七重呼吸道病毒液相芯片核酸检测技术的初步建立

由呼吸道病毒引起的疾病严重威胁着人类的生命健康，为了建立一种快速高通量的呼吸道病毒核酸检测方法，本研究将多重PCR技术同液相芯片技术结合起来，针对呼吸道合胞病毒A型和B型、乙型流感病毒Victoria系和Yamagata系、甲型流感病毒H1型和H3型以及新冠病毒等常见的七种呼吸道病毒，初步建立了七重呼吸道病毒液相芯片核酸检测技术，评价了方法的特异性、敏感性和重复性，并使用来自安徽省疾控的25份临床急性期样本核酸对方法进行验证。结果显示，建立起的基于液相芯片多重核酸检测方法可特异性识别七种目标呼吸道病毒的靶基因序列，与包括副流感病毒在内的9种非目标呼吸道病毒无交叉反应。对七种病毒核酸进行十倍稀释液相检测，其中H3、BV、RSVB可以检出10²拷贝/μL,BY、RSVA和SARS-CoV-2可以检出10³拷贝/μL，对H1的检测限为10⁴拷贝/μL。25份样本核酸检测结果与实际相符。结果表明，本研究建立的七重呼吸道病毒液相芯片核酸检测技术具有特异性强、敏感性高、稳定性好等特点，可用于临床样本的快速检测，为呼吸道类传染病的液相...     

呼吸道病毒核酸快速检测方案的建立与应用

本研究旨在建立一套便携、准确、操作简便的呼吸道病毒核酸快速检测方案。通过实时荧光定量聚合酶链式反应(quantitative real-time polymerase chain reaction,qRT-PCR)验证免提取的呼吸道病毒处理试剂(extraction-free respiratory virus treatment reagent,RTU)对病毒核酸处理的效果以及超快速荧光定量PCR仪(FQ-8A)对核酸扩增的效果;将RTU和FQ-8A结合构建呼吸道病毒核酸快速检测方案,通过荧光定量PCR仪中Ct值判断阳性检出率,以验证该方案检测临床样本时的准确性。结果表明,RTU与全自动核酸提取仪在提取效果上灵敏度相当;RTU在提取不同病毒类型样本时,与其他3种提取方法效果相当,但RTU提取时间少于5 min;FQ-8A检测呼吸道合胞病毒(respiratory syncytial virus,RSV)及腺病毒(adenovirus,ADV)与对照仪器ABI-7500具有良好一致性,kappa系数分别为0.938(P<0.001)和0.887(P<0.001),但FQ-8A耗时更短,扩增时间仅在0.5 h左右;RTU和FQ-8A相结合的快检方案与常规检测方案具有高度一致的检出率,其灵敏度为91.70%,特异度为100%,kappa系数为0.944(P<0.001)。总之,通过RTU与FQ-8A的结合构建了一套可在35 min内完成全部流程的呼吸道病毒核酸快速检测方案。该方案准确性高、操作简便,可为呼吸道病毒快速诊断和治疗提供重要支持。     

呼吸道病毒多病原检测技术研究进展

呼吸道病毒感染是导致人群发病和死亡的主要原因之一。通过多重病原检测迅速筛查大量致病原,已成为呼吸道病毒感染检测的重要技术。本文介绍了呼吸道病毒多病原检测技术及一些对呼吸道病毒检测有潜在应用价值的新兴技术。这些技术包括多重呼吸道病毒快速分离培养技术、传统多重逆转录PCR技术、多重实时定量PCR技术、微芯片技术、质谱技术及宏基因组技术等。这些技术的发展和应用,不但有助于提高呼吸道病毒感染的快速诊断和治疗,而且也将促进新型呼吸道病毒的发现。     

