人用H7N9疫苗的研究进展

2013年3月,在中国首次出现低致病性H7N9病毒感染者并致死的病例。迄今为止,中国共出现5次H7N9病毒流行的疫情。其间,H7N9病毒不断发生变异,新的基因型以及高致病性H7N9病毒相继出现。变异的H7N9病毒对禽类养殖业和人类的公共卫生造成了严重的威胁,疫苗是预防H7N9病毒流行的有效措施。目前,全世界尚无临床可用的人用H7N9疫苗,但各类备选H7N9疫苗都在研究中,如灭活疫苗、减毒疫苗、亚单位疫苗、病毒样颗粒疫苗、核酸疫苗和病毒载体疫苗等。其中,一些H7N9疫苗已进入临床研究阶段。现对各类人用H7N9疫苗的研究进展作一概述。     

H7N9禽流感病毒裂解佐剂(MF59)疫苗稳定性研究

目的评价H7N9禽流感病毒裂解佐剂(MF59)疫苗的稳定性。方法采用国内自主构建的重组H7N9禽流感病毒疫苗株毒种制备单价疫苗原液,制备含MF59佐剂的成品疫苗。按照企业注册质量标准进行检定,分别放置于(37±2)℃、(25±2)℃和(5±3)℃环境下,观察不同时间疫苗的稳定性。结果经检定,成品疫苗的外观、装量、无菌检查、异常毒性检测、细菌内毒素含量、渗透压质量摩尔浓度及其他检定项目均符合企业注册质量标准。H7N9禽流感病毒裂解佐剂(MF59)疫苗在(37±2)℃保存3 d、在(25±2)℃保存3个月、在(5±3)℃保存30个月,疫苗各项指标均符合企业注册质量标准。结论 H7N9禽流感病毒裂解佐剂(MF59)疫苗具有良好的稳定性。     

1例重症肺炎可疑H7N9禽流感的护理

H7N9 禽流感是由新亚型 H7N9禽流感病毒引起,该病毒是全球首次发现,因其是一种新亚型,起病急、进展快、致死率高,受到广泛关注[1].我科2013年4月2日收治1例重症肺炎可疑H7N9禽流感的患者,经采取积极的治疗和护理,患者痊愈出院,现将护理体会报告如下.     

人感染H7N9禽流感的流行病学分析研究

2013年春季的人感染H7N9禽流感,开始发生于我国的长三角地区,首例出现于2月19日,流行持续至7月27日作间歇性停顿。本研究收集在此其间的大部分病例作分析研究。流行以散发为特征,大多数病例集中于3月底到4月中的20天。主要侵犯老年人。准老人(50~60岁),老人(>60岁)分别占本研究总病例的四分之三;男性多于女性,各年龄组平均年龄的性别比例随平均年龄的增加而递增。与有关资料相比,在年龄、性别方面与人H5N1禽流感有显著不同。与禽有接触,或与污染环境有关,或在职业或工作中可能存在暴露危险的患者共33例,占总病例的37.9%。接触禽类与活禽市场,现卖现宰是引发H7N9禽流感的危险因素。患者的密切接触者中有1/1582的发病。在一个家庭中,7天内发现2例确认病例,为疑似聚集性病例,提示可能存在人际传播。     

H7N9和H1N1流感病毒感染BV2细胞的差异表达miRNA初步分析

筛选鉴定H7N9病毒感染BV2细胞的特异聚类microRNA(miRNA)并初步探讨这些miRNA的可能致病机制。H7N9和H1N1流感病毒感染BV2细胞,分别收集12 h、24 h和48 h的细胞并提取总RNA。并利用高通量测序技术进行miRNA测序,同时比较鉴定不同病毒特异性miRNA。筛选出了10个H7N9病毒特异聚类miRNA,其中有3个miRNA被miRBase数据库所收录。这些特异聚类miRNA调控诸多信号通路的信号传导,比如Ras信号通路、PI3K-Akt信号通路、MAPK信号通路、轴突导向和癌症相关基因等。该研究为miRNA调控H7N9禽流感病毒的致病机制提供了科学基础。     

