中东呼吸综合征疫苗研究进展

中东呼吸综合征(Middle East respiratory syndrome,MERS)是由中东呼吸综合征冠状病毒(MERS Coronavirus,MERS-CoV)引起的一种呼吸系统疾病。目前该病已经蔓延到全球25个国家,造成1400余人感染,近500人死亡,并有4个国家报道骆驼感染MERS病例。研发相关疫苗成为预防该病非常重要的措施。研究人员在病毒载体、重组蛋白、DNAs、纳米粒子、MERS-CoV重组的基础上进行了大量的候选疫苗开发,其中一些还在实验动物身上进行了效果试验。本文就当前一些候选疫苗研究进展进行总结概括,以期更多人力物力投入到研发安全有效的疫苗当中。     

严重急性呼吸综合征、中东呼吸综合征和2019冠状病毒病治疗研究进展

严重急性呼吸综合征2019(sever acute respiratory syndrome,SARS)、中东呼吸综合征(Middle East respiratory syndrome,MERS)和2019冠状病毒病(corona virus disease 2019,COVID-19)对全世界人民造成了严重的经济损...     

中东呼吸综合征抗病毒治疗研究进展

中东呼吸综合征冠状病毒(MERS-CoV)目前在全球传播至20多个国家,病死率高达35%左右。目前尚无特异有效的临床救治手段,针对MERS-CoV感染的治疗策略的研发和应用是世界范围内迫切需要解决的重要问题。本文针对MERS-CoV感染抗病毒治疗策略从药物治疗(包括临床批准药物、蛋白酶抑制剂、抗病毒肽及核酸类药物)和免疫治疗(包括恢复期血浆治疗和特异性单/多克隆抗体)两方面的研究进展进行综述。     

环介导逆转录等温扩增技术检测中东呼吸综合征冠状病毒基因

建立了基于浊度仪和羟基萘酚蓝(Hydroxy naphthol blue,HNB)颜色变化的简单、快速和灵敏的环介导逆转录等温扩增技术(RT-LAMP)检测方法,应用于中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus,MERS-CoV)的检测。针对MERS-CoV的核衣壳蛋白基因(Nucleocapsid,N)设计6条特异引物,在等温条件下(63℃)进行60min扩增反应。通过实时浊度仪记录扩增曲线和扩增前在反应体系中加入HNB观察颜色变化两种方式进行检测结果判定。本文对不同人类冠状病毒及常见呼吸道病毒进行了特异性验证,对梯度稀释的体外转录MERS-CoV全N基因RNA进行了定量和检测限分析,同时与已发表的实时荧光定量PCR(rRT-PCR)进行比较。结果显示,本研究建立的RT-LAMP方法特异性高,对于每反应管103至106的拷贝数RNA,出峰时间与每反应管N基因RNA拷贝数对数值有稳定的线性关系。基于浊度仪和颜色判定的RT-LAMP检测方法检测限分别为500拷贝和1 000拷贝。因此,该方法有望应用于MERS-CoV感染的快速筛选,具有在基层医疗卫生机构和现场推广和应用的潜力。     

中东呼吸综合征冠状病毒RT-RAA快速检测方法的建立及应用

建立基于重组酶介导的中东呼吸综合征冠状病毒(MERS-CoV)核酸检测方法。本研究设计、合成特异性中东呼吸综合征冠状病毒基因的重组酶介导检测(RAA)引物及探针,制备MERS-CoV假病毒颗粒阳性对照品,通过一系列条件优化建立了MERS-CoV的快速、灵敏、特异的RT-RAA检测方法,分别与荧光定量RT-PCR检测方法做比较,并且采用首例中国MERS-CoV韩国地区输入病例的咽拭子样品、其它类似呼吸道病毒样本以及英国QCMD的MERS-CoV室间质评灭活样本做临床验证。结果显示:建立的RT-RAA方法检测中东呼吸综合征冠状病毒灵敏度为10拷贝,高于本实验室建立的荧光RT-PCR方法灵敏度(100拷贝),且检测时间(4.8～13.6min)大大低于荧光RT-PCR检测时间(90min);用该方法检测中东呼吸综合征冠状假病毒颗粒为阳性,而检测其他8种对照呼吸道病毒均呈阴性;检测临床阳性样本也与实际结果相符。本研究建立的中东呼吸综合征冠状病毒RT-RAA检测方法灵敏、特异、快速,可用于中东呼吸综合征冠状病毒感染的现场快速诊断和流行病学调查。     