030儿童人偏肺病毒的感染:与呼吸道合胞病毒和流感病毒感染的比较分析

人偏肺病毒（hMPV）是2001年荷兰学者从急性呼吸道感染的儿童和成人中分离到的一种与禽肺病毒密切相关的RNA病毒。研究表明hMPV是婴幼儿期急性呼吸道感染的新现病原。作者为全面评估该病毒在儿童及其家庭成员等感染的情况，采集了1505例已排除外科疾患的15岁以下急诊儿童的咽拭样品，进行hMPV、呼吸道合胞病毒（RSV）和流感病毒核酸的检测，并对包括症状、体征、治疗等方面作了对比研究。     

常见呼吸道病毒多重PCR检测法的质量控制分析

急性呼吸道感染广泛分布于人群中,主要由呼吸道病毒引起,在老年人和婴幼儿中具有较高的发病率和死亡率。快速准确检测出病原体对临床早期诊断和指导治疗有重要意义。本文通过分析16种常见呼吸道病毒多重PCR检测法的质量控制关键环节和质量控制措施,对有效加强实验室质量管理,从而为提高实验室核酸检测质量水平提供了基本的参考数据。     

一种基于新型再测序芯片的不明原因呼吸道感染样品检测方法的建立

再测序芯片(Resequencing Pathogen Microarray,RPM)是一种新的基于微阵列DNA芯片的病原体检测与鉴定技术。为了将RPM应用于不明原因呼吸道感染的检测,提高应对传染病暴发的能力,本研究建立了基于一种新型RPM的呼吸道多病原检测方法。该方法可以同时检测19种常见呼吸道病毒、9种甲型流感(Flu A)和11种鼻病毒(HRV)、28种肠病毒、18种少见呼吸道病毒。选取已验证的16种常见呼吸道病毒感染阳性的样本评价RPM的特异性,用克隆质粒或体外转录的RNA梯度稀释液来检验RPM的灵敏度,在10～103拷贝/反应水平时RPM仍能检测和分辨出相近的病毒亚型。将8份不明原因的咽拭子样品提取的核酸合并,用新建立的方法进行检测,根据RPM结果再以普通PCR加测序作为验证,同时和Abbott公司的质谱测序(PLEX-ID)结果进行比较,除RPM检出假阳性PIV1外,三者的其余检测结果一致。结果表明,这种基于新型RPM的方法具有高灵敏度、高通量的优点,对应对新发和突发传染病具有重要意义。     

采用基因微阵列技术对常见呼吸道病毒进行检测的初步研究

建立一种高通量的基因微阵列检测技术,对常见呼吸道病毒感染进行监控.根据公开发表的8个病毒科38种常见呼吸道病毒的序列,计算其保守区域,设计病毒的特异性检测探针,制备呼吸道病毒检测基因微阵列.利用随机引物PCR方法标记样品中的病毒靶序列,标记产物与基因微阵列上的探针杂交,清洗、扫描后进行结果分析.采用流感病毒、麻疹病毒、腮腺炎病毒和风疹病毒作为报告病毒,并对80例上呼吸道感染患者的咽拭子标本进行验证测试.初步结果表明,该呼吸道病毒微阵列基因芯片检测是可行的,在利用基因微阵列技术对病毒监控方面进行了有益的尝试,得到了有经验的信息.     

新型多重PCR方法及其在呼吸道病毒诊断上的应用

急性呼吸道感染广泛分布于人群中,主要由呼吸道病毒引起,在老年人和婴幼儿中具有较高的发病率和死亡率,给社会带来严重的经济负担。快速、准确检测出病原体对临床早期诊断和指导治疗有重要意义。多重聚合酶链式反应(PCR)技术具有PCR的高灵敏度和快速检测的特点,还能实现多病原的高通量检测。基于多重PCR技术开发的商业化试剂盒能同时检测12种以上的呼吸道病毒,能达到与实时荧光定量PCR(real-time PCR)相当的灵敏度和特异性,为呼吸道病毒的检测与分型提供了新的选择。本文综合了近年来的发展成果,对新型多重PCR方法的原理及其在呼吸道病毒诊断上的应用进行了综述。     

