Improving the evidence base for decision making during a pandemic: the example of 2009 influenza A/H1N1

This article synthesizes and extends discussions held during an international meeting on "Surveillance for Decision Making: The Example of 2009 Pandemic Influenza A/H1N1," held at the Center for Communicable Disease Dynamics (CCDD), Harvard School of Public Health, on June 14 and 15, 2010. The meeting involved local, national, and global health authorities and academics representing 7 countries on 4 continents. We define the needs for surveillance in terms of the key decisions that must be made in response to a pandemic: how large a response to mount and which control measures to implement, for whom, and when. In doing so, we specify the quantitative evidence required to make informed decisions. We then describe the sources of surveillance and other population-based data that can presently--or in the future--form the basis for such evidence, and the interpretive tools needed to process raw surveillance data. We describe other inputs to decision making besides epidemiologic and surveillance data, and we conclude with key lessons of the 2009 pandemic for designing and planning surveillance in the future.     

Nationwide molecular surveillance of pandemic H1N1 influenza A virus genomes: Canada, 2009

Background

In April 2009, a novel triple-reassortant swine influenza A H1N1 virus (“A/H1N1pdm”; also known as SOIV) was detected and spread globally as the first influenza pandemic of the 21^st century. Sequencing has since been conducted at an unprecedented rate globally in order to monitor the diversification of this emergent virus and to track mutations that may affect virus behavior.

Methodology/Principal Findings

By Sanger sequencing, we determined consensus whole-genome sequences for A/H1N1pdm viruses sampled nationwide in Canada over 33 weeks during the 2009 first and second pandemic waves. A total of 235 virus genomes sampled from unique subjects were analyzed, providing insight into the temporal and spatial trajectory of A/H1N1pdm lineages within Canada. Three clades (2, 3, and 7) were identifiable within the first two weeks of A/H1N1pdm appearance, with clades 5 and 6 appearing thereafter; further diversification was not apparent. Only two viral sites displayed evidence of adaptive evolution, located in hemagglutinin (HA) corresponding to D222 in the HA receptor-binding site, and to E374 at HA2-subunit position 47. Among the Canadian sampled viruses, we observed notable genetic diversity (1.47×10⁻³ amino acid substitutions per site) in the gene encoding PB1, particularly within the viral genomic RNA (vRNA)-binding domain (residues 493–757). This genome data set supports the conclusion that A/H1N1pdm is evolving but not excessively relative to other H1N1 influenza A viruses. Entropy analysis was used to investigate whether any mutated A/H1N1pdm protein residues were associated with infection severity; however no virus genotypes were observed to trend with infection severity. One virus that harboured heterozygote coding mutations, including PB2 D567D/G, was attributed to a severe and potentially mixed infection; yet the functional significance of this PB2 mutation remains unknown.

Conclusions/Significance

These findings contribute to enhanced understanding of Influenza A/H1N1pdm viral dynamics.     

超正电荷绿荧光蛋白+36GFP作为核酸载体的细胞穿透性分析

旨在通过原核表达纯化超正电荷绿色荧光蛋白+36GFP,研究其与核酸的结合作用及作为核酸载体的细胞转导功能。将pET+36GFP-HA2质粒转化到大肠杆菌BL21(DE3)菌株中,然后表达纯化+36GFP蛋白。将得到的目的蛋白在特定浓度下分别转导293细胞、HepG2细胞、A549细胞和B16细胞,流式细胞仪检测+36GFP的转导效率;+36GFP蛋白(100 nmol/L)转导A549细胞,激光共聚焦显微镜观察结果;将+36GFP蛋白与质粒DNA按不同比例孵育,凝胶阻滞实验检测+36GFP与DNA的结合能力;激光共聚焦显微镜和流式细胞仪检测+36GFP蛋白携带质粒DNA转导细胞后报告基因的表达。结果显示,+36GFP蛋白具有较高的细胞转导效率,且随浓度升高转导效率增加,呈浓度依赖性。凝胶阻滞实验显示,+36GFP能够与质粒DNA结合,阻滞DNA在凝胶中迁移,且呈现一定的浓度依赖性。+36GFP包裹质粒转导细胞后,可高效携带质粒DNA转导进入细胞,使质粒报告基因得到表达。本研究成功表达纯化了+36GFP蛋白,证实该蛋白具有较高的细胞转导效率,可将外源核酸携带入细胞使外源基因得到表达。     

