肾素-血管紧张素系统：急性呼吸窘迫综合征中的生命之舵

急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)是一种严重的肺部疾病,其特征为肺部细胞因子风暴、弥漫性肺泡损伤、肺血管通透性增加、急性非心源性肺水肿和难治性低氧血症(PaO2/FIO2≤300 mm),最终导致多器官衰竭。ARDS起病快、病情严重并且缺乏有效治疗手段,导致其高病死率(30%～70%),对公共健康构成重大威胁。ARDS可由多种病因引发,包括严重感染(例如SARS-CoV、SARS-CoV-2、H5N1)以及非感染性因素。目前的治疗方法主要是非特异性的处理,包括类固醇、传统中医药、营养支持和机械通气等。2012年更新的柏林标准主要依据发病时间、低氧血症、肺水肿以及相关的放射学和生理学异常来诊断ARDS。最近的研究表明,生物标志物可以提高诊断的灵敏度和特异性。例如,血管紧张素II(Ang II)水平升高与重症肺炎的严重程度和预后相关,强调了肾素-血管紧张素系统(renin-angiotensin system, RAS)在ARDS病理机制中的重要作用。ARDS进展的一个关键因素是局部肺组织中RAS的破坏。研究表明,Ang II-Ang II 1型受体(angiotensin II type 1 receptor, AT1R)轴的激活会促进肺损伤。ACE2是RAS的关键负调节因子,在缓解Ang II过度生成引起的肺损伤中发挥着重要作用。动物模型中ACE2的下调导致RAS失衡,进而引发急性肺损伤。SARS-CoV、SARS-CoV-2和禽流感等病毒感染,以及暴露于某些纳米材料,都能通过降低ACE2水平、破坏RAS平衡,特别是通过激活Ang II-AT1R轴,导致Ang II的增加,从而诱发ARDS。本文讨论了涉及RAS抑制剂的潜在治疗策略,包括血管紧张素受体拮抗剂(angiotensin receptor blockers, ARB)和补充ACE2。研究表明,ARB(包括洛沙坦),能够显著减少由病毒感染和其他因素引起的ARDS动物模型中的肺损伤,并改善存活率。此外,重组人ACE2通过降低Ang II水平和缓解肺损伤表现出保护作用。本文还讨论了ARB在治疗多器官功能障碍综合征(multiple organ dysfuction syndrom, MODS)中的治疗潜力,因为RAS失调在器官损伤中发挥关键作用。临床试验表明,ARB能够改善COVID-19患者的预后。尽管ARB可能产生低血压和电解质失衡等不良反应,但它们仍然是治疗ARDS和MODS有前景的治疗选择。未来的研究应进一步阐明RAS调节在不同病因背景下的分子机制,并开发个体化治疗策略,以优化临床治疗效果。总而言之,靶向RAS,特别是Ang II-AT1R轴,代表了治疗ARDS和MODS的一种新颖而有前景的方法,为危重病人提供了有价值的治疗途径。     

SARS-CoV单克隆抗体的制备及抗原表位的初步鉴定

参照已发表的SARS冠状病毒BJ01株基因序列 ,利用计算机软件预测并选取该病毒S、M、N三种主要结构蛋白部分抗原性优势区域 ,以编码Gly-Pro-Gly序列相连接合成两段嵌合基因A和B。并分别克隆于pGEX -6p- 1载体上用IPTG进行诱导表达 ,以纯化的嵌合蛋白A和B为抗原 ,分别免疫BALB c小鼠制备单克隆抗体。利用单克隆抗体亚型检测试剂盒和SARS CoV商品化ELISA检测试剂盒对其进行亚型和特异性鉴定。结果表明融合表达两段嵌合基因产物 ,其大小分别为 34kD和35kD ,Westernblot分析证实两种表达产物都能被SARS病人康复期血清所识别。获得了 6株能稳定分泌特异性抗体的阳性细胞克隆株。亚型鉴定结果除D3C5为IgG2a外其他单抗均为IgG1,而且所有单抗的轻链均为κ链。特异性鉴定发现除D3D1外 ,其余的 5株单抗均能与SARS CoV商品化ELISA检测试剂盒发生特异性反应。将D3D1与灭活后经超声波裂解的SARS CoV进行Westernblot分析 ,发现它能特异性识别 180kD的蛋白带。分别融合表达了 6个S蛋白的寡肽 (S1- S6 ) ,并对筛选出的单克隆…     

