Persistence of Highly Pathogenic Avian Influenza H5N1 Virus Defined by Agro-Ecological Niche

The highly pathogenic avian influenza (HPAI) H5N1 virus has spread across Eurasia and into Africa. Its persistence in a number of countries continues to disrupt poultry production, impairs smallholder livelihoods, and raises the risk a genotype adapted to human-to-human transmission may emerge. While previous studies identified domestic duck reservoirs as a primary risk factor associated with HPAI H5N1 persistence in poultry in Southeast Asia, little is known of such factors in countries with different agro-ecological conditions, and no study has investigated the impact of such conditions on HPAI H5N1 epidemiology at the global scale. This study explores the patterns of HPAI H5N1 persistence worldwide, and for China, Indonesia, and India includes individual provinces that have reported HPAI H5N1 presence during the 2004–2008 period. Multivariate analysis of a set of 14 agricultural, environmental, climatic, and socio-economic factors demonstrates in quantitative terms that a combination of six variables discriminates the areas with human cases and persistence: agricultural population density, duck density, duck by chicken density, chicken density, the product of agricultural population density and chicken output/input ratio, and purchasing power per capita. The analysis identifies five agro-ecological clusters, or niches, representing varying degrees of disease persistence. The agro-ecological distances of all study areas to the medoid of the niche with the greatest number of human cases are used to map HPAI H5N1 risk globally. The results indicate that few countries remain where HPAI H5N1 would likely persist should it be introduced.     

Selection of H5N1 Influenza Virus PB2 during Replication in Humans

Highly pathogenic H5N1 influenza viruses continue to cause concern, even though currently circulating strains are not efficiently transmitted among humans. For efficient transmission, amino acid changes in viral proteins may be required. Here, we examined the amino acids at positions 627 and 701 of the PB2 protein. A direct analysis of the viral RNAs of H5N1 viruses in patients revealed that these amino acids contribute to efficient virus propagation in the human upper respiratory tract. Viruses grown in culture or eggs did not always reflect those in patients. These results emphasize the importance of the direct analysis of original specimens.Given the continued circulation of highly pathogenic H5N1 avian influenza viruses and their sporadic transmission to humans, the threat of a pandemic persists. However, for H5N1 influenza viruses to be efficiently transmitted among humans, amino acid substitutions in the avian viral proteins may be necessary.Two positions in the PB2 protein affect the growth of influenza viruses in mammalian cells (3, 11, 18): the amino acid at position 627 (PB2-627), which in most human influenza viruses is lysine (PB2-627Lys) and most avian viruses is glutamic acid (PB2-627Glu), and the amino acid at position 701. PB2-627Lys is associated with the efficient replication (16) and high virulence (5) of H5N1 viruses in mice. Moreover, an H7N7 avian virus isolated from a fatal human case of pneumonia possessed PB2-627Lys, whereas isolates from a nonfatal human case of conjunctivitis and from chickens during the same outbreak possessed PB2-627Glu (2).The amino acid at position 701 in PB2 is important for the high pathogenicity of H5N1 viruses in mice (11). Most avian influenza viruses possess aspartic acid at this position (PB2-701Asp); however, A/duck/Guangxi/35/2001 (H5N1), which is highly virulent in mice (11), possesses asparagine at this position (PB2-701Asn). PB2-701Asn is also found in equine (4) and swine (15) viruses, as well as some H5N1 human isolates (7, 9). Thus, both amino acids appear to be markers for the adaptation of H5N1 viruses in humans (1, 3, 17).Massin et al. (13) reported that the amino acid at PB2-627 affects viral RNA replication in cultured cells at low temperatures. Recently, we demonstrated that viruses, including those of the H5N1 subtype, with PB2-627Lys (human type) grow better at low temperatures in cultured cells than those with PB2-627Glu (avian type) (6). This association between the PB2 amino acid and temperature-dependent growth correlates with the body temperatures of hosts; the human upper respiratory tract is at a lower temperature (around 33°C) than the lower respiratory tract (around 37°C) and the avian intestine, where avian influenza viruses usually replicate (around 41°C). The ability to replicate at low temperatures may be crucial for viral spread among humans via sneezing and coughing by being able to grow in the upper respiratory organs. Therefore, the Glu-to-Lys mutation in PB2-627 is an important step for H5N1 viruses to develop pandemic potential.However, there is no direct evidence that the substitutions of PB2-627Glu with PB2-627Lys and PB2-701Asp with PB2-701Asn occur during the replication of H5N1 avian influenza viruses in human respiratory organs. Therefore, here, we directly analyzed the nucleotide sequences of viral genes from several original specimens collected from patients infected with H5N1 viruses.     

