肠道病毒71型和柯萨奇病毒A16型多重反转录聚合酶链反应的建立及初步应用

本文旨在建立一种快速、高效的方法检测肠道病毒71型（EV71）和柯萨奇病毒A16型(CA16)的方法,以用于儿童手足口病的病原学监测。通过设计肠道病毒通用引物和CA16与EV71的型特异性引物,建立不同引物浓度配比及两阶段退火温度以提高检测敏感性和特异性的多重反转录聚合酶链反应（RT-PCR）方法,并对首都儿科研究所附属儿童医院2010年3~10月收集的371例手足口病患儿共381份临床标本同时进行病毒分离和核酸检测。结果显示,本研究建立的多重RT-PCR方法对CA16和EV71的最低模板检测浓度分别为5.32 pg/ml和0.64 pg/ml,反应特异度为100%。应用该方法检测381份手足口病临床标本的总阳性率为78.4%,其中CA16与EV71的检测阳性率分别为32.6%和35.8%,二者检测阳性比为1:1.1。以病毒分离为标准,多重RT-PCR对CA16及EV71检测的准确率分别为95.2%和98.6%。因此,本研究新建立的多重RT-PCR方法准确、简便,适用于较大量样本的手足口病病原学监测。2010年引起北京地区儿童手足口病的主要病原为CA16和EV71。     

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。     

柯萨奇病毒A组16型研究进展

A组16型柯萨奇病毒(Coxsackievirus A16,CVA16)是引起手足口病(Hand,foot and mouth disease,HFMD)的主要病原体之一.近年来,HFMD在亚太地区暴发流行,已经成为重大的公共卫生问题之一.加强对CVA16生物学特征、流行病学特征、临床表现、实验室诊断、防治手段的认识,有助于防控HFMD的蔓延.     

柯萨奇病毒A组16型分子流行病学和疫苗研究进展

柯萨奇病毒A组16型(Coxsackievirus A16,CVA16)是引起手足口病(Hand,foot,and mouth disease,HFMD)的重要致病原,常与另一重要病原体肠道病毒71型(Enterovirus 71,EV-A71)共同或交替流行。该病毒在世界多个国家和地区引起过暴发流行,成为重要的公共卫生问题。CVA16可分为A和B两个基因型;其中基因型B可以分成B1和B2两个基因亚型;B1亚型又可进一步分成B1a、B1b和B1c三个进化分支。基因型A与B2在世界范围内已不再流行;我国大陆分离到的CVA16毒株均属B1a和B1b进化分支。CVA16感染多为自限性轻症,但亦可引起严重的并发症,甚至引起患者死亡。目前尚无针对该病毒的有效药物或治疗手段,研发安全有效的疫苗成为控制该病毒的重要措施。随着EV-A71疫苗三期临床试验的成功完成,CVA16疫苗的研究也显得更加迫切。多家机构正在研究各种类型的CVA16疫苗,包括灭活疫苗、基因工程疫苗及DNA疫苗等。本文就CVA16的分子流行病学及其疫苗研究进展进行了综述。     

中国柯萨奇病毒A组16型部分VP1区序列测定及系统进化分析

利用1999～2004年连续6年从中国深圳及北京地区分离的柯萨奇病毒A组16型(Coxsackievirus A16,Cox．A16)毒株的部分VP1区基因序列进行分析和研究,试图找出中国Cox．A16的种系进化规律和分型依据。6株Cox．A16病毒部分VP1区核苷酸和氨基酸同源性均较高,相互间核苷酸同源性为94．5％～98．0％,氨基酸同源性为97．8％～100％。6株中国分离株与Cox．A16国际参考株相比,部分VP1区核苷酸同源性高于78．2％,氨基酸同源性高于为93．3％。基因系统进化分析表明,中国大陆分离的6株Cox．A16与中国台湾流行株Tainan-5079-98(AF177911),与4株日本分离株、瑞典株及美国株GA95—2095(AF081613)、PA94—5753(AF081628)的关系均较近,核苷酸同源性大于93．3％。了解我国Cox．A16流行株的遗传学背景和种系进化关系,对有效地预防和控制Cox．A16流行有重要意义。     