SARS冠状病毒主要结构蛋白的研究进展

严重急性呼吸综合征(SARS)因其传染性强、危害性大而受到广泛关注。世界各国密切合作,在对SARS的研究方面取得了许多突破。本文针对2005年前后的相关研究进展,综述了对S、N、M和E等4种SARS冠状病毒的结构蛋白的功能、实际应用等研究情况,其中对S、N蛋白进行了更为详细的介绍,重点阐述了主要结构蛋白的特征性功能区域、特异性蛋白、特征性反应、实验研究技术的改进以及疫苗研发等进展。     

新型冠状病毒与系统损伤研究

自2019年12月全国及世界范围爆发了新型冠状病毒性肺炎(corona virus disease 2019,COVID-19),给中国和全球公共卫生安全带来了极大的挑战.研究发现,新型冠状病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)不仅损...     

Enzymatic activity of the SARS coronavirus main proteinase dimer

The enzymatic activity of the SARS coronavirus main proteinase dimer was characterized by a sensitive, quantitative assay. The new, fluorogenic substrate, (Ala-Arg-Leu-Gln-NH)(2)-Rhodamine, contained a severe acute respiratory syndrome coronavirus (SARS CoV) main proteinase consensus cleavage sequence and Rhodamine 110, one of the most detectable compounds known, as the reporter group. The gene for the enzyme was cloned in the absence of purification tags, expressed in Escherichia coli and the enzyme purified. Enzyme activity from the SARS CoV main proteinase dimer could readily be detected at low pM concentrations. The enzyme exhibited a high K(m), and is unusually sensitive to ionic strength and reducing agents.     

Development of immunoglobulin G enzyme-linked immunosorbent assay for the serodiagnosis of severe acute respiratory syndrome

Severe acute respiratory syndrome (SARS) is an emerging infectious disease caused by a novel SARS-associated coronavirus (SARS-CoV). The clinical characteristics are high fever, rapidly progressive diffuse pneumonitis and respiratory distress. It is highly infectious through intimate contact or direct contact with infectious body fluids. Outbreaks within communities and hospitals have been reported. Development of rapid and reliable diagnostic tools is urgently needed. We developed an immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA), using whole virus antigen of SARS-CoV. Eighty-six serum samples collected from patients who were hospitalized for other causes were examined to determine the cut-off O.D. value. The cut-off O.D. value was defined as 0.175 by calculating the mean O.D. value of the 86 sera plus 3 standard deviations. To determine the sensitivity and specificity of the ELISA, 56 positive sera and 204 negative sera were tested. The sensitivity was 96.4% and the specificity was 100%. The results suggest that the IgG ELISA using whole virus antigen of SARS-CoV has a high sensitivity and specificity in detecting SARS IgG antibodies. This IgG ELISA is a powerful tool for serodiagnosis of SARS.     

严重急性呼吸综合征(SARS)冠状病毒S蛋白的鉴定与分析

利用293细胞对SARS病人样品进行病毒扩增,培养上清中病毒颗粒经过纯化后,利用蛋白质组学技术,对纯化得到的SARS冠状病毒颗粒蛋白进行初步分离与鉴定。其中质谱分析结果最终表明,分子量约150kD的蛋白质的氨基酸序列与SARS—CoV基因组所预测S蛋白质序列高度吻合,从而首次从蛋白质水平对SARS冠状病毒S蛋白的氨基酸序列进行了证实。     

在传染性非典型肺炎患者组织和血液中发现冠状病毒

用RT-PCR从广东两例传染性非典型肺炎(非典型肺炎)死亡病例的肺和脾标本中,以及北京、辽宁和宁夏非典型肺炎患者血清中,扩增出冠状病毒核苷酸序列。这些PCR产物为冠状病毒RNA聚合酶基因部分片段,所有测定的序列和国内外SARS病毒序列相同。这些发现提示,冠状病毒和非典型肺炎关系密切,有助于确定我国非典型肺炎的病因。所建立的套式PCR方法可以用于检测临床标本。由于血液中存在SARS病毒,进行血清操作时需要注意安全保护。     

