浙江地区呼吸道合胞病毒G基因分子特征分析

收集2004年冬季浙江省儿童医院呼吸道感染患儿的鼻咽吸引物,进行呼吸道合胞病毒(RSV)分离,对分离株用特异性RT-PCR鉴定;对鉴定阳性的RSV毒株进行G蛋白全基因序列测定,并与RSV国际标准株及各地参考株的G蛋白基因序列进行同源性比较并构建基因进化树。结果表明,在4株RSV浙江分离株中,3株G蛋白基因ORF全长897bp,另1株为894bp;各分离株之间的核苷酸与氨基酸同源性分别为98.05%、97.06%;与A型RSV标准株的核酸同源性为95.69%,与B型RSV标准株的同源性为78.79%;其3’端基因高变区核苷酸序列与RSVGA2亚型的同源性最高。提示2004年冬季浙江省RSV流行株属于RSVGA2亚型。     

浙江地区呼吸道合胞病毒G基因分子特征分析

收集2004年冬季浙江省儿童医院呼吸道感染患儿的鼻咽吸引物,进行呼吸道合胞病毒(RSV)分离,对分离株用特异性RT-PCR鉴定;对鉴定阳性的RSV毒株进行G蛋白全基因序列测定,并与RSV国际标准株及各地参考株的G蛋白基因序列进行同源性比较并构建基因进化树.结果表明,在4株RSV浙江分离株中,3株G蛋白基因ORF全长897bp,另1株为894bp;各分离株之间的核苷酸与氨基酸同源性分别为98.05%、97.06%;与A型RSV标准株的核酸同源性为95.69%,与B型RSV标准株的同源性为78.79%;其3'端基因高变区核苷酸序列与RSV GA2亚型的同源性最高.提示2004年冬季浙江省RSV流行株属于RSV GA2亚型.     

呼吸道合胞病毒B亚型分离株的G蛋白基因分析

对一株长春地区B亚型分离株(CC169)的G蛋白基因进行了 序列分析,结果表明：我国呼吸道合胞病毒(RSV)分离株CC169同RSV B亚型原型株CH18537的 核苷酸同源性为94%,核苷酸的有义突变率达65%。由核苷酸推导出氨基酸序列的同源性为894%,氨基酸的变异全部发生在胞外区,并主要集中在一个高度保守区的两端,胞内区和跨 膜区保守不变。氨基酸的变异导致了分离株既有糖基化位点的改变,又有蛋白长度的变异。 此外还初步探讨了我国RSV B 亚型分离株CC169的G蛋白基因同原型株之间的变异与疫苗研制 中的意义。     

呼吸道合胞病毒在北京地区分离株G蛋白的基因分析

从经单克隆抗体证实为Ａ亚型的北京地区呼吸道合胞病毒（ＲＳＶ）分离株Ｂ７９中,用ＲＴ－ＰＣＲＴ扩增出编码Ｇ蛋白的基因片段,克隆至载体ｐＴＺ１８Ｒ中,经核苷酸序列测定证明,我国北京地区分离的Ａ亚型株Ｂ７９与ＲＳＶＡ亚型原型株（Ａ２株）Ｇ蛋白基因的核苷酸同源性为９３．８％,核苷酸的有义突变率为６５％,由核苷酸推导出氨基酸序列的同源性为８９．６％,氨基酸的变异主要集中在胞外区一个高度保守区的两端,而胞内区     

呼吸道合胞病毒北京地区分离株G蛋白的基因分析

从经单克隆抗体证实为Ａ亚型的北京地区呼吸道合胞病毒（ＲＳＶ）分离株Ｂ７９中,用ＲＴ－ＰＣＲ扩增出编码Ｇ蛋白的基因片段,克隆至载体ｐＴＺ１８Ｒ中。经核苷酸序列测定证明,我国北京地区分离的Ａ亚型株Ｂ７９与ＲＳＶＡ亚型原型株（Ａ２株）Ｇ蛋白基因的核苷酸同源性为９３．８％,核苷酸的有义突变率达６５％。由核苷酸推导出氨基酸序列的同源性为８９．６％。氨基酸的变异主要集中在胞外区一个高度保守区的两端,而胞内区和跨膜区相对保守。本文探讨了我国北京地区ＲＳＶ分离株的Ｇ蛋白基因同原型株之间的变异,在疫苗研制中的意义。     

