人类肠道病毒71型亚单位疫苗壳聚糖佐剂作用的研究

为了解人类肠道病毒71型(EV71)重组保护性衣壳蛋白(rVP1)亚单位疫苗壳聚糖佐剂的作用,本研究利用rVP1蛋白与壳聚糖佐剂制备的疫苗口服免疫新西兰白兔,通过ELISA方法检测兔血清、粘膜洗液(小肠、鼻腔和肺)及粪便中特异性IgG、IgA抗体水平,中和试验检测血清中和抗体滴度,并通过抗原刺激体外培养的兔脾淋巴细胞分泌细胞因子(IFN-γ、IL-4)的水平评价rVP1口服免疫效果。结果显示,单纯口服rVP1蛋白仅可诱导产生较低水平的血清IgG和粘膜IgA抗体,而含佐剂疫苗组与单纯抗原免疫组差异显著,并可诱导产生中和抗体。细胞免疫检测结果显示rVP1含佐剂组兔脾淋巴细胞分泌IFN-γ和IL-4水平明显高于未加佐剂组。本研究为研制EV71VP1口服疫苗奠定了基础。     

柯萨奇病毒A组16型研究进展

柯萨奇病毒A组16型(CA16)是引起手足口病(HFMD)的主要病原体,与肠道病毒71型(EV71)交替或共同流行;特别是近年在西太平洋地区呈现流行强度高、重症和死亡人数多的特点,已成为该地区的重大公共卫生问题。研发安全有效的疫苗是控制HFMD流行的有效手段。由于EV71所致疾病在重症和死亡病例中所占比例高,对其疫苗研发得到了广泛关注,全病毒灭活疫苗已进入III期临床,有望即将应用于婴幼儿HFMD的防控。EV71疫苗的顺利研发随之也增加了对CA16疫苗研发的迫切性。近年来日本、新加坡以及中国台湾地区逐渐开始关注CA16相关的研究,我国也有多家企业开展CA16疫苗的研发。本文就CA16的病原学,流行病学,实验室诊断,治疗和预防等方面进行了综述。     

肠道病毒71型灭活疫苗免疫恒河猴在攻毒实验中的感染动力学

本文旨在根据前期研究建立的恒河猴感染动物模型,对同期研制的肠道病毒71型(EV71)实验性灭活疫苗免疫动物进行全面的免疫保护性评价。评价指标包括病毒攻击后动物体内病毒载量及病理学变化,根据所得结果进行实验性疫苗免疫后动物在病毒攻击中的感染动力学分析。3个疫苗剂量(20、80、320EU)免疫的恒河猴均出现不同效价的中和抗体,80EU和320EU剂量组在二次免疫后第6周抗体效价达1∶128～1∶256,经104.5CCID50病毒鼻腔攻击后均未检出阳性病毒载量。20EU剂量组中,淋巴器官、中枢神经系统及其他主要脏器均出现比对照组低但仍为阳性的病毒增殖现象。病理学方面,各剂量组免疫恒河猴的中枢神经系统以及肺等器官均未出现相关病理损伤。本实验在确定该疫苗对恒河猴有效保护性的同时,亦为明确EV71灭活疫苗免疫剂量提供了直接的实验依据。     

人免疫球蛋白中肠道病毒71型中和抗体效价的测定

采用经典微量细胞病变法,应用近两年分离自中国手足口病(HFMD)高发区的3株肠道病毒71型(EV71)病毒株,对中国不同血液制品厂家生产的35批人免疫球蛋白制品进行抗-EV71中和效价检测。结果显示,3株不同EV71病毒株间的抗-EV71中和效价差异均在4倍以内,差异无显著的统计学意义(F=2.323,P0.05)。根据这3株毒株检测结果判定,35批人免疫球蛋白的抗-EV71均为阳性,肌肉注射用免疫球蛋白(简称肌丙)的抗-EV71-GMTs(525.9)显著高于静脉注射用免疫球蛋白(简称静丙)的GMTs(252.3,F=66.518,P0.01)。30批静丙的抗-EV71-GMTs中和效价分布在128.0~384.0之间。应开展原料血浆中抗-EV71中和效价的筛选,研制高效价的EV71特异性免疫球蛋白制品,用于HFMD的治疗和预防。     