肿瘤患者血清中SARS-CoV抗体阳性原因分析

探讨SARS冠状病毒(SARS—CoV)抗体在SARS病原学诊断中的特异性及其在肿瘤患血清中的假阳性问题。应用ELISA和荧光定量RT-PCR技术检测了111例正常对照和40例肿瘤患血清中SARS—CoV抗体的阳性率。在111例正常对照中,IgM抗体均阴性,IgG抗体的阳性率为3．6％(4／111);IgG抗体诊断SARS的特异性为96．4％,两种抗体同时阳性诊断SARS的特异性为100％。40例肿瘤患中,IgM抗体均阴性,IgG抗体阳性率17．5％(7／40)。经RT—PCR检测,上述肿瘤患阳性病例均为阴性。结果表明,同时测定SARS—CoV的两种抗体可降低诊断的假阳性率,提高诊断的特异性。用非纯化SARS—CoV抗原制备的ELISA试剂盒测定肿瘤患的SARS—CoV抗体,可能出现假阳性。在肿瘤患中出现假阳性的原因可能与包被的抗原有关。     

Calreticulin as a hydrophilic chimeric molecular adjuvant enhances IgG responses to the spike protein of severe acute respiratory syndrome coronavirus

Fragment 450-650 of the spike (S) protein (S450-650) of severe acute respiratory syndrome-associated coronavirus (SARS-CoV) contains epitopes capable of being recognized by convalescent sera of SARS patients. Vaccination of mice with recombinant S450-650 (rS450-650) can induce Abs against SARS-CoV, although the titer is relatively low. In the present study, a fusion protein linking a fragment (residues 39-272) of murine calreticulin (CRT) to S450-650 in a prokaryotic expression system was created. Compared with target antigen alone, the recombinant fusion product (rS450-650-CRT) has much improved hydrophilicity and immunogenicity. The S450-650-specific IgG Abs of BALB/c mice subcutaneously immunized with rS450-650-CRT were in substantially higher titer (approximately fivefold more). Furthermore, the fusion protein, but not rS450-650 alone, was able to elicit S450-650-specific IgG responses in T cell deficient nude mice. Given that rCRT/39-272 can drive the maturation of bone-marrow-derived dendritic cells, directly activate macrophages and B cells, and also elicit helper T cell responses in vivo, we propose that fragment 39-272 of CRT is an effective molecular adjuvant capable of enhancing target Ag-specific humoral responses in both a T cell-dependent and independent manner. Fusion protein rS450-650-CRT is a potential candidate vaccine against SARS-CoV infection.     

Sequence analysis and structural prediction of the severe acute respiratory syndrome coronavirus nsp5

The non-structural proteins (nsp or replicase proteins) of coronaviruses are relatively conserved and can be effective targets for drugs. Few studies have been conducted into the function of the severe acute respiratory syndrome coronavirus (SARS-CoV) nsp5. In this study, bioinformatics methods were employed to predict the secondary structure and construct 3-D models of the SARS-CoV GD strain nsp5. Sequencing and sequential comparison was performed to analyze the mutation trend of the polymerase nsp5 gene during the epidemic process using a nucleotide-nucleotide basic local alignment search tool (BLASTN) and a protein-protein basic local alignment search tool (BLASTP). The results indicated that the nsp5 gene was steady during the epidemic process and the protein was homologous with other coronavirus nsp5 proteins. The protein encoded by the nsp5 gene was expressed in COS-7 cells and analyzed by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE). This study provided the foundation for further exploration of the protein‘s biological function, and contributed to the search for anti-SARS-CoV drugs.     

SARS冠状病毒S受体结合区蛋白片段在杆状病毒载体中的表达及其抗原性研究

目的:利用Bac-to-Bac1杆状病毒系统,在sf9昆虫细胞中表达严重急性呼吸综合征(SARS)冠状病毒(SARS-CoV)的S受体结合区蛋白片段,并对其免疫原性进行研究。方法:将S蛋白的受体结合区基因片段定向克隆至转座载体pFast-Bac1,转化大肠杆菌DH10Bac感受态细胞,用抗生素平板筛选重组杆粒。脂质体介导重组杆粒转染sf9昆虫细胞,待细胞形态明显改变后收获细胞和培养上清液。利用SARS病人恢复期抗血清做ELISA和Western印迹,分析重组蛋白的抗原性。结果:ELISA和Western印迹表明,在sf9昆虫细胞中表达的SARS-CoVS受体结合区重组蛋白可与SARS病人恢复期抗血清发生特异反应。结论:获得了在昆虫细胞内表达的SARS-CoVS受体结合区重组蛋白,并证明该蛋白有可能用于SARS感染的抗体检测,为SARS-CoV免疫机制及其疫苗的进一步研究奠定了基础。     