The Effect of the PB2 Mutation 627K on Highly Pathogenic H5N1 Avian Influenza Virus Is Dependent on the Virus Lineage

Clade 2.2 Eurasian-lineage H5N1 highly pathogenic avian influenza viruses (HPAIVs) were first detected in Qinghai Lake, China, in 2005 and subsequently spread through Asia, Europe, and Africa. Importantly, these viruses carried a lysine at amino acid position 627 of the PB2 protein (PB2 627K), a known mammalian adaptation motif. Previous avian influenza virus isolates have carried glutamic acid in this position (PB2 627E), commonly described to restrict virus polymerase function in the mammalian host. We sought to examine the effect of PB2 627K on viral maintenance in the avian reservoir. Viruses constructed by reverse genetics were engineered to contain converse PB2 627K/E mutations in a Eurasian H5N1 virus (A/turkey/Turkey/5/2005 [Ty/05]) and, for comparison, a historical pre-Asian H5N1 HPAIV that naturally bears PB2 627E (A/turkey/England/50-92/1991 [50-92]). The 50-92 PB2 627K was genetically unstable during virus propagation, resulting in reversion to PB2 627E or the accumulation of the additional mutation PB2 628R and/or a synonymous mutation from an A to a G nucleotide at nucleotide position 1869 (PB2 A1869G). Intriguingly, PB2 628R and/or A1869G appeared to improve the genetic stability of 50-92 PB2 627K. However, the replication of 50-92 PB2 627K in conjunction with these stabilizing mutations was significantly restricted in experimentally infected chickens, where reversion to PB2 627E occurred. In contrast, no significant effects on viral fitness were observed for Ty/05 PB2 627E or 627K in in vitro or in vivo experiments. Our observations suggest that PB2 627K is supported in Eurasian-lineage viruses; in contrast, PB2 627K carries a significant fitness cost in the historical pre-Asian 50-92 virus.     

Recombinant Parainfluenza Virus 5 Expressing Hemagglutinin of Influenza A Virus H5N1 Protected Mice against Lethal Highly Pathogenic Avian Influenza Virus H5N1 Challenge

A safe and effective vaccine is the best way to prevent large-scale highly pathogenic avian influenza virus (HPAI) H5N1 outbreaks in the human population. The current FDA-approved H5N1 vaccine has serious limitations. A more efficacious H5N1 vaccine is urgently needed. Parainfluenza virus 5 (PIV5), a paramyxovirus, is not known to cause any illness in humans. PIV5 is an attractive vaccine vector. In our studies, a single dose of a live recombinant PIV5 expressing a hemagglutinin (HA) gene of H5N1 (rPIV5-H5) from the H5N1 subtype provided sterilizing immunity against lethal doses of HPAI H5N1 infection in mice. Furthermore, we have examined the effect of insertion of H5N1 HA at different locations within the PIV5 genome on the efficacy of a PIV5-based vaccine. Interestingly, insertion of H5N1 HA between the leader sequence, the de facto promoter of PIV5, and the first viral gene, nucleoprotein (NP), did not lead to a viable virus. Insertion of H5N1 HA between NP and the next gene, V/phosphorprotein (V/P), led to a virus that was defective in growth. We have found that insertion of H5N1 HA at the junction between the small hydrophobic (SH) gene and the hemagglutinin-neuraminidase (HN) gene gave the best immunity against HPAI H5N1 challenge: a dose as low as 1,000 PFU was sufficient to protect against lethal HPAI H5N1 challenge in mice. The work suggests that recombinant PIV5 expressing H5N1 HA has great potential as an HPAI H5N1 vaccine.     