肠道病毒71型外壳蛋白VP1全长在大肠杆菌中的高效表达及初步活性测定

目的:重组表达肠道病毒71型(EV71)外壳蛋白VP1全长,用于研制血清学检测试剂和疫苗研发。方法:在获得EV71全长基因并测序正确的基础上,将外壳蛋白VP1全长基因克隆到表达载体pET28a(+)上,构建重组表达质粒pET28a(+)/VP1,转化大肠杆菌BL21,IPTG诱导表达,利用Ni2+亲和层析柱对重组蛋白进行纯化,采用双抗原夹心检测技术评价重组抗原与27份EV71抗体阳性血清和18份阴性血清的反应情况。结果:重组EV71-VP1蛋白在大肠杆菌中诱导6 h后可获得高效表达,能与27份EV71抗体阳性血清中的21份发生阳性反应,EV71双抗原夹心检测与中和血清测试结果具有很好的一致性(P0.05)。结论:实现了肠道病毒71型外壳蛋白VP1的高效表达,为肠道病毒71型诊断试剂和疫苗的研究奠定了基础。     

肠道病毒EV71疫苗效力国家参考品的协作标定

目的建立肠道病毒71型(Enterovirus 71,EV71)疫苗效力参考品,用于EV71疫苗效力的小鼠ED50检测质量控制。方法选取经Ⅲ期临床试验验证具有良好保护效果的一批EV71疫苗作为候选参考品,采用EV71小鼠ED50检测方法,对候选参考品进行效力的协作标定及适用性研究。结果候选参考品在各实验室的ED50均值分别为9.5~51.0 U,CV为3.8%~18.7%;5个实验室总均值为23.5 U,CV为60.9%。各实验室检测结果均符合正态分布;3个EV71灭活疫苗与参考品均表现出了良好的剂量效应关系,中和抗体阳转率均随疫苗稀释度的增加而降低,下降曲线形态相近。当以候选参考品为标准,3个灭活疫苗的体内效价比均值分别为2.7倍、0.8倍和0.9倍;CV分别为5.5%、27.5%和11.2%。结论建立的EV71疫苗效力国家参考品(320 U/0.5 m L),可用于EV71疫苗效力的小鼠ED_(50)检测质量控制。     

流行性出血热(EHF)双价纯化灭活疫苗——I 期临床观察

根据卫生部药审(91)特申体第02号文件,本品纯化灭活双价疫苗92年完成了Ⅰ期人体反应及血清学效果观察。91001批双价疫苗以0,1,2月和0,14,35天程序免疫,91002批以0,1,2月程序免疫,各接种15人。接种后未出现任何不良反应,与Ⅰ型,Ⅱ型单价疫苗相同,是安全可靠的。两种免疫程序,二针次免疫后皆能产生较高免疫抗体,接种后半年仍保持一定抗体水平。中和抗体(PRNT)均在1∶10～1∶20,ELISA1∶478～1∶549(GMT),阳转率100％,再次证明本型纯化疫苗安全有效,并具有较高免疫活性,本型疫苗也可采用二针次(0,1月),总量2ml免疫。     

汉滩病毒84Fli株DNA疫苗诱导小鼠免疫应答的初步研究

为了加强我国病毒性出血热的防治,本研究将汉滩病毒84Fli株核蛋白S和糖蛋白M编码片段分别克隆至pcDNA3.0载体,构建了pcDNA3/84S和pcDNA3/84M重组质粒,等量混合采用肌肉注射途径免疫C57BL/6小鼠,免疫3次,每次间隔2周,同时与双价出血热病毒灭活疫苗进行对比。ELISA及免疫荧光(IFA)分别检测小鼠血清中汉滩病毒核蛋白及糖蛋白特异性抗体,流式细胞仪和ELISPOT方法分析小鼠免疫后的细胞免疫水平。微量中和试验检测小鼠血清抗体的的中和活性。结果显示,DNA疫苗免疫组C57BL/6小鼠在初次免疫2周后即能检测到汉滩病毒核蛋白与糖蛋白的特异性抗体,与灭活疫苗组相比,重组质粒诱导的抗体滴度高,产生时间早,产生的抗体具有中和活性;同时可诱导产生特异性细胞免疫应答。研究表明,汉滩病毒pcDNA3/84S和pcDNA3/84M重组质粒能有效刺激小鼠产生特异性体液免疫和细胞免疫应答。     