Cell-Type-Specific Immune Dysregulation in Severely Ill COVID-19 Patients

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用噬菌体随机肽库筛选SARS冠状病毒S蛋白单克隆抗体2C5的模拟表位

SARS-CoVS蛋白特异的单克隆抗体2C5具有病毒中和作用。以单克隆抗体2C5为筛选靶分子,筛选噬菌体展示随机7肽库。经三轮淘洗后随机挑选20个噬菌体克隆进行ELISA分析和序列测定。在10个ELISAOD值大于0.2的阳性噬菌体克隆中,有8个噬菌体克隆展示有共同的7肽序列TPEQQFT。展示有该序列的噬菌体克隆能竞争抑制SARS-CoVS蛋白抗原与单抗2C5的结合。结果表明TPEQQFT为单克隆抗体2C5的模拟表位。该结果可对进一步研究S蛋白结构与功能和设计SARS疫苗有一定的参考意义。     

Ecological dynamics of emerging bat virus spillover

Viruses that originate in bats may be the most notorious emerging zoonoses that spill over from wildlife into domestic animals and humans. Understanding how these infections filter through ecological systems to cause disease in humans is of profound importance to public health. Transmission of viruses from bats to humans requires a hierarchy of enabling conditions that connect the distribution of reservoir hosts, viral infection within these hosts, and exposure and susceptibility of recipient hosts. For many emerging bat viruses, spillover also requires viral shedding from bats, and survival of the virus in the environment. Focusing on Hendra virus, but also addressing Nipah virus, Ebola virus, Marburg virus and coronaviruses, we delineate this cross-species spillover dynamic from the within-host processes that drive virus excretion to land-use changes that increase interaction among species. We describe how land-use changes may affect co-occurrence and contact between bats and recipient hosts. Two hypotheses may explain temporal and spatial pulses of virus shedding in bat populations: episodic shedding from persistently infected bats or transient epidemics that occur as virus is transmitted among bat populations. Management of livestock also may affect the probability of exposure and disease. Interventions to decrease the probability of virus spillover can be implemented at multiple levels from targeting the reservoir host to managing recipient host exposure and susceptibility.     

Using models to identify routes of nosocomial infection: a large hospital outbreak of SARS in Hong Kong

Two factors dominated the epidemiology of severe acute respiratory syndrome (SARS) during the 2002-2003 global outbreak, namely super-spreading events (SSE) and hospital infections. Although both factors were important during the first and the largest hospital outbreak in Hong Kong, the relative importance of different routes of infection has not yet been quantified. We estimated the parameters of a novel mathematical model of hospital infection using SARS episode data. These estimates described levels of transmission between the index super-spreader, staff and patients, and were used to compare three plausible hypotheses. The broadest of the supported hypotheses ascribes the initial surge in cases to a single super-spreading individual and suggests that the per capita risk of infection to patients increased approximately one month after the start of the outbreak. Our estimate for the number of cases caused by the SSE is substantially lower than the previously reported values, which were mostly based on self-reported exposure information. This discrepancy suggests that the early identification of the index case as a super-spreader might have led to biased contact tracing, resulting in too few cases being attributed to staff-to-staff transmission. We propose that in future outbreaks of SARS or other directly transmissible respiratory pathogens, simple mathematical models could be used to validate preliminary conclusions concerning the relative importance of different routes of transmission with important implications for infection control.     

Expression, purification and sublocalization of SARS-CoV nucleocapsid protein in insect cells

The causative agent of severe acute respiratory syndrome (SARS) is a previously unidentified coronavirus, SARS-CoV. The nucleocapsid (N) protein of SARS-CoV is a major viral protein recognized by acute and early convalescent sera from SARS patients. To facilitate the studies on the function and structure of the N protein, this report describe the expression and purification of recombinant SARS-CoV N protein using the baculovirus