Phylogenetic Analysis of Enterovirus 71 Circulating in Beijing,China from 2007 to 2009

The major pathogens of hand, foot and mouth disease (HFMD) in Beijing, China from 2007 to 2009 were identified in this study. A total of 186 HFMD cases were included, and 136 cases (73%) were positive for enterovirus (EV). In 2007, 75% (27/36) were Coxsackievirus A16 (CA16) positive and 19% (7/36) were Enterovirus 71 (EV71) positive cases. However, EV71 was the predominant virus in 2008, when 56% (31/55) of the cases were positive for EV71 and 22% (12/55) were positive for CA16. In 2009, EV71 and CA16, with positive rates of 36% (16/45) and 29% (13/45), respectively, were still the major pathogens of HFMD. Phylogenetic analysis revealed that the dominant genotype of EV71 was C4, with co-circulation of genotype A in 2009. The prevalent cluster of the EV71 subgenotype C4 changed over time. A proposed new sublineage of EV71, C4a-2, was the predominant virus associated with the Beijing and nationwide HFMD outbreaks since 2008 and amino acid substitution, which possibly link to the central nervous system tropism of EV71, was found in genotype A viruses. Persistent surveillance of HFMD-associated pathogens is required for predicting potential emerging viruses and related disease outbreaks.     

Conformational Plasticity of the 2A Proteinase from Enterovirus 71

The 2A proteinase (2A^pro) is an enterovirally encoded cysteine protease that plays essential roles in both the processing of viral precursor polyprotein and the hijacking of host cell translation and other processes in the virus life cycle. Crystallographic studies of 2A^pro from enterovirus 71 (EV71) and its interaction with the substrate are reported here. EV71 2A^pro was comprised of an N-terminal domain of a four-stranded antiparallel β sheet and a C-terminal domain of a six-stranded antiparallel β barrel with a tightly bound zinc atom. Unlike in other 2A^pro structures, there is an open cleft across the surface of the protein in an open conformation. As demonstrated by the crystallographic studies and modeling of the complex structure, the open cleft could be fitted with the substrate. On comparison 2A^pro of EV71 to those of the human rhinovirus 2 and coxsackievirus B4, the open conformation could be closed with a hinge motion in the bII2 and cII β strands. This was supported by molecular dynamic simulation. The structural variation among different 2A^pro structures indicates a conformational flexibility in the substrate-binding cleft. The open structure provides an accessible framework for the design and development of therapeutics against the viral target.     

Phylogenetic Analysis of Enterovirus 71 Strains Isolated during Linked Epidemics in Malaysia, Singapore, and Western Australia

Enterovirus 71 (EV71) is a frequent cause of hand, foot, and mouth disease (HFMD) epidemics associated with severe neurological sequelae in a small proportion of cases. There has been a significant increase in EV71 epidemic activity throughout the Asia-Pacific region since 1997. Recent HFMD epidemics in this region have been associated with a severe form of brainstem encephalitis associated with pulmonary edema and high case fatality rates. In this study, we show that four genetic lineages of EV71 have been prevalent in the Asia-Pacific region since 1997, including two previously undescribed genogroups (B3 and B4). Furthermore, we show that viruses belonging to genogroups B3 and B4 have circulated endemically in Southeast Asia during this period and have been the primary cause of several large HFMD or encephalitis epidemics in Malaysia, Singapore, and Western Australia.     

Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong,China, in Pre- and Post-2010 HFMD Epidemic Period

Background

Human Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China.

Methodology/Principal Findings

A cross sectional study of Enterovirus 71 (EV71) and Coxsackie A16 (CA16) seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD) epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT) was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic.

Conclusions

These results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine.     

人肠道病毒71型基因重组的研究进展

人肠道病毒71 型(Enterovirus 71,HEV-A71),是手足口病(Hand,footandmouthdisease,HFMD)的常见病因,属于人肠道病毒属中的肠道病毒A型,隶属于微小RNA病毒科.许多研究证明HEV-A71经常发生基因重组并且使得HEV-A71在全球内多次暴发,这对疫苗的研发和疾病的防控是一种新的挑战.本文对HEV-A71不同亚型内、不同型间和多重重组等不同基因重组类型及其毒力、抗原性变化进行了综述.     

Norepinephrine and Epinephrine Enhanced the Infectivity of Enterovirus 71

Background

Enterovirus 71 (EV71) infections may be associated with neurological complications, including brainstem encephalitis (BE). Severe EV71 BE may be complicated with autonomic nervous system (ANS) dysregulation and/or pulmonary edema (PE). ANS dysregulation is related to the overactivation of the sympathetic nervous system, which results from catecholamine release.

Objective

The aims of this study were to explore the effects of catecholamines on severe EV71 infection and to investigate the changes in the percentages of EV71-infected cells, virus titer, and cytokine production on the involvement of catecholamines.