HEVAg-PLGA纳米颗粒疫苗小鼠体内免疫学研究

研究重组戊型肝炎抗原(HEVAg)-乳酸/乙醇酸共聚物(PLGA)纳米颗粒抗原能否在动物体内诱导产生免疫应答。制备HEVAg-PLGA纳米颗粒抗原后,通过皮下、滴鼻、口服途径接种Balb/c小鼠,每隔4周加强免疫两次,HEVAg与铝盐佐剂(铝佐剂疫苗Al_2O_3-Ag)为对照组,一定时间内检测抗体及细胞因子的应答水平。结果HEVAg-PLGA纳米颗粒抗原在小鼠体内诱导产生有效的体液免疫、细胞免疫。滴鼻、口服途径黏膜系统中诱导产生较高滴度的IgA抗体,ELISPOT结果显示鼻腔、唾液腺中IgA ASCs数量显著增加;皮下途径诱导产生较高滴度的IgG抗体;常规铝佐剂疫苗相比于HEVAg-PLGA纳米颗粒抗原诱导较强的IgG抗体水平,未诱导产生黏膜免疫应答;HEVAg-PLGA纳米颗粒抗原诱导产生较强细胞免疫应答,皮下接种途径IFN-γ、IL-4生成细胞数量显著高于其它免疫组。与铝佐剂疫苗相比,HEVAg-PLGA纳米颗粒抗原能有效诱导产生系统免疫及黏膜免疫应答,显示HEVAg-PLGA有潜力成为备选HEV黏膜疫苗抗原,同时展示PLGA颗粒作为黏膜系统抗原递送载体及黏膜佐剂的优越性。     

肠道病毒71型2C蛋白原核表达及抗体制备

肠道病毒71型(EV71)的非结构蛋白2C(P2C)在病毒复制周期中起着重要的作用,制备P2C的特异性抗体,对研究P2C的生物学功能以及EV71与宿主相互作用的具体机制有非常重要的意义。实验将2C基因克隆到原核表达载体p ET-28a(+)上,在大肠埃希菌BL21(DE3)中表达出重组蛋白r P2C,进一步优化原核表达条件,在温度为30℃,诱导剂IPTG浓度为1 mmol/L时,蛋白表达量最高,且主要以包涵体形式存在。直接将获得的r P2C通过SDS-PAGE分离后免疫新西兰兔,制备EV71病毒P2C的兔多克隆抗体。通过Western blot检测,该抗体在110 000稀释比例下仍能很好地识别原核表达的r P2C。同时该抗体也能很好地检测到EV71感染RD细胞中的P2C。因此,实验制备出的抗P2C抗体特异性强、效价高,为后续P2C功能的研究以及EV71病毒检测提供了良好的材料。     

肠道病毒71型实验室诊断研究进展

肠道病毒71型(Enterovirus 71,EV71)为手足口病(Handf,oot and mouth disease,HFMD)和相关疾病的主要病原体,多感染婴幼儿,少数病例可以并发呼吸道感染和心肌炎、无菌性脑膜炎、脑炎、急性弛缓性麻痹等严重疾病,可致残、致死。因此EV71实验室诊断对EV71引起疾病的治疗和防控具有重要意义。本文将从核酸检测、抗体检测及其他检测等三部分对EV71的实验室诊断方法研究进展进行了综述。     

肠道病毒71型在RD细胞和Vero细胞中的增殖动力学特征

目的:利用噬斑法比较肠道病毒71型(EV71)在RD细胞和Vero细胞中的增殖动力学特征。方法:首先探讨培养基类型、羟乙基哌嗪乙磺酸(HEPES)、胎牛血清(FBS)、牛血清白蛋白(BSA)及甲基纤维素(MC)含量对EV71噬斑形成的影响,得到最适营养覆盖物配比;进一步,EV71以感染复数(MOI)为0.1分别接种RD细胞和Vero细胞,收集接种后不同时间点的细胞培养液,噬斑法测定各时间点培养液上清中的病毒滴度,并绘制log2(病毒滴度)-时间图,对比分析EV71在2种细胞中的增殖动力学特征。结果:终浓度含1%MC和2%FBS的MEM(1×)或DMEM(1×)为EV71噬斑形成的最适营养覆盖物;EV71在RD细胞和Vero细胞中的增殖周期均约为12 h,MOI=0.1时,EV71在RD细胞中的增殖活动较Vero细胞中活跃,增殖效率比Vero细胞中高2个数量级。结论:用RD细胞扩增EV71比Vero细胞更具优势。     