H5N1高致病性禽流感病毒的危害及生态问题

高致病性禽流感(HPAI)H5N1病毒亚型已对人类健康、养殖业发展、野生鸟类及生态环境带来极大危害,引起国内外广泛关注。研究发现,禽流感病毒通过发生重组或者突变,可产生感染人类或其他生物的新病毒亚型,或产生更高的致病性,而人类亦具有丰富的与H5N1结合的受体。对候鸟迁徙停歇地禽流感调查表明,湿地、湖泊可能是HPAI病毒存活、散播的疫源地,病毒可随着鸟类的迁徙到处传播。因此,野生鸟类及其赖以生存的主要湿地环境处于感染HPAI的风险之中。     

Mammalian Adaptation in the PB2 Gene of Avian H5N1 Influenza Virus

The substitution of glutamic acid (E) for lysine (K) at position 627 of the PB2 protein of avian H5N1 viruses has been identified as a virulence and host range determinant for infection of mammals. Here, we report that the E-to-K host-adaptive mutation in the PB2 gene appeared from day 4 and 5 along the respiratory tracts of mice and was complete by day 6 postinoculation. This mutation correlated with efficient replication of the virus in mice.     

Experimental Infection of Macaques with a Wild Water Bird-Derived Highly Pathogenic Avian Influenza Virus (H5N1)

Highly pathogenic avian influenza virus (HPAIV) continues to threaten human health. Non-human primate infection models of human influenza are desired. To establish an animal infection model with more natural transmission and to determine the pathogenicity of HPAIV isolated from a wild water bird in primates, we administered a Japanese isolate of HPAIV (A/whooper swan/Hokkaido/1/2008, H5N1 clade 2.3.2.1) to rhesus and cynomolgus monkeys, in droplet form, via the intratracheal route. Infection of the lower and upper respiratory tracts and viral shedding were observed in both macaques. Inoculation of rhesus monkeys with higher doses of the isolate resulted in stronger clinical symptoms of influenza. Our results demonstrate that HPAIV isolated from a water bird in Japan is pathogenic in monkeys by experimental inoculation, and provide a new method for HPAIV infection of non-human primate hosts, a good animal model for investigation of HPAIV pathogenicity.     

人源中和性抗高致病性禽流感病毒H5N1基因工程全抗体的研制

运用噬菌体表面呈现技术,从禽流感病人恢复期血中获得淋巴细胞,通过基因工程手段,构建了人源抗H5NI禽流感病毒基因工程抗体文库.用纯化的人源H5N1禽流感病毒颗粒(A/Anhui/1/2005)及重组血凝素蛋白HA(A/Viet Nam/1203/2004)对Fab噬菌体抗体库进行富集筛选,成功地获得了抗禽流感病毒H5N1血凝素蛋白HA的人源单抗Fab段基因,并在大肠杆菌中获得有效表达.通过序列测定确定抗体轻重链型别,然后将阳性克隆的轻链和重链Fd段基因分别克隆入全抗体表达载体pAC-L-Fc后转染昆虫Sf9细胞,利用杆状病毒/昆虫细胞系统实现全抗体的分泌型表达.用ELISA、IFA和流式细胞术对所获人源单抗的功能特性进行鉴定.结果表明,我们获得了2株特异性针对H5N1禽流感病毒血凝素蛋白HA而与甲1型和甲3型人流感病毒无交叉反应的人源单抗(AVFlulgG01、AVFlulgG03).微量中和试验结果表明,除A/Guangdong/1/2006外,AVFlu-IgG01能够广泛地中和HA基因进化上属于Clade 2的中国南方、北方及中部地区的H5N1禽流感病毒分离株,同时还对属于Clade Ⅰ的越南H5N1分离株A/Viet Nam/1203/2004具有中和活性;AVFluIgG03虽然不能中和A/Viet Nam/1203/2004,但是对属于Clade 2的所有中国H5N1分离株均具有中和作用.人源中和性抗禽流感病毒H5N1基因工程全抗体的获得不仅为高致病性禽流感病毒H5N1的预防和治疗带来了希望,同时也为其疫苗研制提供了新的思路.     