Study Design

Plasma levels of norepinephrine (NE) and epinephrine (EP) in EV71-infected patients were measured using an enzyme-linked immunoassay. The expression of adrenergic receptors (ADRs) on RD, A549, SK-N-SH, THP-1, Jurkat and human peripheral blood mononuclear cells (hPBMCs) were detected using flow cytometry. The percentages of EV71-infected cells, virus titer, and cytokine production were investigated after treatment with NE and EP.

Results

The plasma levels of NE and EP were significantly higher in EV71-infected patients with ANS dysregulation and PE than in controls. Both α_1A- and β₂-ADRs were expressed on A549, RD, SK-N-SH, HL-60, THP-1, Jurkat cells and hPBMCs. NE treatment elevated the percentages of EV71-infected cells to 62.9% and 22.7% in THP-1 and Jurkat cells, respectively. Via treatment with EP, the percentages of EV71-infected cells were increased to 64.6% and 26.9% in THP-1 and Jurkat cells. The percentage of EV71-infected cells increased upon NE or EP treatment while the α- and β-blockers reduced the percentages of EV71-infected cells with NE or EP treatment. At least two-fold increase in virus titer was observed in EV71-infected A549, SK-N-SH and hPBMCs after treatment with NE or EP. IL-6 production was enhanced in EV71-infected hPBMCs at a concentration of 10² pg/mL NE.

Conclusion

The plasma levels of NE and EP elevated in EV71-infected patients with ANS dysregulation and PE. Both NE and EP enhanced the percentages of infected cells and virus titers in EV71 infection in vitro. NE and EP may play a role in the pathogenesis of EV71 BE complicated with ANS dysregulation and PE.     

Seroepidemiology and Molecular Epidemiology of Enterovirus 71 in Russia

Enterovirus 71 (EV71) is an emerging human pathogen causing massive epidemics of hand, foot and mouth disease with severe neurological complications in Asia. EV71 also circulates in Europe, however it does not cause large outbreaks. The reason for distinct epidemiological patterns of EV71 infection in Europe and Asia and the risk of EV71 epidemic in Europe and Russia remain unknown. Seroepidemiology of EV71 and molecular epidemiology of occasional EV71 isolates were studied to explore circulation of EV71 in Russia. In six regions of Russian Federation, seroprevalence of EV71 in sera collected in 2008 ranged from 5% to 20% in children aged 1–2 years and from 19% to 83% in children aged 3–5 years. The seroprevalence among elder children was significantly higher (41–83% vs. 19–27%) in Asian regions of Russia. EV71 strains identified in Russia in 2001–2011 belonged to subtypes C1 and C2, while genotype C4 that was causing epidemics in Asia since 1998 emerged in 2009 and became dominant in 2013.     

Mitochondria Redistribution in Enterovirus A71 Infected Cells and Its Effect on Virus Replication

Enterovirus A71(EV-A71) is one of the main causative agents of hand, foot and mouth disease(HFMD) and it also causes severe neurologic complications in infected children. The interactions between some viruses and the host mitochondria are crucial for virus replication and pathogenicity. In this study, it was observed that EV-A71 infection resulted in a perinuclear redistribution of the mitochondria. The mitochondria rearrangement was found to require the microtubule network, the dynein complex and a low cytosolic calcium concentration. Subsequently, the EV-A71 non-structural protein 2 BC was identified as the viral protein capable of inducing mitochondria clustering. The protein was found localized on mitochondria and interacted with the mitochondrial Rho GTPase 1(RHOT1) that is a key protein required for attachment between the mitochondria and the motor proteins, which are responsible for the control of mitochondria movement.Additionally, suppressing mitochondria clustering by treating cells with nocodazole, EHNA, thapsigargin or A23187 consistently inhibited EV-A71 replication, indicating that mitochondria recruitment played a crucial role in the EV-A71 life cycle. This study identified a novel function of the EV-A71 2 BC protein and provided a potential model for the regulation of mitochondrial motility in EV-A71 infection.     