柯萨奇病毒A组16型灭活抗原对小鼠免疫保护作用的研究

为了研究柯萨奇病毒A组16型(Coxsackievirus A16,CVA16)灭活抗原在小鼠体内所产生免疫保护作用效果,我们选用CVA16临床分离株521-01T,在Vero细胞中进行大量培养,并对培养产物进行甲醛灭活及超速离心纯化。SDS-PAGE和Western blot对纯化的灭活病毒纯度及性质进行初步分析。Al(OH)3+CVA16及单独CVA16抗原,分别经皮下注射免疫雌性ICR小鼠;相同免疫途径、剂量于第14和28d加强免疫2次。ELISA法检测CVA16特异性血清IgG抗体滴度;微量中和试验法鉴定血清中和抗体滴度;酶联免疫斑点试验(ELISPOT)检测特异性T淋巴细胞的活化。对Al(OH)3+CVA16抗原免疫组母鼠所产仔鼠进行脑腔攻毒,检测母传抗体对新生乳鼠的保护作用。结果显示,Al(OH)3+CVA16灭活抗原在小鼠体内能诱生高滴度的特异性抗体,3次免疫后产生的特异性血清IgG抗体滴度最高可达1∶1×105(P=0.000),中和滴度高于1∶256。同时,该抗原还可以诱导特异性T淋巴细胞的活化。以1 000LD50的病毒量脑腔接种48h内新生乳鼠的病毒攻击实验显示,该母传抗体对新生乳鼠具有100%的保护。这一结果表明该灭活CVA16病毒抗原具有较好的免疫原性及保护性,为CVA16灭活疫苗的研究及评价体系提供了参考。     

柯萨奇病毒A组10型研究进展

自2008年以来,由多种肠道病毒引起的手足口病已成为严重威胁中国婴幼儿健康的重大公共卫生问题之一。其中,肠道病毒71型(enterovirus 71,EV71)和柯萨奇病毒A组16型(coxsackievirus A16,CVA16)是引起手足口病的主要病原体。但2011年以后,中国手足口病的流行趋势发生了变化,柯萨奇病毒A组10型(coxsackievirus A10,CVA10)和柯萨奇病毒A组6型(coxsackievirus A6,CVA6)引起的手足口病呈增多趋势,在部分地区已替代EV71和CVA16成为引起手足口病的主要病原体,已引起越来越多的关注。现就CVA10的病原学、流行病学、实验室诊断、动物模型及疫苗相关研究作一综述。     

Simultaneous detection of waterborne viruses by multiplex real-time PCR

Norovirus, Rotavirus group A, the Hepatitis A virus, and Coxsackievirus are all common causes of gastroenteritis. Conventional diagnoses of these causative agents are based on antigen detection and electron microscopy. To improve the diagnostic potential for viral gastroenteritis, internally controlled multiplex real-time polymerase chain reaction (PCR) methods have been recently developed. In this study, individual real-time PCRs were developed and optimized for specific detections of Norovirus genogroup I, Norovirus genogroup II, Rotavirus group A, the Hepatitis A virus, and Coxsackievirus group B1. Subsequently, individual PCRs were combined with multiplex PCR reactions. In general, multiplex real-time PCR assays showed comparable sensitivities and specificities with individual assays. A retrospective clinical evaluation showed increased pathogen detection in 29% of samples using conventional PCR methods. Prospective clinical evaluations were detected in 123 of the 227 (54%) total samples used in the multiplex real-time PCR analysis. The Norovirus genogroup II was found most frequently (23%), followed by Rotavirus (20%), the Hepatitis A virus (4.5%), Coxsackievirus (3.5%), and Norovirus genogroup I (2.6%). Internally controlled multiplex real-time PCR assays for the simultaneous detection of Rotavirus, Coxsackievirus group B, the Hepatitis A virus, and Norovirus genogroups I and II showed significant improvement in the diagnosis of viral gastroenteritis.     