呼吸道上皮细胞模型的研究进展

呼吸道病毒严重威胁人类的健康。呼吸道上皮细胞是机体防御呼吸道病毒和细菌等外来病原体的第一道防线,因此建立呼吸道上皮细胞体外分化模型,为研究呼吸系统疾病发病机理、筛选有效的治疗药物奠定基础。本文主要介绍人呼吸道上皮细胞原代培养技术的研究进展及其在呼吸道病毒和呼吸系统疾病方面的应用。     

629例住院儿童临床七种常见呼吸道病毒分布特征

目的了解本地区七种常见呼吸道病毒临床分布特征,旨在为呼吸道病毒的预防、治疗提供帮助。方法随机选取2 001例呼吸科住院患者样本,采用直接免疫荧光法进行呼吸道病毒抗原检测。结果 2 001例患者样本中,共检测出629例阳性病毒,阳性率为31.43%,阳性率前三位的病毒依次为甲型流感病毒(FluA)、呼吸道合胞病毒(RSV)、乙型流感病毒,分别为12.14%、9.90%和3.80%,而副流感病毒II型检出率最低,为0.50%。冬、春季节为呼吸道病毒高发季节,其中一月和二月的检出率高达56.91%和43.15%;而夏、秋季节检出率相对较低,六月的检出率仅为7.00%;1岁年龄组病毒阳性检出率最高,且随年龄增大,阳性检出率明显降低。结论冬、春季节是呼吸道病毒的高发季节;FluA和RSV是呼吸道感染中最常见的病毒;1岁年龄组病毒阳性检出率最高。     

Impact of non-pharmaceutical interventions during the COVID-19 pandemic on common childhood respiratory viruses – An epidemiological study based on hospital data

Considering common childhood respiratory viruses and SARS-CoV-2 share similar transmission routes, non-pharmaceutical interventions (NPIs) to prevent SARS-CoV-2 may affect the epidemiology of respiratory viruses. Therefore, our study aimed to observe the epidemiologic characteristics of common childhood respiratory viruses in 2020 (after the pandemic) compared with 2019 (before the pandemic) in Hangzhou, China. The data were compared between 2019 and 2020 based on age and month, respectively. One or more viruses were detected in 3135/21452 (14.61%) specimens in 2019, which was significantly lower in 1110/8202 (13.53%) specimens in 2020. Respiratory syncytial virus (RSV) was the most commonly detected virus in 2019 and 2020. The positive rate of adenovirus (ADV), parainfluenza virus (PIV)1, PIV2, and PIV3 in 2020 was significantly decreased in 2019. In 2020, RSV replaced ADV as the most predominant virus in children aged 1–6 years, and the positive rate of influenza virus A (FluA), influenza virus B (FluB), PIV1, and PIV2 was not correlated to age. FluA, FluB, and PIV2 were not almost detected from February 2020. The positive rates of ADV and PIV1 were uncorrelated to the month in 2020. By strict NPIs, besides controlling the COVID-19 pandemic, incredible progress has been made to reduce the prevalence of common childhood respiratory viruses.     

Limiting Respiratory Viral Infection by Targeting Antiviral and Immunological Functions of BST‐2/Tetherin: Knowledge and Gaps

Recent findings regarding the cellular biology and immunology of BST‐2 (also known as tetherin) indicate that its function could be exploited as a universal replication inhibitor of enveloped respiratory viruses (e.g., influenza, respiratory syncytial virus, etc.). BST‐2 inhibits viral replication by preventing virus budding from the plasma membrane and by inducing an antiviral state in cells adjacent to infection via unique inflammatory signaling mechanisms. This review presents the first comprehensive summary of what is currently known about BST‐2 anti‐viral function against respiratory viruses, how these viruses construct countermeasures to antagonize BST‐2, and how BST‐2 function might be targeted to develop therapies to treat respiratory virus infections. The authors address the current gaps in knowledge, including the need for mechanistic understanding of BST‐2 antagonism by respiratory viruses, that should be bridged to achieve that goal.