流感病毒NP表位序列增强H7N9 HA DNA疫苗免疫效果研究

为增强H7N9流感病毒HA DNA疫苗的免疫效果,本文构建了含有流感病毒NP的5个重复优势T表位或B表位(包括B_1线性表位和B_2构象表位)的表达质粒(简称NPT和NPB),以小鼠为动物模型,将NPT和NPB分别与H7N9流感病毒HA DNA混合免疫BALB/c小鼠1次,21 d后用致死剂量(20 LD_(50))的H7N9流感病毒攻击小鼠。通过检测免疫后小鼠血清特异性抗体滴度和攻毒后的免疫保护性指标-存活率、肺部残余病毒滴度及体重丢失率,评价表位质粒与HA DNA疫苗混合免疫对小鼠的保护效果。试验结果表明:用致死性H7N9流感病毒攻击小鼠后,HA DNA组小鼠全部死亡,HA+NPT免疫组小鼠存活率达到100%,HA+NPB1和HA+NPB2免疫组,小鼠存活率分别为30%和75%;混合免疫HA+NPT后小鼠抗体滴度升高明显,攻毒后小鼠体重丢失明显降低。综上表明,含有5个NP优势T表位或B表位的表达质粒能增强H7N9流感病毒HA DNA疫苗的免疫效果,混合免疫一次可以使小鼠得到较好的保护。HA DNA和表位疫苗的混合免疫,节约了疫苗用量,降低了免疫成本,为流感病毒核酸疫苗的临床开发提供了一定的试验基础。     

H7N9 禽流感的研究现状及对未来的思考简

始发于2013年3月的人感染H7N9禽流感疫情给我国卫生、农业与经济带来了严峻而巨大的挑战,尽管目前疫情已经得到初步控制,但随后出现的散发病例提示H7N9卷土重来的势头已现端倪.对于H7N9禽流感,目前仍存在太多的不确定因素.基于此,本文将对目前H7N9禽流感的流行发展势态和研究现状进行综述,并在此基础上,提出一系列目前未知、但亟待解决的关键论题和研究方向,以作抛砖引玉之用.     

H7N9亚型禽流感假病毒的制备与验证

根据A/Anhui/1/2013(H7N9)病毒株HA和NA基因序列研究H7N9禽流感病毒的结构并制备相应的假病毒，并对此假病毒进行初步验证。将H7N9病毒株的HA和NA基因序列经公司优化合成后，经过接菌、提取质粒、假病毒构建等步骤来制备假病毒，并通过假病毒感染实验、透射电镜以及血清中和实验来验证假病毒制备是否成功。成功制备滴度均超过标准值104的A/Anhui/1/2013(H7N9)假病毒，在电镜下可观察到典型的流感病毒形态，并进一步使用本科室保存的29份血清样本（含4份H7N9阳性血清样本）、国家流感中心制备的四种不同亚型免疫组分（H1型、H3型、BV型和BY型）的抗血清以及商品化H7N9特异性抗体进行中和试验，结果显示4份阳性血清中和活性明显高于25份阴性血清，四种不同亚型抗血清的中和效率均低于40%，且商品化H7N9特异性抗体能够与其有效结合。本研究成功构建了H7N9假病毒并有效筛选出阳性血清，且具有良好的特异性，为流感大流行或疫苗免疫后人群血清学监测建立了科学有效的技术手段。     

一例混合感染中H3N2和H7N9流感病毒的分子遗传特性

【目的】揭示一例混合感染中H3N2和N7N9流感病毒的分子遗传特性。【方法】通过荧光定量PCR法对标本进行流感病毒分型检测。通过二代测序技术对病毒分离物进行全基因组测序分析。【结果】2013年4月在南京市检测到一例人季节性H3N2流感病毒和禽流感H7N9病毒混合感染,混合病毒分别命名为A/Nanjing/M1/2013 (H3N2) (M1-H3N2)和A/Nanjing/M2/2013 (H7N9) (M2-H7N9)。分离株M2-H7N9 HA蛋白的Q226L位点和PB2蛋白E627K位点发生突变,增强了病毒对人体的感染能力。【结论】报道了一起人混合感染H3N2和N7N9流感病毒病例,提示人可能成为流感病毒基因“混合器”,应高度关注H7N9病毒与人季节性流感病毒的基因重配现象。     

