Preparing the biochemistry laboratory for the next outbreak: lessons from SARS in Singapore

Severe acute respiratory syndrome (SARS) is an emerging disease characterised by fever and atypical pneumonia and caused by a novel coronavirus. Singapore was affected by the global pandemic in early 2003, with 238 cases and 33 deaths. Samples sent to the biochemistry laboratory made up the majority (69%) of all SARS samples, yet remained a minority (29%) of total biochemistry workload. This paper describes the problems encountered and solutions adopted by the biochemistry laboratory at the designated SARS hospital in coping with this epidemic. It provides practical advice for laboratories planning for the handling of samples from future outbreaks.     

冠状病毒的新成员--SARS-CoV的基因组特性

2003年3月,人类发现一种新的冠状病毒SARS-CoV,这种病毒是非典型性肺炎(SARS)的病原体。SARS-CoV的基因组序列已经由包括中国科学家在内的全世界的科研人员测定完成。该文对国际报道的SARS病源的基因序列进行了收录,阐述了SARS-CoV基因组的基本特性：SARS-CoV的基因组长约28-30kb,与冠状病毒科的基因组长度相符合,其中包括11个编码序列,基因组的组织方式也与其他冠状病毒类似,从表面蛋白(S蛋白)、外膜蛋白(M蛋白)和核蛋白(N蛋白)上看,SARS病毒与其他冠状病毒的对应蛋白进化关系接近。同时发现,在某些区域,SARS病毒的基因序列与其他冠状病毒存在相当大的差异,具有自身比较保守的基因组序列结构。而且氨基酸的序列也与其他冠状病毒有很大程度的不同。基因信息的冗余分析表明,SARS-CoV具有较低的冗余度,即发生变异的可能性比较大。虽然SARS-CoV外表与冠状病毒类似,亲缘关系未超出冠状病毒科界限,但由于蛋白基因与氨基酸的序列与其他冠状病毒有本质不同,因此可能不是其他冠状病毒的变异体,而是一种与冠状病毒类似、但早已独立存在、此前未被人类所认识的新病毒。     

SARS冠状病毒的起源研究进展

SARS冠状病毒（SARS-CoV）是一种新现病毒,可感染多种动物,果子狸是人类sARs-CoV重要的动物宿主之一,是已知较理想的实验动物模型。遗传因素在SARS-CoV的出现过程中起重要作用,它很可能是哺乳动物和鸟类冠状病毒之间重组产生的新物种,但发生基因重组不是SARS在人群中暴发的原因。     

严重急性呼吸道综合征冠状病毒疫苗研究现状

冠状病毒被认为是新近爆发的严重急性呼吸道综合征的病原体.迄今公共数据库中已发表了不同国家和地区分离的12个SARS病毒株基因组完整序列.突起蛋白是冠状病毒的主要抗原,包含许多抗原决定簇.SARS冠状病毒突起蛋白的相对保守性为有效疫苗的开发奠定了很好的研究基础.灭活或减毒的冠状病毒疫苗存在一定的局限性和危险性.开展基因工程疫苗和核酸疫苗的制备研究以及相关候选疫苗的联合应用研究将是一个切实可行的途径.     

SARS冠状病毒的变异特性分析

通过对目前所发表或公布的CARS相关资料进行分析,结合所做的一些工作,对SARS-CoV的变异特性、影响变异的可能因素以及变异与Ⅰ临床病程发展的联系进行了探讨。结果显示,SARS．CoV在变异发生频率和动态变化上具有RNA病毒的普遍特性,但由于其在人类的传播时间较短,相对于常见的引起慢性感染的RNA病毒,如丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)等,得到鉴定的变异序列数量相对较少。SARS-CoV5基因尤其是S1区变异程度较高,Ⅳ基因较为保守。就目前有限的研究结果分析,没有发现病毒变异与Ⅰ临床病程发展之间有明确的联系。     