Highly Pathogenic H5N1 Influenza Virus Infection in Migratory Birds

H5N1avianinfluenza virus(AIV)has emerged as a pathogenic entityfor a variety of species,including humans,inre-cent years.Here we report an outbreak among migratory birds on Lake Qinghaihu,China,in May and June2005,inwhich more than a thousand birds were affected.Pancreatic necrosis and abnormal neurological symptoms were the majorclinical features.Sequencing of the complete genomes of four H5N1AIVstrains revealedthemto be reassortants relatedto a peregrine falconisolate from Hong Kong an…     

Highly Pathogenic H5N1 Avian Influenza Virus Induces Extracellular Ca2+ Influx,Leading to Apoptosis in Avian Cells

In this study, we show that the highly pathogenic H5N1 avian influenza virus (AIV) (A/crow/Kyoto/53/04 and A/chicken/Egypt/CL6/07) induced apoptosis in duck embryonic fibroblasts (DEF). In contrast, apoptosis was reduced among cells infected with low-pathogenic AIVs (A/duck/HK/342/78 [H5N2], A/duck/HK/820/80 [H5N3], A/wigeon/Osaka/1/01 [H7N7], and A/turkey/Wisconsin/1/66 [H9N2]). Thus, we investigated the molecular mechanisms of apoptosis induced by H5N1-AIV infection. Caspase-dependent and -independent pathways contributed to the cytopathic effects. We further showed that, in the induction of apoptosis, the hemagglutinin of H5N1-AIV played a major role and its cleavage sequence was not critical. We also observed outer membrane permeabilization and loss of the transmembrane potential of the mitochondria of infected DEF, indicating that mitochondrial dysfunction was caused by the H5N1-AIV infection. We then analyzed Ca²⁺ dynamics in the infected cells and demonstrated an increase in the concentration of Ca²⁺ in the cytosol ([Ca²⁺]_i) and mitochondria ([Ca²⁺]_m) after H5N1-AIV infection. Regardless, gene expression important for regulating Ca²⁺ efflux from the endoplasmic reticulum did not significantly change after H5N1-AIV infection. These results suggest that extracellular Ca²⁺ may enter H5N1-AIV-infected cells. Indeed, EGTA, which chelates extracellular free Ca²⁺, significantly reduced the [Ca²⁺]_i, [Ca²⁺]_m, and apoptosis induced by H5N1-AIV infection. In conclusion, we identified a novel mechanism for influenza A virus-mediated cell death, which involved the acceleration of extracellular Ca²⁺ influx, leading to mitochondrial dysfunction and apoptosis. These findings may be useful for understanding the pathogenesis of H5N1-AIV in avian species as well as the impact of Ca²⁺ homeostasis on influenza A virus infection.Avian influenza viruses (AIVs) are classified as highly or low-pathogenic AIVs (HPAIVs or LPAIVs, respectively) based on their pathogenicity in chickens (1). HPAIVs cause systemic infections and high mortality in chickens (28), whereas poultry are asymptomatic or develop mild respiratory problems and/or intestinal illness after LPAIV infection (49). Hemagglutinin (HA) cleavability is a critical determinant of AIV pathogenicity in avian species (61). Other determinants, such as nonstructural (NS) protein and neuraminidase (NA) protein, reportedly regulate the virulence of AIVs (9, 29, 44). However, waterfowl, known as the natural host for AIVs, do not usually have any symptoms during an HPAIV infection (21), whereas they show neurologic symptoms and death after infection with some of the recently emerged HPAIVs, such as the Asian H5N1 virus (11, 46, 62). Thus, the entire mechanism responsible for the pathogenicity of the AIVs is not yet known. Unknown cellular and viral factors probably underlie the pathogenesis of HPAIVs in avian species, especially waterfowl.The alveolar epithelial cells (66) or vascular endothelial cells (32) of human patients and chickens infected by H5N1-AIV show apoptosis. Other reports suggest that apoptosis of these cells is essential for the development of acute lung injury in mice and acute respiratory distress syndrome in humans (39), which is often observed in H5N1-AIV-infected patients. Therefore, it is necessary to evaluate whether apoptosis is critical for the pathogenesis of H5N1-AIV in vivo and to understand the molecular mechanisms of the apoptotic cell death induced by H5N1-AIV infection.Ca²⁺ is a key regulator of cell survival, and the breakdown of Ca²⁺ homeostasis, due to sustained elevations in Ca²⁺ inside cells, triggers programmed cell death involving apoptosis (24). Indeed, disruption of Ca²⁺ homeostasis plays a key role in apoptosis during the pathogenic process of several types of viral infections, including those with human immunodeficiency virus (HIV), hepatitis C virus, and human T-cell leukemia virus type 1 (3, 4, 31, 57). In addition, the HIV gp120 envelope protein induces neuronal cell death through Ca²⁺ dysregulation, even in the absence of viral particles (25).In this study, we used duck embryonic fibroblasts (DEF) to elucidate the molecular mechanisms of the apoptotic cell death induced by H5N1-AIV. We show here that H5N1-AIV infection triggered extracellular Ca²⁺ influx and that this alteration in the concentration of Ca²⁺ inside the cells subsequently induced mitochondrial dysfunction and led to apoptotic cell death. In addition, we demonstrate that H5N1-HA was a critical viral factor for inducing apoptosis.     