H7N9灭活疫苗联合MF59佐剂在小鼠体内诱导的长效体液免疫应答

以BALB/c小鼠为模型,探讨H7N9流感病毒灭活疫苗免疫小鼠后所诱导的长效体液免疫应答的动态变化。不同剂量的流感H7N9全病毒灭活疫苗单独或辅以MF59佐剂肌肉注射免疫小鼠一次。连续采集免疫后小鼠15个月的血清,用ELISA方法检测特异性IgG抗体水平,血凝抑制(hemagglutination inhibition,HI)试验和微量中和(microneutralization,MN)试验检测第15个月时的HI抗体和中和抗体效价。实验结果发现,小鼠血清中的特异性IgG抗体水平随时间变化持续缓慢上升,第5个月时达到顶峰,随后略有下降但一直持续平稳状态;IgG抗体滴度与疫苗剂量成正相关,且添加佐剂能提高抗体滴度。HI及MN抗体检测表明,免疫后第15个月产生的抗体能有效中和病毒,且抗体跟疫苗剂量成正比。以上研究表明,H7N9流感病毒灭活疫苗免疫小鼠一次诱导产生的特异性抗体能在较长期内保持比较平稳的抗体滴度,为小鼠提供免疫保护;增加抗原剂量和添加MF59佐剂能增加疫苗特异性抗体水平。该研究为H7N9流感疫苗产生的长期保护效应提供了一定的数据积累和参考。     

禽流感疫苗研究进展

禽流感是由正黏病毒科流感病毒属的A型流感病毒引起的 ,发生于各种家禽和野鸟的一种急性传染病。由于其重要的经济和公共卫生学意义 ,使得禽流感的防治显得突出重要。疫苗的使用是控制禽流感的主要手段。目前实际应用中仍以禽流感全病毒灭活疫苗为主 ,但由于其潜在的缺点使得人们将目光转向其它类型疫苗的研制。从常规疫苗、新型疫苗和交叉保护性疫苗三个方面对禽流感疫苗研究进展加以阐述。常规疫苗包括基因工程亚单位疫苗和重组活载体疫苗 :新型疫苗主要有冷适应流感弱毒疫苗 ,基因工程活流感病毒疫苗 ,复制缺陷型病毒疫苗 ,DNA疫苗 ,RNA复制子疫苗 ,表位疫苗等 :交叉保护性疫苗主要依据流感病毒表面的保守蛋白M和NP的特性 ,构建疫苗来达到交叉保护的目的。     

Phylogeography of Avian influenza A H9N2 in China

Background

During the past two decades, avian influenza A H9N2 viruses have spread geographically and ecologically in China. Other than its current role in causing outbreaks in poultry and sporadic human infections by direct transmission, H9N2 virus could also serve as an progenitor for novel human avian influenza viruses including H5N1, H7N9 and H10N8. Hence, H9N2 virus is becoming a notable threat to public health. However, despite multiple lineages and genotypes that were detected by previous studies, the migration dynamics of the H9N2 virus in China is unclear. Increasing such knowledge would help us better prevent and control H9N2 as well as other future potentially threatening viruses from spreading across China. The objectives of this study were to determine the source, migration patterns, and the demography history of avian influenza A H9N2 virus that circulated in China.

Results

Using Bayesian phylogeography framework, we showed that the H9N2 virus in mainland China may have originated from the Hong Kong Special Administrative Region (SAR). Southern China, most likely the Guangdong province acts as the primary epicentre for multiple H9N2 strains spreading across the whole country, and eastern China, most likely the Jiangsu province, acts as an important secondary source to seed outbreaks. Our demography inference suggests that during the long-term migration process, H9N2 evolved into multiple diverse lineages and then experienced a selective sweep, which reduced its genetic diversity. Importantly, such a selective sweep may pose a greater threat to public health because novel strains confer higher fitness advantages than strains being replaced and could generate new viruses through reassortment.