中东呼吸综合征冠状病毒假病毒系统的建立及其在中和抗体检测中的应用

目的:为了避免中东呼吸综合征冠状病毒(MERS-CoV)感染与中和试验中操作活病毒带来的生物安全隐患,构建只具有一次感染能力而无复制能力的MERS假病毒,建立MERS假病毒系统,并应用于中和抗体检测。方法:构建含有MERS-CoV S基因的重组质粒pcDNA3.1-MERS-S,与缺失Env基因、含有萤光素酶报告基因的HIV-1骨架质粒pNL4-3.Luc.RE共转染293T细胞,收获含有假病毒的上清;通过Western印迹、细胞感染实验和血清中和试验,确定是否包装出MERS假病毒,及是否能有效应用于细胞感染与中和试验。结果:MERS假病毒pMERS-S培养上清经Western印迹鉴定出相对分子质量为25×103的HIV-1 P24蛋白和相对分子质量为180×103的MERS-CoV S蛋白;与阴性对照假病毒pEnv-相比,pMERS-S能有效感染MERS-CoV敏感细胞系Huh-7,在感染细胞中产生荧光信号,感染细胞的假病毒量与产生的荧光信号呈明显的量效关系;在MERS假病毒中和试验中,pMERS-S能被MERS-CoV中和抗体中和而失去感染力,反映抗体对MERS-CoV的中和活性。结论:建立了不依赖于BSL-3高等级生物安全条件的MERS假病毒系统,并有效应用于中和抗体检测,为MERS-CoV疫苗、药物评价及病毒致病机制研究提供了良好的技术支撑手段。     

表达中东呼吸综合征冠状病毒S蛋白的重组痘苗病毒的构建及免疫效果初步评价

目的:以痘苗病毒天坛株为载体,构建表达中东呼吸综合征冠状病毒(MERS-Co V)S蛋白的重组病毒疫苗,并进行免疫效果评价。方法:通过PCR扩增获得去除跨膜区的S蛋白基因片段SQ,并构建重组痘苗病毒载体质粒p JSC11Lac Z7.5SQ,将重组质粒与痘苗病毒同源重组并单斑纯化获得重组病毒毒株RVVMERS-SQ,重组病毒免疫小鼠后用酶联免疫吸附实验(ELISA)和假病毒微量中和实验检测其诱发的S蛋白体液免疫反应水平。结果:构建了表达MERS-Co V去跨膜区S蛋白的重组病毒RVVMERS-SQ,其免疫小鼠后诱发了强的S蛋白体液免疫反应,血清Ig G抗体滴度为1∶3200,中和抗体滴度达到1∶1000。结论:重组痘苗病毒RVVMERS-SQ可在BALB/c小鼠体内诱发强的免疫反应,为MERS-Co V疫苗的研发提供了实验基础。     

中东呼吸综合征冠状病毒S1蛋白在昆虫细胞中的重组表达及免疫效果评价

目的:利用昆虫杆状病毒表达系统重组表达中东呼吸综合征冠状病毒(MERS-Co V)S1蛋白,并对其免疫效果进行评价。方法:构建含有MERS-Co V S1基因的重组杆状病毒质粒,转染Sf9细胞包装杆状病毒;重组病毒传代3次获得种子病毒,感染Sf9细胞,收获感染上清,通过镍离子亲和层析纯化获得S1重组蛋白;用纯化的S1蛋白免疫BALB/c小鼠,采用ELISA检测免疫小鼠血清抗原特异性的抗体水平;采用假病毒中和试验检测血清中抗体的中和活性。结果:获得了表达MERS-Co V S1蛋白的重组病毒株,在昆虫细胞中表达并纯化了S1重组蛋白;利用重组表达的S1蛋白免疫小鼠3次,血清S1特异性Ig G抗体滴度可达1∶102 400,免疫小鼠血清稀释至1/5120后中和百分比仍达50%以上。结论:利用昆虫细胞重组表达的MERS-Co V S1蛋白具有良好的免疫原性,并能有效诱导产生高滴度中和抗体,为发展MERS-Co V重组蛋白疫苗奠定了基础。     