菏泽地区2009年肠道病毒71型与其他肠道病毒所致手足口病临床差异研究

目的:探讨EV71引起小儿手足口病与其他肠道病毒所致手足口病的临床特点的差异.方法:回顾性分析2009年3月-9月菏泽地区各定点医院收治的病原学检测为阳性的320例小儿手足口病的临床资料,筛出EV71感染的手足口病患儿进行分析,其他肠道病毒所致手足口痛患儿作为对照组.结果:菏泽地区2009年抽取的病原学检测为阳性的320例患儿,肠道病毒71型引起手足口病占106例,其余为其他肠道病毒所致手足口病.(1)男女发病基本相同,发病年龄1～3岁居多,农村患儿占绝大多数.(2)EV71感染的患儿临床主要表现高热、神经系统症状、无皮疹,大多数外周血象高、血糖高,可合并心肌损害,心电图异常、部分发现胸片、脑电图及核磁异常,部分符合重症手足口病标准.(3)其他肠道病毒感染的惠儿临床症状以皮疹、低热、上感症状为主,少数患儿有精神差,基本不出现神经系统症状,少数发现外周血象高、血糖高、合并心肌损害,一般胸片不会发现异常.(4)56例出现神经系统症状的患儿收集脑脊液进行两次RT-PCR扩增,发现50例EV71阳性.结论:EV71导致的手足口病,病情凶险,易致神经损害及肺水肿,早期识别重症病例,及时救治,普及病原体的检测对提高诊治能力,加强疾病的认识,对减少致残率及死亡率很有帮助.     

肠道病毒71型的RT-PCR诊断及基因特征

2002～2003年从上海市和重庆市手足口病患儿的疱液标本中分离到10株病毒,其中上海9株,重庆1株.利用两对分别针对EV71和Cox.A16病毒VP1区的特异性引物,用RT-PCR方法对病毒进行初步鉴别.根据PCR所用引物及PCR扩增出的产物片段大小不同,可初步判定出EV71和Cox.A16病毒的血清型别.RT-PCR结果提示,上海分离到的9株病毒中,有2株为EV71,其余7株病毒为Cox.A16;重庆分离到的1株病毒为EV71.10株病毒的RT-PCR产物经序列测定和分析证实,PCR定型结果正确,说明PCR法具有很高的特异性,可作为EV71初步鉴定的首选方法.对所分离的3株EV71病毒进行VP1区编码基因全序列的测定和遗传学分析,通过同源性比较和构建系统发生树发现,此3株EV71病毒和中国大陆已发表的7株EV71病毒(SHZH03、SHZH98、SH-F1、SH-F2、SH-H25、SH-H26和CHN-87)全部属于C基因型,与该型代表株比较,同源性为89.3%～94.6%;与A、B基因型代表株比较,同源性为81.3%～84.0%,差异较大.在C基因型中,此3株EV71病毒和中国大陆先前分离的6株病毒(SHZH03、SHZH98、SH-F1、SH-F2、SH-H25、SH-H26)的同源性较高,在94.5%～100%范围内.在系统发生树上,这9株病毒形成一个较独立的分支.与CHN-87株的同源性在92.1%～93.6%之间.与已知的C1、C2、C3亚型代表株比较,同源性在89.3%～92.9%,差异≥7%,因此认为可将这9株病毒划分为C4亚型.上海、重庆和深圳的EV71病毒有较高的同源性,提示该病毒EV71-CA亚型在中国大陆1998～2003年间有较广泛的传播.建立中国流行的EV71病毒毒株库和基因库,对诊断、预防和控制EV71在中国的爆发有重要意义,对加强EV71的实验室诊断、病毒学监测和病毒基因型和亚型的标准命名和分子流行病学研究有重要帮助.     

Molecular epidemiology and recombination of Enterovirus A71 in mainland China from 1987 to 2017

International Microbiology - Enterovirus A71 (EV-A71) is an important pathogen of severe hand, foot, and mouth disease (HFMD) in young children. This study aimed to retrospectively analyze the...     

以主要流行EV71 VP1基因高度保守区为靶点的TaqMan荧光定量PCR检测方法的建立

在我国,肠道病毒71型(enterovirus 71,EV71)C4型是引起手足口病的主要流行基因型。为建立EV71C4型TaqMan荧光定量PCR检测方法,在C4型EV71VP1基因的高保守区,设计合成引物和TaqMan探针,将包含此目的区段的基因片段克隆到pcDNA3.1载体中,通过体外转录获得标准品,并以梯度稀释的标准品为模板建立工作曲线,进而在优化反应条件的基础上建立TaqMan荧光实时定量PCR检测方法。实验中,所设计引物、探针的高度保守性保证了C4型EV71的高效扩增。经反应条件优化,引物和探针的最佳工作浓度分别为300 nmol/L和200 nmol/L,在1×10~301×10~3拷贝数检测范围内具有良好的线性关系(R~2=1),灵敏度可达到10~2 copies/μL。通过对该方法进行检验发现,批间和组间重复实验的变异系数均小于0.5%,且该方法对柯萨奇A16(coxsackievirus A16,CA16)柯萨奇B1(coxsackievirus B1,CB1)人轮状病毒(human rotavirus,HRV)单纯疱疹病毒2型(herpes Simplex virus type 2,HSV-2)均无交叉反应,对6份EV71阳性样本检出率为100%。以上数据表明,文中建立的TaqMan荧光定量PCR方法可为我国主要流行C4型EV71感染的快速诊断及疾病监控提供有效途径。     