Conclusion

Our analyses indicate that migratory birds, poultry trade and transportation have all contributed to the spreading of the H9N2 virus in China. The ongoing migration and evolution of H9N2, which poses a constant threat to the human population, highlights the need for a more comprehensive surveillance of wild birds and for the enhancement of biosafety for China’s poultry industry.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2164-15-1110) contains supplementary material, which is available to authorized users.     

季节性流感疫苗对小鼠感染 H7N9 禽流感病毒的保护效力简

目的 评价季节性流感裂解疫苗对流感病毒H7N9的免疫保护效力.方法 用我国2012～2013年度季节性流感裂解疫苗,以腹腔注射方式免疫BALB/c小鼠,并设PBS免疫模型组,末次免疫14 d后以5 LD50 A/Anhui/1（H7N9）进行攻试验.感染后观察记录小鼠临床表现,体重变化,并分别于第2天和第4天每组处死3只小鼠,取肺组织和鼻甲骨测病毒滴度和载量.结果 感染后疫苗与模型组小鼠体重下降明显,疫苗组存活率为10%,模型组全部死亡.感染后第4天疫苗组鼻甲骨滴度显著低于模型组.血凝抑制试验及中和实验表明免疫小鼠血清无中和H7N9病毒抗体.结论 季节性流感疫苗在小鼠中对于H7N9流感病毒感染无明显保护作用.     

Conservation of T cell epitopes between seasonal influenza viruses and the novel influenza A H7N9 virus

A novel avian influenza A (H7N9) virus recently emerged in the Yangtze River delta and caused diseases, often severe, in over 130 people. This H7N9 virus appeared to infect humans with greater ease than previous avian influenza virus subtypes such as H5N1 and H9N2. While there are other potential explanations for this large number of human infections with an avian influenza virus, we investigated whether a lack of conserved T-cell epitopes between endemic H1N1 and H3N2 influenza viruses and the novel H7N9 virus contributes to this observation. Here we demonstrate that a number of T cell epitopes are conserved between endemic H1N1 and H3N2 viruses and H7N9 virus. Most of these conserved epitopes are from viral internal proteins. The extent of conservation between endemic human seasonal influenza and avian influenza H7N9 was comparable to that with the highly pathogenic avian influenza H5N1. Thus, the ease of inter-species transmission of H7N9 viruses (compared with avian H5N1 viruses) cannot be attributed to the lack of conservation of such T cell epitopes. On the contrary, our findings predict significant T-cell based cross-reactions in the human population to the novel H7N9 virus. Our findings also have implications for H7N9 virus vaccine design.     

Single immunization with MF59-adjuvanted inactivated whole-virion H7N9 influenza vaccine provides early protection against H7N9 virus challenge in mice

H7N9 influenza infection in humans would result in severe respiratory illness. Vaccination is the best way to prevent influenza virus. In this paper, we investigated the effect of early protection provided by inactivated whole-virion H7N9 influenza vaccine in a mouse model.Mice were immunized intramuscularly once with different doses of inactivated whole-virion H7N9 influenza vaccine alone or in combination with MF59 adjuvant. Specific IgM and IgG antibody titers in sera of mice were detected by ELISA 3, 5 and 7days after immunization. To evaluate the early protection provided by the vaccine, mice were challenged with lethal dose (40LD₅₀) of homologous virus 3, 5 and 7 days after immunization respectively. The survival rate and body weight change of mice during 21 days after challenge and the residual lung virus titer on 3rd day after challenge were determined. The results demonstrated that mice could obtain effective protection 3 days after immunization with the vaccine at a high dose, and 5–7 days after immunization even at a low dose. Thus early immune responses induced by inactivated whole-virion H7N9 vaccine could provide effective protection.