高致病性中东呼吸综合征冠状病毒识别细胞受体分子机制的破译

冠状病毒属巢状病毒日（Order：Nidovirales）冠状病毒科（Family：Coronaviridae）冠状病毒属（Genus：Coronavirus）,为一类具囊膜的RNA病毒。     

利用I-Mutant2.0辅助设计与优化中东呼吸综合征冠状病毒融合抑制多肽

Ⅰ型膜融合蛋白(class I membrane fusion protein)在Ⅰ型包膜病毒入侵宿主细胞过程中发挥重要作用。基于抑制六螺旋结构形成的多肽类融合抑制剂设计的原理是模拟该蛋白融合区域的自身序列,与病毒融合蛋白结合形成异源六聚体,从而阻断病毒与靶细胞膜的融合。此类融合抑制剂的传统设计主要基于一级与二级结构,但为进一步强化其抗病毒活性,通常需依赖病毒膜融合蛋白三级结构信息,从而限制了对那些尚无病毒蛋白三级结构信息的新发病毒的多肽类融合抑制剂的快速优化和研发。本研究提出了不依赖蛋白三级结构信息,而利用I-Mutant2.0软件来辅助设计和优化多肽类病毒膜融合抑制剂的设想。根据I-Mutant2.0的预测结果,以中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus,MERS-CoV)为模型,分析该病毒HR2区融合抑制剂序列中若干适合与不适合优化的位点,并设计了一系列多肽。结果发现,对适合优化的位点进行调整的多肽,其对HR1的结合能力及对病毒的抑制活性均有所提升;反之,多肽活性明显下降。结果表明,利用I-Mutant2.0辅助设计与优化病毒融合抑制多肽的方法具有一定的可行性,为进一步开发新的融合抑制剂设计方法奠定了基础。     

Middle East respiratory syndrome coronavirus (MERS-CoV): Impact on Saudi Arabia, 2015

Middle East respiratory syndrome is the acute respiratory syndrome caused by betacoronavirus MERS-CoV. The first case of this disease was reported from Saudi Arabia in 2012. This virus is lethal and is a close relative of a severe acute respiratory syndrome (SARS), which is responsible for more than 3000 deaths in 2002–2003. According to Ministry of Health, Saudi Arabia. The number of new cases is 457 in 2015. Riyadh has the highest number of reports in comparison to the other cities. According to this report, males are more susceptible than female, especially after the age of 40. Because of the awareness and early diagnosis the incidence is falling gradually. The pre-existence of another disease like cancer or diabetic etc. boosts the infection. MERS is a zoonotic disease and human to human transmission is low. The MERS-CoV is a RNA virus with protein envelope. On the outer surface, virus has spike like glycoprotein which is responsible for the attachment and entrance inside host cells. There is no specific treatment for the MERS-CoV till now, but drugs are in pipeline which bind with the spike glycoprotein and inhibit its entrance host cells. MERS-CoV and SAR-CoV are from the same genus, so it was thought that the drugs which inhibit the growth of SARS-CoV can also inhibit the growth of MERS-CoV but those drugs are not completely inhibiting virus activity. Until we don’t have proper structure and the treatment of MERS-CoV, We should take precautions, especially the health care workers, Camel owners and Pilgrims during Hajj and Umrah, because they are at a higher risk of getting infected.     

A novel human coronavirus: Middle East respiratory syndrome human coronavirus

In 2012,a novel coronavirus,initially named as human coronavirus EMC(HCoV-EMC) but recently renamed as Middle East respiratory syndrome human coronavirus(MERS-CoV),was identified in patients who suffered severe acute respiratory infection and subsequent renal failure that resulted in death.Ongoing epidemiological investigations together with retrospective studies have found 61 laboratory-confirmed cases of infection with this novel coronavirus,including 34 deaths to date.This novel coronavirus is culturable and two complete genome sequences are now available.Furthermore,molecular detection and indirect immunofluorescence assay have been developed.The present paper summarises the limited recent advances of this novel human coronavirus,including its discovery,genomic characterisation and detection.     