Common antigen between coxsackievirus A 16 and enterovirus 71.

Cross immunofluorescence revealed that coxsackievirus A 16 (CA 16) shared a common antigen with enterovirus 71 (E 71). The cross reactivity of these two serotypes was also examined by complement fixation test with purified virus preparations fractionated by sucrose density gradient centrifugation and two peaks of antigenicity were detected, one being type-specific and the other cross-reacting. The common antigen was heat-stable and attributable to empty capsids. Immuno-diffusion also revealed the common antigen. Infants without antibody to E 71 developed complement fixing and precipitin antibody to E 71 after recovery from hand, foot and mouth disease caused by CA 16.     

MA104 Cell line presents characteristics suitable for enterovirus A71 isolation and proliferation

Enterovirus A71 (EV‐A71), one of the most important causative agents of hand, foot and mouth disease (HFMD) in children, can lead to severe clinical outcomes, even death. However, the infection spectrum of EV‐A71 in different cell lines remains unknown. Therefore, in this study, the biological characteristics of EV‐A71 Subgroup C4 in different cell lines were investigated. To this end, the infectivity of EV‐A71Jinan1002 isolated from children with severe HFMD was assessed in 18 different host cell lines. It was found that the MA104 cell line displayed biological characteristics suitable for EV‐A71 Subgroup C4 strain isolation and proliferation; indeed, it was found that a broad spectrum of cell lines can be infected by EV‐A71Jinan1002. Among the screened cells, four cell lines (HEK293, RD, MA104 and Marc145) produced high 50% tissue culture infective dose (TCID₅₀) values calculated in viral proliferations (ranged from 10^7.6 to 10^7.8); the TCID₅₀ being negatively associated with the time to appearance of CPE. Proliferation curves demonstrated that EV‐A71Jinan1002 amplifies more efficiently in MA104, Hep‐2 and RD cells. Remarkably, the virus isolation rate was much higher in MA104 cells than in RD cells. Thus this study, to our knowledge, is for the first to explore the infection spectrum of EV‐A71 subgroup C4 in such a large number of different cell lines. Our data provide useful reference data for facilitating further study of EV‐A71.     

Development of a multiplex real-time PCR assay with an internal amplification control for the detection of total and pathogenic Vibrio parahaemolyticus bacteria in oysters

Vibrio parahaemolyticus is an estuarine bacterium that is the leading cause of shellfish-associated cases of bacterial gastroenteritis in the United States. Our laboratory developed a real-time multiplex PCR assay for the simultaneous detection of the thermolabile hemolysin (tlh), thermostable direct hemolysin (tdh), and thermostable-related hemolysin (trh) genes of V. parahaemolyticus. The tlh gene is a species-specific marker, while the tdh and trh genes are pathogenicity markers. An internal amplification control (IAC) was incorporated to ensure PCR integrity and eliminate false-negative reporting. The assay was tested for specificity against >150 strains representing eight bacterial species. Only V. parahaemolyticus strains possessing the appropriate target genes generated a fluorescent signal, except for a late tdh signal generated by three strains of V. hollisae. The multiplex assay detected <10 CFU/reaction of pathogenic V. parahaemolyticus in the presence of >10(4) CFU/reaction of total V. parahaemolyticus bacteria. The real-time PCR assay was utilized with a most-probable-number format, and its results were compared to standard V. parahaemolyticus isolation methodology during an environmental survey of Alaskan oysters. The IAC was occasionally inhibited by the oyster matrix, and this usually corresponded to negative results for V. parahaemolyticus targets. V. parahaemolyticus tlh, tdh, and trh were detected in 44, 44, and 52% of the oyster samples, respectively. V. parahaemolyticus was isolated from 33% of the samples, and tdh(+) and trh(+) strains were isolated from 19 and 26%, respectively. These results demonstrate the utility of the real-time PCR assay in environmental surveys and its possible application to outbreak investigations for the detection of total and pathogenic V. parahaemolyticus.     

