia-Pacific area, and these are closely associated with severe neurological symptoms in young children. No effective antiviral therapy is currently available for the treatment of EVA71 infection. The development of monoclonal antibodies (mAbs) has demonstrated promise as a novel therapy for the prevention and treatment of infectious diseases. Several medical conditions have been treated using bispecific or multi-specific antibodies that recognize two or more distinct epitopes simultaneously. However, bispecific or multi-specific antibodies often encounter protein expression and product stability problems. In this study, we developed an IgG-like bispecific antibody (E18-F1) comprising two anti-EVA71 antibodies: E18 mAb and llama-derived F1 single-domain antibody. E18-F1 was demonstrated to exhibit superior binding affinity and antiviral activity compared with E18 or F1. Additionally, E18-F1 not only improved survival rate, but also reduced clinical signs in human SCARB2 receptor (hSCARB2) transgenic mice challenged with a lethal dose of EVA71. Altogether, our results reveal that E18-F1 is a simple format bispecific antibody with promising antiviral activity for EVA71.     

Mutations at KFRDI and VGK domains of enterovirus 71 3C protease affect its RNA binding and proteolytic activities

The 3C proteases (3C^pro) of enterovirus 71 (EV71) is a good molecular target for drug discovery. Notably, this protease was found to possess RNA-binding activity. The regions responsible for RNA binding were classified as KFRDI (positions 82–86) and VGK (positions 154–156) in 3C^pro by mutagenesis study. Although the RNA-binding regions are structurally distinct from the catalytic site of EV71 3C^pro, mutations in the RNA-binding regions influenced 3C^pro proteolytic activity. In contrast, mutations at the catalytic site had almost no influence on RNA binding ability. We identified certain mutations within 3C^pro which abrogated both the RNA-binding activity of the expressed, recombinant, protease and the ability to rescue virus from an infectious full-length clone of EV71 (pEV71). Interestingly, mutation at position 84 from Arg(R) to Lys(K) was found to retain good RNA binding and proteolytic activity for the recombinant 3C^pro; however, no virus could be rescued when pEV71 with the R84K mutation was introduced into the infectious copy. Together, these results may provide useful information for using 3C^pro as the molecular target to develop anti-EV71 agents.The second and the third authors contributed equally to this work.     

Development of a sandwich ELISA for the quantification of enterovirus 71

Since 2008, enterovirus 71 (EV71) has been responsible for high-mortality seasonal epidemics of hand, foot and mouth disease in China. Currently many groups in the world are in the process of developing EV71 vaccines to combat this deadly disease. We have developed three EV71-specific monoclonal antibodies, and in this study we report the establishment of a fast and cost-effective sandwich ELISA kit for measurement of virus concentration in EV71 vaccines using a pair of mouse anti-EV71 monoclonal antibodies. The system is specific for EV71 virus, with no cross-reactivity to coxsackievirus A16, H1N1, rabies, and hepatitis A. Using a reference EV71 vaccine standard, the sensitivity of the assay kit was determined to be 0.82 U/ml, with a linear range between 3.75 and 120 U/ml.     

Recent developments in antiviral agents against enterovirus 71 infection

Enterovirus 71 (EV-71) is the main etiological agent of hand, foot and mouth disease (HFMD). Recent EV-71 outbreaks in Asia-Pacific were not limited to mild HFMD, but were associated with severe neurological complications such as aseptic meningitis and brainstem encephalitis, which may lead to cardiopulmonary failure and death. The absence of licensed therapeutics for clinical use has intensified research into anti-EV-71 development. This review highlights the potential antiviral agents targeting EV-71 attachment, entry, uncoating, translation, polyprotein processing, virus-induced formation of membranous RNA replication complexes, and RNA-dependent RNA polymerase. The strategies for antiviral development include target-based synthetic compounds, anti-rhinovirus and poliovirus libraries screening, and natural compound libraries screening. Growing knowledge of the EV-71 life cycle will lead to successful development of antivirals. The continued effort to develop antiviral agents for treatment is crucial in the absence of a vaccine. The coupling of antivirals with an effective vaccine will accelerate eradication of the disease.