miR-34b调控肠道病毒71型在人横纹肌肉瘤细胞中的复制及机制

【背景】研究发现microRNAs(miRNAs)可以参与调控病毒在宿主细胞内感染和复制的过程。【目的】研究miR-34b对肠道病毒71型(Enterovirus71,EV71)在宿主细胞内的复制及其可能机制。【方法】在人横纹肌肉瘤(Rhabdomyosarcoma,RD)细胞中转染miR-34b mimics和Inhibitor,通过Western blot和Real-time PCR实验检验EV71病毒的复制和表达情况。随后利用双荧光素酶报告系统验证miR-34b与潜在靶点eIF4E的相互作用,并检测miR-34b对RD细胞中eIF4E mRNA表达水平的影响。【结果】miR-34b可以促进病毒在RD细胞中的复制和表达,而miR-34b抑制剂有抑制病毒复制的作用,细胞内miR-34b可以通过作用于靶基因eIF4E调控EV71在宿主细胞中的复制过程。【结论】揭示了miR-34b在EV71病毒复制过程中的调控作用及机制,研究EV71病毒与宿主miRNAs的相互作用机制为进一步阐明EV71病毒感染与复制机理奠定了基础。     

Structures of the Procapsid and Mature Virion of Enterovirus 71 Strain 1095

Enterovirus 71 (EV71) is an important emerging human pathogen with a global distribution and presents a disease pattern resembling poliomyelitis with seasonal epidemics that include cases of severe neurological complications, such as acute flaccid paralysis. EV71 is a member of the Picornaviridae family, which consists of icosahedral, nonenveloped, single-stranded RNA viruses. Here we report structures derived from X-ray crystallography and cryoelectron microscopy (cryo-EM) for the 1095 strain of EV71, including a putative precursor in virus assembly, the procapsid, and the mature virus capsid. The cryo-EM map of the procapsid provides new structural information on portions of the capsid proteins VP0 and VP1 that are disordered in the higher-resolution crystal structures. Our structures solved from virus particles in solution are largely in agreement with those from prior X-ray crystallographic studies; however, we observe small but significant structural differences for the 1095 procapsid compared to a structure solved in a previous study (X. Wang, W. Peng, J. Ren, Z. Hu, J. Xu, Z. Lou, X. Li, W. Yin, X. Shen, C. Porta, T. S. Walter, G. Evans, D. Axford, R. Owen, D. J. Rowlands, J. Wang, D. I. Stuart, E. E. Fry, and Z. Rao, Nat. Struct. Mol. Biol. 19:424–429, 2012) for a different strain of EV71. For both EV71 strains, the procapsid is significantly larger in diameter than the mature capsid, unlike in any other picornavirus. Nonetheless, our results demonstrate that picornavirus capsid expansion is possible without RNA encapsidation and that picornavirus assembly may involve an inward radial collapse of the procapsid to yield the native virion.     

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。     

湖北地区2001年度流感疫情分析

通过流感病毒分离、人群流感抗体水平测定和流行病学调查对2001年度(2001年3月至2002年3月)湖北地区流感疫情进行了分析.结果表明本年度湖北武汉地区出现过两次流感季节性小流行,第一次在2001年8～9月,主要由甲1型流感病毒引起;第二次在2001年12月至2002年1月,以甲3型流感病毒占优势.从病毒分离鉴定和抗体水平测定的情况分析,这次流行的甲3型流感病毒与1999年分离的毒株相比,可能发生了抗原性漂移.     

TAR DNA-Binding Protein 43 is Cleaved by the Protease 3C of Enterovirus A71

Enterovirus A71(EV-A71) is one of the etiological pathogens leading to hand, foot, and mouth disease(HFMD), which can cause severe neurological complications. The neuropathogenesis of EV-A71 infection is not well understood. The mislocalization and aggregation of TAR DNA-binding protein 43(TDP-43) is the pathological hallmark of amyotrophic lateral sclerosis(ALS). However, whether TDP-43 was impacted by EV-A71 infection is unknown. This study demonstrated that TDP-43 was cleaved during EV-A71 infection. The cleavage of TDP-43 requires EV-A71 replication rather than the activated caspases due to viral infection. TDP-43 is cleaved by viral protease 3 C between the residues 331 Q and332 S, while mutated TDP-43(Q331 A) was not cleaved. In addition, mutated 3 C which lacks the protease activity failed to induce TDP-43 cleavage. We also found that TDP-43 was translocated from the nucleus to the cytoplasm, and the mislocalization of TDP-43 was induced by viral protease 2 A rather than 3 C. Taken together, we demonstrated that TDP-43 was cleaved by viral protease and translocated to the cytoplasm during EV-A71 infection, implicating the possible involvement of TDP-43 in the pathogenesis of EV-A71 infection.