     

南京地区2010～2011年度呼吸道感染患儿腺病毒的流行病学研究

本研究为了解南京地区儿童腺病毒(ADV)感染的流行特点及型别,收集2010年8月至2011年7月南京医科大学附属南京儿童医院住院及门诊呼吸道感染患儿的鼻咽抽吸物(NPA)及咽拭子(NPS)共644例,采用巢氏聚合酶链反应法(Nested-PCR)检测ADV hexon基因,将阳性PCR扩增产物进行测序、同源性和进化分析。同时对12种其他呼吸道相关病毒进行PCR检测,包括人博卡病毒(HBoV),呼吸道合胞病毒(RSV),人鼻病毒(HRV),副流感病毒1～4型(PIV1-4),流感病毒A和B(IFVA/B),人偏肺病毒(HMPV),冠状病毒NL63和HKU1(HCoV-NL63和HCoV-HKU1)。结果显示:644例标本中共检出ADV阳性扩增产物171份,检出率为26.55%,3型120例(70.18%,120/171),7型16例(9.36%,16/171),1型12例(7.02%,12/171),2型10例(5.85%,10/171),5型6例(3.51%,6/171),6型3例(1.75%,3/171),57型3例(1.75%,3/171),41型1例(0.58%,1/171)。ADV感染呈全年散发,其发病高峰主要在4～7月。以7岁以下儿童多见(96.49%)。171例ADV感染患儿中有99例(57.89%)存在混合感染,其中以呼吸道合胞病毒(RSV)、人鼻病毒(HRV)多见。ADV阳性患儿诊断以下呼吸道感染为主(63.16%),肺炎占30.41%。结论:ADV是2010年8月到2011年7月南京地区儿童呼吸道感染的重要病原之一,其优势流行株为3型,长期监测其流行型别具有重要意义。     

Severity of respiratory signs and symptoms and virus profiles in Japanese children with acute respiratory illness

Associations between the severity of respiratory signs and symptoms and the respiratory viruses identified in 214 Japanese children with acute respiratory illness (ARI) enrolled between January and December 2012 were studied. Respiratory rate, wheezing, cyanosis, and the use of accessory muscles were used as indices of respiratory severity and phylogenetic analysis of the viruses identified in these children was performed. Respiratory viruses such as respiratory syncytial virus (RSV), human rhinovirus (HRV), human parainfluenza virus (HPIV), and human metapneumovirus (HMPV) were prevalent, being detected in approximately 70% of the patients (151/214 patients). Co‐detection of viruses occurred in about 9% of patients. RSV was identified more frequently in cases scored as moderate/severe than in those scored as mild (P < 0.05). Severity scores of patients with RSV were significantly higher than those of cases with HPIV. Moreover, severity scores in patients with mild disease and co‐detections were higher than in those in whom only HPIV or adenovirus was detected. Phylogenetic analysis showed that many genotypes of HRV‐A and ‐C with wide genetic divergence were associated with acute respiratory illness (ARI). On the other hand, only a limited number of genotypes of RSV were associated with ARI. HPIV and HMPV were associated with ARI at similar frequencies. These results suggest that different respiratory viruses with unique genetic characteristics can be found in patients with mild to severe ARI.     

A nested real-time PCR assay has an increased sensitivity suitable for detection of viruses in aerosol studies

Aims:  Influenza is commonly spread by infectious aerosols; however, detection of viruses in aerosols is not sensitive enough to confirm the characteristics of virus aerosols. The aim of this study was to develop an assay for respiratory viruses sufficiently sensitive to be used in epidemiological studies.
Method:  A two-step, nested real-time PCR assay was developed for MS2 bacteriophage, and for influenza A and B, parainfluenza 1 and human respiratory syncytial virus. Outer primer pairs were designed to nest each existing real-time PCR assay. The sensitivities of the nested real-time PCR assays were compared to those of existing real-time PCR assays. Both assays were applied in an aerosol study to compare their detection limits in air samples.
Conclusions:  The nested real-time PCR assays were found to be several logs more sensitive than the real-time PCR assays, with lower levels of virus detected at lower Ct values. The nested real-time PCR assay successfully detected MS2 in air samples, whereas the real-time assay did not.
Significance and Impact of the Study:  The sensitive assays for respiratory viruses will permit further research using air samples from naturally generated virus aerosols. This will inform current knowledge regarding the risks associated with the spread of viruses through aerosol transmission.     