一步法双重RT—PCR检测SARS冠状病毒技术研究

参照WHO公布的PCR检测SARS相关冠状病毒的引物序列,我们合成了4对引物,建立了一步法RT-PCR检测SARS相关冠状病毒的方法。利用该方法,对武汉市非典型肺炎疑似病例喉澈液进行了SARS相关冠状病毒检测,其中w20用4对引物检测均在相应的位置出现了DNA条带,W1只有BNIin-s／as引物出现预期产物。同时我们将样品W20的RT-PCR扩增产物进行了序列测定,结果显示该片段序列与其他地区和国家分离的SARS冠状病毒基因高度同源性,这进一步说明RT-PCR扩增的产物是SARS冠状病毒基因片段。在此基础上我们又建立了四种SARS冠状病毒一步法双重RT-PCR检测方法,在一个RT-PCR反应中用两套引物同时对SARS冠状病毒基因两个不同的片段进行检测,检测结果具有更高的特异性。     

一步法双重RT-PCR检测SARS冠状病毒技术研究

参照WHO公布的PCR检测SARS相关冠状病毒的引物序列,我们合成了4对引物,建立了一步法RT-PCR检测SARS相关冠状病毒的方法.利用该方法,对武汉市非典型肺炎疑似病例喉漱液进行了SARS相关冠状病毒检测,其中w20用4对引物检测均在相应的位置出现了DNA条带,W1只有BNIin-s/as引物出现预期产物.同时我们将样品W20的RT-PCR扩增产物进行了序列测定,结果显示该片段序列与其他地区和国家分离的SARS冠状病毒基因高度同源性,这进一步说明RT-PCR扩增的产物是SARS冠状病毒基因片段.在此基础上我们又建立了四种SARS冠状病毒一步法双重RT-PCR检测方法,在一个RT-PCR反应中用两套引物同时对SARS冠状病毒基因两个不同的片段进行检测,检测结果具有更高的特异性.     

The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned

The outbreak of severe acute respiratory syndrome (SARS) in the first half of 2003 in Canada was unprecedented in several respects. Understanding the psychological impact of the outbreak on healthcare workers, especially those in hospitals, is important in planning for future outbreaks of emerging infectious diseases. This review draws upon qualitative and quantitative studies of the SARS outbreak in Toronto to outline the factors that contributed to healthcare workers' experiencing the outbreak as a psychological trauma. Overall, it is estimated that a high degree of distress was experienced by 29-35% of hospital workers. Three categories of contributory factors were identified. Relevant contextual factors were being a nurse, having contact with SARS patients and having children. Contributing attitudinal factors and processes were experiencing job stress, perceiving stigmatization, coping by avoiding crowds and colleagues, and feeling scrutinized. Pre-existing trait factors also contributed to vulnerability. Lessons learned from the outbreak include: (i) that effort is required to mitigate the psychological impact of infection control procedures, especially the interpersonal isolation that these procedures promote; (ii) that effective risk communication is a priority early in an outbreak; (iii) that healthcare workers may have a role in influencing patterns of media coverage that increase or decrease morale; (iv) that healthcare workers benefit from resources that facilitate reflection on the effects of extraordinary stressors; and (v) that healthcare workers benefit from practical interventions that demonstrate tangible support from institutions.     

Network theory and SARS: predicting outbreak diversity

Many infectious diseases spread through populations via the networks formed by physical contacts among individuals. The patterns of these contacts tend to be highly heterogeneous. Traditional "compartmental" modeling in epidemiology, however, assumes that population groups are fully mixed, that is, every individual has an equal chance of spreading the disease to every other. Applications of compartmental models to Severe Acute Respiratory Syndrome (SARS) resulted in estimates of the fundamental quantity called the basic reproductive number R0--the number of new cases of SARS resulting from a single initial case--above one, implying that, without public health intervention, most outbreaks should spark large-scale epidemics. Here we compare these predictions to the early epidemiology of SARS. We apply the methods of contact network epidemiology to illustrate that for a single value of R0, any two outbreaks, even in the same setting, may have very different epidemiological outcomes. We offer quantitative insight into the heterogeneity of SARS outbreaks worldwide, and illustrate the utility of this approach for assessing public health strategies.     