Modulation of the immune response by Middle East respiratory syndrome coronavirus

Coronavirus (CoV) infections are commonly associated with respiratory and enteric disease in humans and animals. In 2012, a new human disease called Middle East respiratory syndrome (MERS) emerged in the Middle East. MERS was caused by a virus that was originally called human coronavirus-Erasmus Medical Center/2012 but was later renamed as Middle East respiratory syndrome coronavirus (MERS-CoV). MERS-CoV causes high fever, cough, acute respiratory tract infection, and multiorgan dysfunction that may eventually lead to the death of the infected individuals. The exact origin of MERS-CoV remains unknown, but the transmission pattern and evidence from virological studies suggest that dromedary camels are the major reservoir host, from which human infections may sporadically occur through the zoonotic transmission. Human to human transmission also occurs in healthcare facilities and communities. Recent studies on Middle Eastern respiratory continue to highlight the need for further understanding the virus-host interactions that govern disease severity and infection outcome. In this review, we have highlighted the major mechanisms of immune evasion strategies of MERS-CoV. We have demonstrated that M, 4a, 4b proteins and Plppro of MERS-CoV inhibit the type I interferon (IFN) and nuclear factor-κB signaling pathways and therefore facilitate innate immune evasion. In addition, nonstructural protein 4a (NSP4a), NSP4b, and NSP15 inhibit double-stranded RNA sensors. Therefore, the mentioned proteins limit early induction of IFN and cause rapid apoptosis of macrophages. MERS-CoV strongly inhibits the activation of T cells with downregulation of antigen presentation. In addition, uncontrolled secretion of interferon ɣ-induced protein 10 and monocyte chemoattractant protein-1 can suppress proliferation of human myeloid progenitor cells.     

Middle East respiratory syndrome coronavirus infection: virus-host cell interactions and implications on pathogenesis

Middle-East Respiratory Syndrome coronavirus (MERS-CoV) was identified to cause severe respiratory infection in humans since 2012. The continuing MERS epidemic with a case-fatality of more than 30 % poses a major threat to public health worldwide. Currently, the pathogenesis of human MERS-CoV infection remains poorly understood. We reviewed experimental findings from human primary cells and ex vivo human lung tissues, as well as those from animal studies, so as to understand the pathogenesis and high case-fatality of MERS. Human respiratory epithelial cells are highly susceptible to MERS-CoV and can support productive viral replication. However, the induction of antiviral cytokines and proinflammatory cytokines/chemokines are substantially dampened in the infected epithelial cells, due to the antagonistic mechanisms evolved by the virus. MERS-CoV can readily infect and robustly replicate in human macrophages and dendritic cells, triggering the aberrant production of proinflammatory cytokines/chemokines. MERS-CoV can also effectively infect human primary T cells and induce massive apoptosis in these cells. Although data from clinical, in vitro and ex vivo studies suggested the potential for virus dissemination, extrapulmonary involvement in MERS patients has not been ascertained due to the lack of autopsy study. In MERS-CoV permissive animal models, although viral RNA can be detected from multiple organs of the affected animals, the brain of human DPP4-transgenic mouse was the only extrapulmonary organ from which the infectious virus can be recovered. More research findings on the pathogenesis of MERS and the tissue tropisms of MERS-CoV may help to improve the treatment and infection control of MERS.     

The role of laboratory diagnostics in emerging viral infections: the example of the Middle East respiratory syndrome epidemic

Rapidly emerging infectious disease outbreaks place a great strain on laboratories to develop and implement sensitive and specific diagnostic tests for patient management and infection control in a timely manner. Furthermore, laboratories also play a role in real-time zoonotic, environmental, and epidemiological investigations to identify the ultimate source of the epidemic, facilitating measures to eventually control the outbreak. Each assay modality has unique pros and cons; therefore, incorporation of a battery of tests using traditional culture-based, molecular and serological diagnostics into diagnostic algorithms is often required. As such, laboratories face challenges in assay development, test evaluation, and subsequent quality assurance. In this review, we describe the different testing modalities available for the ongoing Middle East respiratory syndrome (MERS) epidemic including cell culture, nucleic acid amplification, antigen detection, and antibody detection assays. Applications of such tests in both acute clinical and epidemiological investigation settings are highlighted. Using the MERS epidemic as an example, we illustrate the various challenges faced by laboratories in test development and implementation in the setting of a rapidly emerging infectious disease. Future directions in the diagnosis of MERS and other emerging infectious disease investigations are also highlighted.