肺部菌群与呼吸道疾病的相互关系

由于呼吸道黏膜免疫系统具有很好的防御保护作用和强大的清除病原体的能力,过去学术界曾经一度认为健康机体的肺是无菌的。随着不依赖于体外培养的第二代测序技术的发展,关于肺部共生微生物的结构组成及其免疫调节功能的研究越来越受重视。肺部菌群的结构组成与出生方式、饮食结构、生活环境和抗生素使用等多种因素有关,生命早期的肺部菌群的形成和发育会影响全生命周期的呼吸道疾病的发生和发展。肺部菌群通过与宿主免疫系统相互作用调节肺部免疫稳态,还可以与肠道菌群、呼吸道病毒相互作用影响呼吸道感染。因此,干预生命早期肺部菌群的结构组成可以成为预防和控制呼吸道疾病的有效策略和新靶点。     

The role of the local microbial ecosystem in respiratory health and disease

Respiratory tract infections are a major global health concern, accounting for high morbidity and mortality, especially in young children and elderly individuals. Traditionally, highly common bacterial respiratory tract infections, including otitis media and pneumonia, were thought to be caused by a limited number of pathogens including Streptococcus pneumoniae and Haemophilus influenzae. However, these pathogens are also frequently observed commensal residents of the upper respiratory tract (URT) and form—together with harmless commensal bacteria, viruses and fungi—intricate ecological networks, collectively known as the ‘microbiome’. Analogous to the gut microbiome, the respiratory microbiome at equilibrium is thought to be beneficial to the host by priming the immune system and providing colonization resistance, while an imbalanced ecosystem might predispose to bacterial overgrowth and development of respiratory infections. We postulate that specific ecological perturbations of the bacterial communities in the URT can occur in response to various lifestyle or environmental effectors, leading to diminished colonization resistance, loss of containment of newly acquired or resident pathogens, preluding bacterial overgrowth, ultimately resulting in local or systemic bacterial infections. Here, we review the current body of literature regarding niche-specific upper respiratory microbiota profiles within human hosts and the changes occurring within these profiles that are associated with respiratory infections.     

北京地区住院患儿WU多瘤病毒感染的流行病学研究

自2007年Gaynor A M等人通过高通量测序在肺炎患儿呼吸道样本中发现了WU多瘤病毒(Washington University polyomavirus,WUPyV)以来,WUPyV在世界各地被广泛检出。为了解北京地区急性呼吸道感染住院儿童中WUPyV感染情况及其临床特征,收集北京地区2017年4月至2018年3月共1 276份呼吸道感染住院患儿的鼻咽抽吸物样本,使用real time PCR方法对样本进行WUPyV检测,同时对WUPyV阳性样本进行17种常见呼吸道病毒筛查。共检出WUPyV阳性样本76份(5.96%,76/1 276),4岁以下儿童居多(92.11%,70/76);WUPyV感染全年可见,无显著季节性;多伴随其他呼吸道病毒混合感染(60.53%,46/76),最常见混合感染为鼻病毒和A型流感病毒;WUPyV单一感染者与混合感染者病毒载量无显著性差异,临床诊断和表现基本一致;WUPyV感染患儿的常见诊断为支气管炎(68.42%,52/76)和肺炎(30.26%,23/76);临床症状主要表现为高热、咳嗽、咳痰。研究结果提示WUPyV是北京地区急性呼吸道感染住院患儿呼吸道样本中常见病毒之一,多见于4岁以下儿童。