严重急性呼吸综合征(SARS)冠状病毒抗体的检测及其临床意义

To investigate the k inetics of antibody to SARS coronavirus in SARS patients and its clinical implication,ELISA was used to dete ct antibody to SARS coronavirus(SA RS CoV),RT-PCR was used to detect the SARS CoV RNA and,besides,the C D+4 and CD+8 T cells in peripheral blood of SARS patients and healthy controls were assayed by flowcytom etryThe results showed that SARS CoV IgM were first detected from da y 7 to day 47 after SARS onset,wit h average at day 193±101SARS Co V IgG were first detected from day 4 to day 47 after SARS onset,with average at day 207±101,and the p roduction of SARS CoV IgG was corr elated with CD+4 T cell number(P<005),but had no relationship with SARS CoV RNAMost SARS patients pr oduced SARS CoV antibody,IgM produ ced almost at the same time wit h IgGSARS CoV IgG is a protective antibody against SARS CoV and the titer of IgG may be used as an ind ex indicating the specific immunit y production in SARS patients     

Prediction for Target Sites of Small Interfering RNA Duplexes in SARS Coronavirus

High doses of ionizing irradiation and chemical mutagens induce random mutations and chromosome aberrations in cells of affected organisms and cause acute symptoms, delayed increased risk of cancer and accelerated aging. The mechanism of disease development remains unclear and no treatment exists for consequences of the mutagenic damage. We have proposed recently that extracellular genomic DNA from tissue fluids of a healthy organism, innate receptor-mediated nuclear delivery of this DNA, and its homologous recombination with cellular genomic sequences might function concertedly as a natural proofreading mechanism for somatic cell genomes. Here we hypothesize that cells dying from irradiation or chemical mutagens release heavily damaged DNA fragments that propagate mutations and chromosome aberrations to DNA-recipient cells via this mechanism, inducing cell death and release of their mutated DNA again into the bloodstream. The repeated release of the mutated DNA followed by its incorporation into cellular genomes would spread mutational damage in the affected organism, thus making this DNA the etiologic agent of either radiation sickness or post-mutagen exposure syndrome. The hypothesis opens a possibility to inhibit and treat the disease via administration of non-mutated genomic DNA fragments that would compete with the circulating mutant DNA fragments, entering cells in greater numbers, leading to replacement of mutant segments in cellular genomes. Injection of fragmented mouse DNA, but not human DNA, into lethally irradiated mice dramatically increased their survival. Similarly, the mouse DNA was more potent than human and salmon DNA in accelerating recovery of the normal leukocyte level in mice treated with the chemical mutagen cyclophosphamide. The species specificity of the DNA therapy suggests that the genomic sequences are the agent producing the effects.     

SARS冠状病毒M基因的克隆及其表达

从SARS冠状病毒(GD322株)组织培养上清中提取RNA,进行RTPCR扩增其M基因并克隆到巴氏毕赤酵母表达载体pPICZaB,电穿孔法将重组体整合人酵母菌P．pastoris,经抗生素Zeocin筛选产生的转化子进行表型鉴定,取Mut^-菌用甲醇诱导表达,SDS-PAGE检测其表达产物。Mut^-酵母转化菌经甲醇诱导可分泌表达约65kDa和42kDa的蛋白质,与SARS恢复期病人血清的免疫印迹证实它们为特异的重组M蛋白质,且获得的重组M蛋白质具有免疫反应性。     

SARS冠状病毒M基因的克隆及其表达

从SARS冠状病毒(GD322株)组织培养上清中提取RNA,进行RT-PCR扩增其M基因并克隆到巴氏毕赤酵母表达载体pPICZαB,电穿孔法将重组体整合入酵母菌P.pastoris,经抗生素Zeocin筛选产生的转化子进行表型鉴定,取Mut+菌用甲醇诱导表达,SDS-PAGE检测其表达产物.Mut+酵母转化菌经甲醇诱导可分泌表达约65kDa和42 kDa的蛋白质,与SARS恢复期病人血清的免疫印迹证实它们为特异的重组M蛋白质,且获得的重组M蛋白质具有免疫反应性.     