人呼吸道合胞病毒M蛋白非复制型重组腺病毒的构建和鉴定

人呼吸道合胞病毒（human respiratory syncytial virus, RSV)基质蛋白（matrix protein,M）在RSV形态发生上具有重要作用,因含有CTL抗原表位,在疫苗研究上具有一定意义。为此,应用RT-PCR 方法从感染RSV的HEp-2 细胞中扩增获得M蛋白基因,构建了含M基因的非复制型重组腺病毒并进行表达和鉴定。基因序列分析显示RSV M基因仅有一处碱基发生错义突变。非复制型重组腺病毒DNA分子FGAd/RSVM转染293细胞,观察到细胞出现CPE,RT-PCR发现M基因有转录,Western blotting及间接免疫荧光分析检测到M蛋白。成功克隆A亚型RSV Long株M基因,并获得一株可表达A亚型RSV M蛋白的非复制型重组腺病毒FGAd/RSVM,可用于体内研究观察其免疫效果及免疫保护作用。     

呼吸道合胞病毒G蛋白的相关研究

呼吸道合胞病毒G蛋白介导病毒附着在宿主细胞表面,且具有亚型间抗原结构变异大的特点,其抗原变异推测是呼吸道合胞病毒逃避已存在免疫监视,引起反复感染的原因,了解G蛋白与免疫反应的关系对研制呼吸道合胞病毒亚单位疫苗,有效地防治该病毒感染具有重要意义。     

急性下呼吸道感染患儿中RSV的分离鉴定及分析

目的对2015年兰州单中心急性下呼吸道感染患儿中呼吸道合胞病毒(respiratory syncytial virus,RSV)进行分离鉴定及分析。方法收集临床急性下呼吸道感染患儿痰分泌物226份,在HEP-2细胞中连续盲传培养3代,收获的培养物用半巢式RT-PCR进行检测,选取强阳性样品进行测序以确定其型别,并对其流行病学特征进行分析。结果 226份样品中RSV阳性样本为76份(阳性率为34%)。RSV阳性患儿中,男女性别比为3∶1;年龄分布6月龄患儿占45%,6月龄~2岁占35%,2~5岁的占20%。冬季为发病高峰。76例RSV阳性患儿中,临床诊断依次为毛细支气管炎31例(40.79%)、喘息性支气管炎21例(27.36%)、支气管肺炎20例(26.32%)和支气管哮喘4例(5.26%)。40份强阳性RSV样品经测序确定为B亚型。结论 RSV是引起婴幼儿急性下呼吸道感染的重要病原之一,2015年RSV的流行株主要为B亚型。     

北京地区人呼吸道合胞病毒核蛋白基因的序列分析及原核表达

为了解北京地区流行的人呼吸道合胞病毒(HRSV)N蛋白基因的特征,并用大肠杆菌表达获得N蛋白,从2006年1月至3月收集的首都儿科研究所附属儿童医院急性呼吸道感染患儿标本中分离到7株HRSV毒株(3株A亚型,4株B亚型),分别经RT-PCR扩增得到HRSV N蛋白全基因,克隆至pUCm-T载体中并进行测序和分析;从重组质粒pUCm-N9968中经PCR扩增获得N基因,亚克隆入原核表达载体pET30a( )中,得到重组表达质粒pET30a-N9968,转化大肠杆菌BL21(DE3),IPTG诱导培养;SDS-PAGE和Western blot检测目的蛋白的表达和抗原性。经扩增并测序,7株HRSV N蛋白基因全长均为1 176 bp,编码一个含391个氨基酸的蛋白;北京地区7株RSV分离株的N蛋白基因之间的核苷酸和推导的氨基酸同源性分别在85.4%~99.7%之间和95.4%~100%之间,进一步证明N蛋白基因的高度保守性。经诱导培养产生大量带6个组氨酸标记的重组N蛋白,主要以包涵体形式存在。N蛋白粗提物经Ni2 亲和层析获得较理想纯化。Western blot结果显示,所表达的蛋白能与特异性单克隆抗体和人血清反应。说明本研究构建的重组pET30a-N9968原核表达质粒使N蛋白获得了高效表达,并且具有特异的抗原活性,为今后进一步研究奠定了基础。     