Gasdermin E is required for induction of pyroptosis and severe disease during enterovirus 71 infection

Pyroptosis is an inflammatory form of programmed cell death that is executed by the gasdermin (GSDM)-N domain of GSDM family proteins, which form pores in the plasma membrane. Although pyroptosis acts as a host defense against invasive pathogen infection, its role in the pathogenesis of enterovirus 71 (EV71) infection is unclear. In the current study, we found that EV71 infection induces cleavage of GSDM E (GSDME) by using western blotting analysis, an essential step in the switch from caspase-3-mediated apoptosis to pyroptosis. We show that this cleavage is independent of the 3C and 2A proteases of EV71. However, caspase-3 activation is essential for this cleavage, as GSDME could not be cleaved in caspase-3-KO cells upon EV71 infection. Further analyses showed that EV71 infection induced pyroptosis in WT cells but not in caspase-3/GSDME double-KO cells. Importantly, GSDME is required to induce severe disease during EV71 infection, as GSDME deficiency in mice was shown to alleviate pathological symptoms. In conclusion, our results reveal that GSDME is important for the pathogenesis of EV71 via mediating initiation of pyroptosis.     

2008～2010年河南省人肠道病毒71型基因特征和重组分析

对河南省2008～2010年河南省人肠道病毒71型进行基因特征及重组特点研究。对河南省2008～2010年分离的5株肠道病毒EV71型构建VP1序列系统进化树并分析其全基因组序列的重组特点。VP1序列系统进化分析显示2008～2010年河南株均属于C4基因型的C4a亚群,Bootscan分析和5’NCR、P1、P2、P3区的进化树证实C4基因型在2A～2B处存在EV71的B基因型和C基因型的型内重组及在3B～3C处存在EV71的B基因型和CA16/G-10间的型间重组。2008～2010年河南EV71分离株为C4基因型的C4a亚群,与2004年以来的中国大陆优势株流行趋势完全一致,EV71C4基因型存在基因型内和型间双重组现象。     

Construction and characterization of infectious cDNA clones of enterovirus 71(EV71)

<正>Dear Editor,Enterovirus 71(EV71),a member of the genus Enterovirus of the family Picornaviridae,is a single-stranded,positive-sense RNA virus that usually causes mild handfoot-mouth disease(HFMD)in children,with symptoms such as fever,diarrhea,and herpangina(Liu et al.,2013).However,certain strains of EV71 infection can cause severe neurological complications,such as SDLY107(Sun et al.,2014).EV71 is classified into three distinct genotypes(A–C);the B and C genotypes are further divided into B1–B5 and C1–C5 genotypes,respectively,based on     

Unusual ent-atisane type diterpenoids with 2-oxopropyl skeleton from the roots of Euphorbia ebracteolata and their antiviral activity against human rhinovirus 3 and enterovirus 71

Two novel ent-atisane type diterpenoids possessing the extra unusal 2-oxopropyl moiety (1 and 2) and four known analogues have been isolated from the roots of Euphorbia ebracteolata. The structures and absolute configurations of these compounds were determined by extensive spectroscopic data analysis, including 2D NMR, single-crystal X-ray crystallography, ¹³C NMR calculation, and electronic circular dichroism spectra calculation. Compounds 1 and 2 are the first examples of natural products with ent-atisane type diterpenoids possessing 2-oxopropyl skeleton. Compounds 2, 3, 5, and 6 show antiviral activities against human rhinovirus 3, with IC₅₀ values of 25.27–90.35 μM. Compounds 5 and 6 showed moderate antiviral activities against EV71 at a concentration of 100 μM.