Relative importance of water, energy, and heterogeneity in determining regional pteridophyte and seed plant richness in China

Environmental variables, such as ambient energy, water availability, and environmental heterogeneity have been frequently proposed to account for species diversity gradients. How taxon-specific functional traits define large-scale richness gradients is a fundamental issue in understanding spatial patterns of species diversity, but has not been well documented. Using a large dataset on the regional flora from China, we examine the contrast spatial patterns and environmental determinants between pteridophytes and seed plants which differ in dispersal capacity and environmental requirements. Pteridophyte richness shows more pronounced spatial variation and stronger environmental associations than seed plant richness. Water availability generally accounts for more spatial variance in species richness of pteridophytes and seed plants than energy and heterogeneity do, especially for pteridophytes which have high dependence on moist and shady environments. Thus, pteridophyte richness is disproportionally affected by water-related variables; this in turn results in a higher proportion of pteridophytes in regional vascular plant floras (pteridophyte proportion) in wet regions. Most of the variance in seed plant richness, pteridophyte richness, and pteridophyte proportion explained by energy is included in variation that water and heterogeneity account for, indicating the redundancy of energy in the study extent. However, heterogeneity is more important for determining seed plant distributions. Pteridophyte and seed plant richness is strongly correlated, even after the environmental effects have been removed, implying functional linkages between them. Our study highlights the importance of incorporating biological traits of different taxonomic groups into the studies of macroecology and global change biology.     

Increased T cell proliferative responses to islet antigens identify clinical responders to anti-CD20 monoclonal antibody (rituximab) therapy in type 1 diabetes

Type 1 diabetes mellitus is believed to be due to the autoimmune destruction of β-cells by T lymphocytes, but a single course of rituximab, a monoclonal anti-CD20 B lymphocyte Ab, can attenuate C-peptide loss over the first year of disease. The effects of B cell depletion on disease-associated T cell responses have not been studied. We compare changes in lymphocyte subsets, T cell proliferative responses to disease-associated target Ags, and C-peptide levels of participants who did (responders) or did not (nonresponders) show signs of β-cell preservation 1 y after rituximab therapy in a placebo-controlled TrialNet trial. Rituximab decreased B lymphocyte levels after four weekly doses of mAb. T cell proliferative responses to diabetes-associated Ags were present at baseline in 75% of anti-CD20- and 82% of placebo-treated subjects and were not different over time. However, in rituximab-treated subjects with significant C-peptide preservation at 6 mo (58%), the proliferative responses to diabetes-associated total (p = 0.032), islet-specific (p = 0.048), and neuronal autoantigens (p = 0.005) increased over the 12-mo observation period. This relationship was not seen in placebo-treated patients. We conclude that in patients with type 1 diabetes mellitus, anti-B cell mAb causes increased proliferative responses to diabetes Ags and attenuated β-cell loss. The way in which these responses affect the disease course remains unknown.     

Upregulation of FIk-1 by bFGF via the ERK pathway is essential for VEGF-mediated promotion of neural stem cell proliferation

Neural stem cells (NSCs) constitute the cellular basis for embryonic brain development and neurogenesis.The processis regulated by NSC niche including neighbor cells such as vascular and glial cells.Since both vascular and glial cellssecrete vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF),we assessed the effect ofVEGF and bFGF on NSC proliferation using nearly homogeneous NSCs that were differentiated from mouse embryonicstem cells.VEGF alone did not have any significant effect.When bFGF was added,however,VEGF stimulated NSCproliferation in a dose-dependent manner,and this stimulation was inhibited by ZM323881,a VEGF receptor (Flk-1)-specific inhibitor.Interestingly,ZM323881 also inhibited cell proliferation in the absence of exogenous VEGF,suggestingthat VEGF autocrine plays a role in the proliferation of NSCs.The stimulatory effect of VEGF on NSC proliferationdepends on bFGF,which is likely due to the fact that expression of Flk-1 was upregulated by bFGF via phosphoryla-tion of ERK1/2.Collectively,this study may provide insight into the mechanisms by which mieroenvironmental nichesignals regulate NSCs.     