南京地区2010～2011年度呼吸道感染患儿腺病毒的流行病学研究

本研究为了解南京地区儿童腺病毒(ADV)感染的流行特点及型别,收集2010年8月至2011年7月南京医科大学附属南京儿童医院住院及门诊呼吸道感染患儿的鼻咽抽吸物(NPA)及咽拭子(NPS)共644例,采用巢氏聚合酶链反应法(Nested-PCR)检测ADV hexon基因,将阳性PCR扩增产物进行测序、同源性和进化分析。同时对12种其他呼吸道相关病毒进行PCR检测,包括人博卡病毒(HBoV),呼吸道合胞病毒(RSV),人鼻病毒(HRV),副流感病毒1～4型(PIV1-4),流感病毒A和B(IFVA/B),人偏肺病毒(HMPV),冠状病毒NL63和HKU1(HCoV-NL63和HCoV-HKU1)。结果显示:644例标本中共检出ADV阳性扩增产物171份,检出率为26.55%,3型120例(70.18%,120/171),7型16例(9.36%,16/171),1型12例(7.02%,12/171),2型10例(5.85%,10/171),5型6例(3.51%,6/171),6型3例(1.75%,3/171),57型3例(1.75%,3/171),41型1例(0.58%,1/171)。ADV感染呈全年散发,其发病高峰主要在4～7月。以7岁以下儿童多见(96.49%)。171例ADV感染患儿中有99例(57.89%)存在混合感染,其中以呼吸道合胞病毒(RSV)、人鼻病毒(HRV)多见。ADV阳性患儿诊断以下呼吸道感染为主(63.16%),肺炎占30.41%。结论:ADV是2010年8月到2011年7月南京地区儿童呼吸道感染的重要病原之一,其优势流行株为3型,长期监测其流行型别具有重要意义。     

Severity of respiratory signs and symptoms and virus profiles in Japanese children with acute respiratory illness

Associations between the severity of respiratory signs and symptoms and the respiratory viruses identified in 214 Japanese children with acute respiratory illness (ARI) enrolled between January and December 2012 were studied. Respiratory rate, wheezing, cyanosis, and the use of accessory muscles were used as indices of respiratory severity and phylogenetic analysis of the viruses identified in these children was performed. Respiratory viruses such as respiratory syncytial virus (RSV), human rhinovirus (HRV), human parainfluenza virus (HPIV), and human metapneumovirus (HMPV) were prevalent, being detected in approximately 70% of the patients (151/214 patients). Co‐detection of viruses occurred in about 9% of patients. RSV was identified more frequently in cases scored as moderate/severe than in those scored as mild (P < 0.05). Severity scores of patients with RSV were significantly higher than those of cases with HPIV. Moreover, severity scores in patients with mild disease and co‐detections were higher than in those in whom only HPIV or adenovirus was detected. Phylogenetic analysis showed that many genotypes of HRV‐A and ‐C with wide genetic divergence were associated with acute respiratory illness (ARI). On the other hand, only a limited number of genotypes of RSV were associated with ARI. HPIV and HMPV were associated with ARI at similar frequencies. These results suggest that different respiratory viruses with unique genetic characteristics can be found in patients with mild to severe ARI.     

569例呼吸道感染住院儿童7种常见呼吸道病毒病原学分析

目的了解呼吸道感染住院患儿呼吸道病毒的分布情况。方法选取2015年7月至2016年6月呼吸道感染的住院患儿病例,抽取鼻咽分泌物,采用直接免疫荧光法检测常见的7种病毒,即呼吸道合胞病毒(RSV)、甲型流感病毒(IVA)、乙型流感病毒(IVB)、副流感病毒1型(PIV1)、副流感病毒2型(PIV2)、副流感病毒3型(PIV3)、腺病毒(IVD)。结果共有569例样本送检,193例病毒检测阳性(33.92%),其中有3例为2种病毒的混合感染。男性共369例,女性共200例。其中RSV、PIV3、ADV的感染率居前三位。呼吸道病毒的感染率随着患儿年龄的增长逐渐下降,除新生儿外,6个月内的婴幼儿呼吸道病毒检出率最高。RSV检测阳性率自11月开始呈增高趋势,12月最高,达55.86%。PIV3的检出高峰出现在7月,达13.64%。结论 RSV是本地区儿童呼吸道感染最常见的病毒。呼吸道病毒的检出率与年龄、季节等因素有关。     

Respiratory syncytial virus infections during an epidemic period in Salvador, Brazil. Viral antigenic group analysis and description of clinical and epidemiological aspects