A Novel Bivalent Vaccine Based on a PB2-Knockout Influenza Virus Protects Mice from Pandemic H1N1 and Highly Pathogenic H5N1 Virus Challenges

Vaccination is an effective means to protect against influenza virus. Although inactivated and live-attenuated vaccines are currently available, each vaccine has disadvantages (e.g., immunogenicity and safety issues). To overcome these problems, we previously developed a replication-incompetent PB2-knockout (PB2-KO) influenza virus that replicates only in PB2 protein-expressing cells. Here, we generated two PB2-KO viruses whose PB2-coding regions were replaced with the HA genes of either A/California/04/2009 (H1N1pdm09) or A/Vietnam/1203/2004 (H5N1). The resultant viruses comparably, or in some cases more efficiently, induced virus-specific antibodies in the serum, nasal wash, and bronchoalveolar lavage fluid of mice relative to a conventional formalin-inactivated vaccine. Furthermore, mice immunized with these PB2-KO viruses were protected from lethal challenges with not only the backbone virus strain but also strains from which their foreign HAs originated, indicating that PB2-KO viruses with antigenically different HAs could serve as bivalent influenza vaccines.     

Geographical Spread of Highly Pathogenic Avian Influenza Virus H5N1 during the 2006 Outbreak in Austria

In spring 2006, highly pathogenic avian influenza virus (HPAIV) of subtype H5N1 was detected in Austria in 119 dead wild birds. The hemagglutinin cleavage site showed that the amino acid sequence motif was identical to that of the Qinghai lineage. For detailed analysis, the hemagglutinin (HA) and neuraminidase (NA) genes of 27 selected Austrian H5N1 viruses originating from different regions and wild bird species were analyzed phylogenetically, which revealed two clearly separated Austrian subclusters, both belonging to European cluster EMA-1. Subcluster South (SCS) contains virus isolates from the south of Austria as well as from Slovenia, Turkey, Egypt, and Nigeria. The second subcluster, Northwest (SCN), covered a larger group of viruses originating from different locations and wild bird species in the northern and very western parts of Austria, as well as from Bavaria and Switzerland. Surprisingly, virus isolates originating from two mute swans and one wild duck found on the north side of the Alps did not cluster with SCN but with SCS. Together with isolates from Bavarian, the Czech Republic, Italy, and Slovakia, they form a genuine subgroup, named subgroup Bavaria (SGB). This subgroup forms a link to SCN, indicating a spread of the virus from south to north. There has been a general assumption that the generic HPAI introduction route into Europe was from Russia to north Germany, introducing cluster EMA-2 into Europe. Interestingly, our findings support the assumption of an alternative introduction of the HPAI H5N1 virus from Turkey to central Europe, where it spread as cluster EMA-1 during the outbreak of 2006.Highly pathogenic H5N1 viruses have been recognized in Asia since 1996, when the first Asian H5N1 virus (A/Goose/Guandgdong/1/96) was isolated from sick geese in southern China (25). Since then, this virus has caused endemic infections in poultry in many southeast Asian countries (13, 18). Although influenza viruses in wild aquatic birds occasionally are transmitted to chickens and turkeys, where they may produce outbreaks of severe disease, they do not appear to have entered the wild bird populations to a substantial extent until late April to June 2005, when a large outbreak of H5N1 infection occurred at Qinghai Lake in western China, a major breeding site of migratory birds (2). Subsequently to the outbreak at Qinghai Lake from April to June 2005, H5N1 viruses have continued to cause outbreaks in Asia and Europe (http://www.who.int).A major molecular determinant for the pathogenicity of H5 and H7 viruses is the amino acid sequence specifying the proteolytic cleavage site of hemagglutinin (HA). In lowly pathogenic avian influenza virus (LPAIV), single basic residues at the cleavage site restrict the proteolytic activation of HA to the respiratory and intestinal tracts. In contrast, insertional