SARS冠状病毒复制酶蛋白nsp8的原核表达

以SARS冠状病毒(BJ01株)基因组RNA为模板,经RT-PCR扩增得到SARS-CoVnsp8基因,并克隆到原核表达载体pGEX-6p-1中,构建重组质粒pNSP8E。pNSP8E转化大肠杆菌BL21(DE3),经IPTG诱导表达出可溶性的GST-nsp8融合蛋白,经亲和层析和自剪切获得了高纯度nsp8蛋白。以nsp8为抗原免疫家兔,制备了nsp8的多克隆抗体,为下一步研究其在病毒感染的细胞中的功能奠定了基础。     

严重急性呼吸综合征(SARS)冠状病毒N蛋白基因的表达及其初步应用

SARS coronavirus N gene w as expressed by Ecoli expression systemThe expressed protein was p urified and an ELISA method was se t up for detection of SARS virus i nfected patient's serum antibodyT he recombinant SARS coronavirus N protein offers an efficient way fo r serological diagnosis and is use ful for epidemiological study and vaccine development     

SARS冠状病毒非结构蛋白Nsp的原核表达

严重急性呼吸综合征病毒,即SARS冠状病毒((Severe acute respiratory syndrome coronavirus,SARS-CoV),为具有囊膜的单股正链RNA病毒,基因组约长29~31kb。基因组从5'到3'端依次编码复制酶蛋白(Rep)、刺突蛋白(S)、囊膜蛋白(E)、膜蛋白(M)和核蛋白(N)以及其他一些辅助性蛋白[1]。编码复制酶蛋白的基因,从基因组5'端起约占全长的2/3区域(≈21.2kb),在该区域的nt13392-13398存在保守的UUUAAAC位点,此位点含有-1位的核糖体翻译移框(frameshift),可引发自单一起始位点的蛋白翻译扩展,即由ORF1a编码的Pp1a(约486kDa)扩展为由ORF1b编…     

SARS冠状病毒非结构蛋白Nsp的原核表达

严重急性呼吸综合征病毒,即SARS冠状病毒((Severe acute respiratory syndrome coronavirus,SARS-CoV),为具有囊膜的单股正链RNA病毒,基因组约长29～31kb.基因组从5′到3′端依次编码复制酶蛋白(Rep)、刺突蛋白(S)、囊膜蛋白(E)、膜蛋白(M)和核蛋白(N)以及其他一些辅助性蛋白[1].     

严重急性呼吸综合征(SARS)患者不同组织中冠状病毒的分离和鉴定

严重急性呼吸综合征(SARS)自2002年11月在中国广东爆发后,已迅速蔓延成为全球性传染疾患。为了了解SARS冠状病毒的特征,对先前SARS冠状病毒PCR检测呈阳性的来自广东的3份尸检肺组织标本、2份尸检脾组织标本：来自北京的2份咽拭子标本和1份血清标本,利用10种不同的细胞系分离病毒。结果显示,上述标本在感染细胞后,分别可在293、Vero—E6、Vero、RD和HeLa细胞系中产生细胞病变(CPE)。不同标本在上述细胞系中致CPE的能力不同,但CPE出现的时间和病变形态学特征无显著性差异。以恢复期SARS病人血清为抗体,用间接免疫荧光法对感染后细胞培养的检测,冠状病毒RT-_PCR对感染后细胞RNA的检测,初步证明分离的病毒为冠状病毒。结果再次证明冠状病毒为SARS的病原,它具有较广泛的器官分布和细胞感染能力。血清中SARS冠状病毒的分离,高度提示在SARS发病过程中存在有病毒血症。