Acute respiratory infections (ARI) caused by respiratory syncytial virus (RSV) were studied in 482 children from Salvador, BA, Brazil, over a period of 12 months. The epidemic period of RSV infections in Salvador occurred from February (summer) to August (winter), with peaks in May, June, and July. The grouping characteristics of 84 RSV present in nasopharyngeal secretions of children seen at a reference university hospital were analyzed. RSV represented 17.4% of all cases and 54.5% of the positive samples. Sixty-four RSV strains were assigned to group A and 14 to group B. Both groups circulated in the five months of the epidemic period studied. Infections by both groups of RSV were more frequent in children up to one year of age. The incidence of RSV ARI was slightly more frequent in males, although group B had more infected females.     

Frequency of viruses associated with acute respiratory infections in children younger than five years of age at a locality of Mexico City

A locality in the district of Tlalpan, Mexico City, was selected in order to identify the viral agents in children younger than 5 years of age with acute respiratory infection (ARI). A total of 300 children were randomly selected and were included in this study for a period of 13 months. During this period nasopharyngeal exudates were collected for the isolation of viral agents. Monoclonal fluorescent antibodies were used for viral identification after cell culture. Viral infection was detected in 65% of the specimens. The respiratory syncytial virus (RSV) was the most common virus agent detected. Children required an average of two consultations during the study period. Two high incidence peaks were observed, one during the summer and the other during winter; the most frequent viruses during these seasons were influenza A and RSV, respectively. The largest number of viruses was isolated in the group of children between 1 and 2 years of age and in the group between 4 and 5 years of age. This study demonstrated the presence of ARI and of different viruses in a period of 13 months, as well as the most frequent viruses in children younger than 5 years of age from a community of Mexico City.     

The central conserved cystine noose of the attachment G protein of human respiratory syncytial virus is not required for efficient viral infection in vitro or in vivo

The G glycoprotein of human respiratory syncytial virus (RSV) was identified previously as the viral attachment protein. Although we and others recently showed that G is not essential for replication in vitro, it does affect the efficiency of replication in a cell type-dependent fashion and is required for efficient replication in vivo. The ectodomain of G is composed of two heavily glycosylated domains with mucin-like characteristics that are separated by a short central region that is relatively devoid of glycosylation sites. This central region contains a 13-amino acid segment that is conserved in the same form among RSV isolates and is overlapped by a second segment containing four cysteine residues whose spacings are conserved in the same form and which create a cystine noose. The conserved nature of the cystine noose and flanking 13-amino acid segment suggested that this region likely was important for attachment activity. To test this hypothesis, we constructed recombinant RSVs from which the region containing the cysteine residues was deleted together with part or all of the conserved 13-amino acid segment. Surprisingly, each deletion had little or no effect on the intracellular synthesis and processing of the G protein, the kinetics or efficiency of virus replication in vitro, or sensitivity to neutralization by soluble heparin in vitro. In addition, neither deletion had any discernible effect on the ability of RSV to infect the upper respiratory tract of mice and both resulted in a 3- to 10-fold reduction in the lower respiratory tract. Thus, although the G protein is necessary for efficient virus replication in vivo, this activity does not require the central conserved cystine noose region.     

Viral and atypical bacterial detection in acute respiratory infection in children under five years

Background

Acute respiratory infection (ARI) is a leading cause of morbidity and mortality in children worldwide. This study aimed to determine the viral and atypical bacterial causes of different severities and clinical manifestations of ARI in preschool children from low-income families in North-East Brazil.

Methods

Clinical/demographic data and nasopharyngeal aspirates (NPA) were prospectively collected from children <5 years presenting with ARI over one year to a paediatric A&E department. Disease severity was grouped according to presence of lower respiratory tract signs, need for hospital admission and need for oxygen. Clinical manifestation of ARI was based on discharge diagnosis from hospital with four conditions predominating: bronchiolitis, pneumonia, episodic viral wheeze/asthma and upper respiratory tract infection. Multiplex PCR was used to detect 17 common respiratory viral and atypical bacterial pathogens in NPA.

Findings

407 children with a median age of eight months were recruited. Pathogens were detected in 85·5% samples with co-infection being particularly common (39·5%). Respiratory Syncytial Virus (RSV; 37%), Adenoviruses (AdV; 25%), Rhinoviruses (hRV; 19%), Bocavirus (hBoV; 19%), human Meta-pneumovirus (hMPV; 10%) and Mycoplasma pneumoniae (Mpp; 10%) were most prevalent. Detection and co-infection rates were similar in all severities and clinical manifestations of ARI apart from RSV, which was associated with more severe disease and specifically more severe cases of bronchiolitis, and Mpp, which was associated with more severe cases of pneumonia. Mpp was detected in 17% of children admitted to hospital with pneumonia.