mutations at the genomic locus encoding the endoproteolytic cleavage site resulting in the presence of a polybasic site render it accessible for ubiquitous protease, resulting in severe, systemic infections (17). All analyzed viruses originating from Qinghai Lake showed the series of basic amino acids at the HA cleavage site PQGERRRKKRGLF, which is characteristic of high pathogenicity in chickens. They also exhibited a 20-amino-acid deletion of the neuraminidase (NA) stalk (residues 49 to 68) that is characteristic of the NA of the A/Goose/Guandgdong/1/96 virus (2).Salzberg et al. analyzed 36 isolates of highly pathogenic avian influenza (HPAI) H5N1 viruses collected from Europe, northern Africa, the Middle East, and Asia and described the genetic relationships among these isolates, which affect birds and humans (16). He grouped the isolates into three distinct lineages, one encompassing all known non-Asian isolates, and hypothesized that this Europe-African lineage has been introduced into the European-African region at least three times and has split into three distinct, independently evolving sublineages: EMA-1, EMA-2, and EMA-3. These three clades possibly represent either separate introductions or a single introduction from Asia via Russia into Europe or any other western site, which then has subsequently evolved into three sublineages, EMA-1, EMA-2, and EMA-3 (16). EMA-2 contains the first German H5N1-positive swan found at the beginning of February 2006 on the Baltic island Ruegen (A/Cygnus cygnus/Germany/R65/06). This suggests a single introduction route for this cluster, because a phylogenetic analysis of the HA and the NA nucleotide sequences revealed that the closest genetic relative was an isolate from Astrakhan (A/Cygnus olor/Astrakhan/Ast05-2-3/2005). From Astrakhan, located in southern Russia, a westward movement of wild birds to central Europe in late January/early February 2006 is suggested (24).The aim of this study was to perform a phylogenetic analysis of Austrian HPAI H5N1 isolates from the outbreak of 2006 to determine their linkage to the European clusters EMA-1, EMA-2, and EMA-3 and to identify possible implications for H5N1 introduction routes into Austria.     

Comparative Pathogenesis of an Avian H5N2 and a Swine H1N1 Influenza Virus in Pigs

Pigs are considered intermediate hosts for the transmission of avian influenza viruses (AIVs) to humans but the basic organ pathogenesis of AIVs in pigs has been barely studied. We have used 42 four-week-old influenza naive pigs and two different inoculation routes (intranasal and intratracheal) to compare the pathogenesis of a low pathogenic (LP) H5N2 AIV with that of an H1N1 swine influenza virus. The respiratory tract and selected extra-respiratory tissues were examined for virus replication by titration, immunofluorescence and RT-PCR throughout the course of infection. Both viruses caused a productive infection of the entire respiratory tract and epithelial cells in the lungs were the major target. Compared to the swine virus, the AIV produced lower virus titers and fewer antigen positive cells at all levels of the respiratory tract. The respiratory part of the nasal mucosa in particular showed only rare AIV positive cells and this was associated with reduced nasal shedding of the avian compared to the swine virus. The titers and distribution of the AIV varied extremely between individual pigs and were strongly affected by the route of inoculation. Gross lung lesions and clinical signs were milder with the avian than with the swine virus, corresponding with lower viral loads in the lungs. The brainstem was the single extra-respiratory tissue found positive for virus and viral RNA with both viruses. Our data do not reject the theory of the pig as an intermediate host for AIVs, but they suggest that AIVs need to undergo genetic changes to establish full replication potential in pigs. From a biomedical perspective, experimental LP H5 AIV infection of pigs may be useful to examine heterologous protection provided by H5 vaccines or other immunization strategies, as well as for further studies on the molecular pathogenesis and neurotropism of AIVs in mammals.