Generation of neutralizing monoclonal antibodies against Enterovirus 71 using synthetic peptides

Enterovirus 71 (EV71) has led to recent outbreaks of hand, foot and mouth disease (HFMD) in China, resulting in high mortality. In this study, several monoclonal antibodies were generated by immunizing mice with two synthetic peptides, SP55 and SP70, containing amino acids 163-177 and 208-222 of VP1. The specificities of the anti-EV71 peptide monoclonal antibodies were confirmed by Western blot analysis and immunocytochemistry against EV71 virus. Most importantly, we have identified a monoclonal antibody, clone 22A12, which shows strong neutralizing activity against EV71 in an in vitro neutralization assay. Because there is no vaccine available and treatment is very limited, mouse anti-EV71 monoclonal antibody, clone 22A12, could be a promising candidate to be humanized and used for treatment of EV71 infection.     

CA16滴度微量检测方法的建立及其验证

目的建立用Vero细胞检测柯萨奇病毒A组16型(CA16)滴度的方法,并对其适用性进行初步验证。方法通过对细胞种类的选择、细胞接种浓度和细胞病变判定时间的优化,建立测定CA16滴度的半数细胞感染剂量法(CCID50法),并对其进行初步验证。结果通过对病毒感染后细胞病变情况的观察,确定了以Vero细胞作为CA16病毒滴度检定用细胞。Vero细胞的最佳接种浓度和结果判定时间分别为5×104~1×105细胞/mL(即96孔板内每孔加入的最终细胞量为5×103~1×104细胞)和7 d。由4组人员对6批CA16病毒液进行重复检测,实验结果表明不同实验人员测定结果的变异系数(CV)在1.739%~4.974%之间,说明该方法测定结果重复性好,准确度高。结论该法简便、稳定,可以灵敏、准确地检测CA16病毒的滴度,可用于相关疫苗生产过程中的质量控制。     

Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong,China, in Pre- and Post-2010 HFMD Epidemic Period

Background

Human Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China.

Methodology/Principal Findings

A cross sectional study of Enterovirus 71 (EV71) and Coxsackie A16 (CA16) seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD) epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT) was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic.

Conclusions

These results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine.     

Recombinant Adeno-Vaccine Expressing Enterovirus 71-Like Particles against Hand,Foot, and Mouth Disease

Enterovirus 71 (EV71) and coxsackieviruses (CV) are the major causative agents of hand, foot and mouth disease (HFMD). There is not currently a vaccine available against HFMD, even though a newly developed formalin-inactivated EV71 (FI-EV71) vaccine has been tested in clinical trial and has shown efficacy against EV71. We have designed and genetically engineered a recombinant adenovirus Ad-EVVLP with the EV71 P1 and 3CD genes inserted into the E1/E3-deleted adenoviral genome. Ad-EVVLP were produced in HEK-293A cells. In addition to Ad-EVVLP particles, virus-like particles (VLPs) formed from the physical association of EV71 capsid proteins, VP0, VP1, and VP3 expressed from P1 gene products. They were digested by 3CD protease and confirmed to be produced by Ad-EVVLP-producing cells, as determined using transmission electron microscopy and western blotting. Mouse immunogenicity studies showed that Ad-EVVLP-immunized antisera neutralized the EV71 B4 and C2 genotypes. Activation of VLP-specific CD4⁺ and CD8⁺/IFN-γ T cells associated with Th1/Th2-balanced IFN-ɣ, IL-17, IL-4, and IL-13 was induced; in contrast, FI-EV71 induced only Th2-mediated neutralizing antibody against EV71 and low VLP-specific CD4⁺ and CD8⁺ T cell responses. The antiviral immunity against EV71 was clearly demonstrated in mice vaccinated with Ad-EVVLP in a hSCARB2 transgenic (hSCARB2-Tg) mouse challenge model. Ad-EVVLP-vaccinated mice were 100% protected and demonstrated reduced viral load in both the CNS and muscle tissues. Ad-EVVLP successfully induced anti-CVA16 immunities. Although antisera had no neutralizing activity against CVA16, the 3C-specific CD4⁺ and CD8⁺/IFN-γ T cells were identified, which could mediate protection against CVA16 challenge. FI-EV71 did not induce 3C-mediated immunity and had no efficacy against the CVA16 challenge. These results suggest that Ad-EVVLP can enhance neutralizing antibody and protective cellular immune responses to prevent EV71 infection and cellular immune responses against CV infection.