Interpretation

This study underlines the importance of viral and atypical bacterial pathogens in ARI in pre-school children and highlights the complex epidemiology of these pathogens in this age group. Generally, viruses and atypical bacteria were detected in all severities and clinical manifestations of ARI but RSV and Mpp were associated with more severe cases of bronchiolitis and pneumonia respectively.     

Optimized detection of respiratory viruses in nasopharyngeal secretions

Nasopharyngeal secretions (NPS) from 121 (110 pediatric) patients with acute respiratory infections were examined for respiratory virus detection by: i) conventional virus isolation in cell cultures (CC) using HEp-2, LLC-MK2, and MDCK cells; ii) rapid virus isolation using shell vial cultures (SVC) of a mixture (MIX) of mink lung epithelial cells (Mv1Lu) and human lung carcinoma (A549) cells in comparison to LLC-MK2 and MDCK cells; iii) direct fluorescent antibody (DFA) assay on NPS cells. A pool of monoclonal antibodies (MAbs) to influenzavirus A and B, parainfluenzavirus types 1 to 3, adenoviruses and respiratory syncytial virus (RSV), as well as single MAbs to the same viruses, were used for virus identification in all three procedures. Results on 101 NPS examined in parallel showed a sensitivity of 89.5%, 73.7%, and 81.6% for CC, SVC, and DFA, respectively, with the relevant negative predictive values of 94.0%, 86.3%, and 90.0%. Specificity and positive predictive values were 100%. However, the combination of DFA and SVC gave best results in terms of sensitivity (94.7%) and negative predictive value (95.5%). Use of the new MIX cell culture system in the SVC procedure enhanced virus detection, while use of the MAb pool allowed prompt identification of negative samples and saving of reagents and time for all three procedures. The combination of DFA and SVC allows diagnosis of the large majority of viral respiratory infections within 48h, while conventional virus isolation on CC may be limited to laboratories involved in research and epidemiological studies.     

Incidence and Risk Factors for Respiratory Syncytial Virus and Human Metapneumovirus Infections among Children in the Remote Highlands of Peru

Introduction

The disease burden and risk factors for respiratory syncytial virus (RSV) and human metapneumovirus (MPV) infections among children living in remote, rural areas remain unclear.

Materials and Methods

We conducted a prospective, household-based cohort study of children aged <3 years living in remote rural highland communities in San Marcos, Cajamarca, Peru. Acute respiratory illnesses (ARI), including lower respiratory tract infection (LRTI), were monitored through weekly household visits from March 2009 through September 2011. Nasal swabs collected during ARI/LRTI were tested for RSV, MPV, and other respiratory viruses using real-time RT-PCR. Incidence rates and rate ratios were calculated using mixed effects Poisson regression.

Results

Among 892 enrolled children, incidence rates of RSV and MPV ARI were 30 and 17 episodes per 100 child-years, respectively. The proportions of RSV and MPV ARI that presented as LRTI were 12.5% and 8.9%, respectively. Clinic visits for ARI and hospitalizations were significantly more frequent (all p values <0.05) among children with RSV (clinic 41% and hospital 5.3%) and MPV ARI (38% and 3.5%) when compared with other viral infections (23% and 0.7%) and infections without virus detected (24% and 0.6%). In multivariable analysis, risk factors for RSV detection included younger age (RR 1.02, 95% CI: 1.00-1.03), the presence of a smoker in the house (RR 1.63, 95% CI: 1.12-2.38), residing at higher altitudes (RR 1.93, 95% CI: 1.25-3.00 for 2^nd compared to 1^st quartile residents; RR 1.98, 95% CI: 1.26-3.13 for 3^rd compared to 1^st quartile residents). Having an unemployed household head was significantly associated with MPV risk (RR 2.11, 95% CI: 1.12-4.01).

Conclusion

In rural high altitude communities in Peru, childhood ARI due to RSV or MPV were common and associated with higher morbidity than ARI due to other viruses or with no viral detections. The risk factors identified in this study may be considered for interventional studies to control infections by these viruses among young children from developing countries.