HSC的活化、增殖与TGF-β1及其Ⅰ型受体在中晚期纤维化肝组织中的改变及护肝片对其的影响

目的 探讨护肝片对中、晚期纤维化大鼠肝组织肝星状细胞（HSC）的活化与增殖及转化生长因子-β1（TGF-β1）及其工型受体（TβRⅠ）表达的影响。方法 采用12．5％CCh诱导的大鼠肝纤维化模型,自造模之日起,大鼠分组灌胃给药（护肝片921mg·kg^-1）或溶媒,每日一次,直至8或13周末,分别处死动物,取左叶肝组织石蜡包埋,制作组织芯片,免疫组化S-P法检测大鼠肝组织α-平滑肌肌动蛋白（α-SMA）、TGF-β1及TβRⅠ蛋白的表达,并用Meta Morph图像分析系统计数α-SMA阳性细胞数、对TGF-β1。及TβRⅠ蛋白表达量进行定量分析。结果 1．模型复制8周和13周,模型组的肝损伤及其纤维化分级均明显高于正常组（P〈0．01）,护肝片组的肝损伤及其纤维化分级均轻于模型组。2．模型复制8周和13周,模型组活化的HSC（即α-SMA阳性细胞）数量较正常组明显增多、TGF-β1及TβRⅠ蛋白的表达较正常组明显增强（P〈0．01）;3．护肝片显著抑制8、13周纤维化肝组织HSC的活化与增殖和TGF-β1及TβRⅠ蛋白的表达（P〈0．01）。结论 抑制HSC的活化与增殖和TGF-β1及TβRⅠ的表达可能是护肝片抗肝纤维化作用的靶点之一。     

粤紫萁离体再生技术研究

粤紫萁(Osmunda mildei)为新近形成的自然杂交种,其分布区狭窄、种群个体数量少、有性繁殖能力极低。该文以孢子为外植体,以MS、3/4MS、1/2MS和1/4MS为基本培养基,探讨不同生长调节剂对粤紫萁孢子萌发、原叶体增殖和孢子体形成的影响。结果表明:粤紫萁孢子中极少的可育孢子在植物生长调节剂的作用下,能够萌发并发育形成原叶体;原叶体生长及增殖的最适组合为1/2MS+1.0 mg·L^-16-BA+0.05 mg·L^-1 NAA和1/2MS+1.0 mg·L^-16-BA+0.5 mg·L^-1 IBA;在1/4MS基本培养基中,原叶体增殖的同时生长发育完善,形成正常的幼孢子体,形成率达83.49%;孢子体最佳生根配方为MS+0.5 mg·L^-1 IBA;组培苗在河沙∶黄土∶腐殖质=1∶1∶3的栽培基质中成活率在98%以上,且生长旺盛。综上结果,该研究为粤紫萁的人工繁育及其资源保护以及其他濒危蕨类植物的人工保育提供了参考。     

传统中国医药与现代系统生物学研究理论的殊途同归

系统生物学是研究一个生物系统中所有组成成分(基因、mRNA、蛋白质等)的构成与组分之间相互关系的学科,近年来,系统生物学作为后基因组学时代研究的一个重要内容,已广泛深入到生命科学和医药学的各个领域。而作为中国传统医学而言,似乎与之相去甚远,然而当我们对这两个新老学科基础理论进行比较时,我们发现:传统中国医药与现代系统生物学研究理论的殊途同归。有鉴于此,本文论述了系统生物学和中医学的思想起源、相互联系,基于系统生物学的发展、研究思路和方法,阐述了生物学由还原论的研究方法过渡到系统论的研究方法,强调对生命现象从系统和整体的层次进行研究和把握,对传统中医学研究方法的变革起到了推动作用,最后对系统生物学在中医药学未来发展进行了评价。