3001
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Zhai J, Briese T, Dai E, Wang X, Pang X, Du Z, Liu H, Wang J, Wang H, Guo Z, Chen Z, Jiang L, Zhou D, Han Y, Jabado O, Palacios G, Lipkin WI, Yang R. Real-time polymerase chain reaction for detecting SARS coronavirus, Beijing, 2003. Emerg Infect Dis 2004; 10:300-3. [PMID: 15030701 PMCID: PMC3322935 DOI: 10.3201/eid1002.030799] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
During the 2003 severe acute respiratory syndrome (SARS) outbreak, a real-time quantitative polymerase chain reaction, which targets the nucleocapsid gene at the 3′-end of the viral genome, was established to detect and identify the SARS-associated coronavirus. We describe the use of this assay to screen >700 clinical samples.
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Affiliation(s)
- Junhui Zhai
- Institute of Microbiology and Epidemiology, Beijing, China
- Junhui Zhai and Thomas Briese contributed equally to the manuscript
| | - Thomas Briese
- Mailman School of Public Health of Columbia University, New York, New York, USA
- Junhui Zhai and Thomas Briese contributed equally to the manuscript
| | - Erhei Dai
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Xiaoyi Wang
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Xin Pang
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Zongmin Du
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Haihong Liu
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Jin Wang
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Hongxia Wang
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Zhaobiao Guo
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Zeliang Chen
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Lingxiao Jiang
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Dongsheng Zhou
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Yanping Han
- Institute of Microbiology and Epidemiology, Beijing, China
| | - Omar Jabado
- Mailman School of Public Health of Columbia University, New York, New York, USA
| | - Gustavo Palacios
- Mailman School of Public Health of Columbia University, New York, New York, USA
| | - W. Ian Lipkin
- Mailman School of Public Health of Columbia University, New York, New York, USA
| | - Ruifu Yang
- Institute of Microbiology and Epidemiology, Beijing, China
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3002
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Wu HS, Chiu SC, Tseng TC, Lin SF, Lin JH, Hsu YF, Wang MC, Lin TL, Yang WZ, Ferng TL, Huang KH, Hsu LC, Lee LL, Yang JY, Chen HY, Su SP, Yang SY, Lin TH, Su IJ. Serologic and molecular biologic methods for SARS-associated coronavirus infection, Taiwan. Emerg Infect Dis 2004; 10:304-10. [PMID: 15030702 PMCID: PMC3322922 DOI: 10.3201/eid1002.030731] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome (SARS) has raised a global alert since March 2003. After its causative agent, SARS-associated coronavirus (SARS-CoV), was confirmed, laboratory methods, including virus isolation, reverse transcriptase-polymerase chain reaction (RT-PCR), and serologic methods, have been quickly developed. In this study, we evaluated four serologic tests ( neutralization test, enzyme-linked immunosorbent assay [ELISA], immunofluorescent assay [IFA], and immunochromatographic test [ICT]) for detecting antibodies to SARS-CoV in sera of 537 probable SARS case-patients with correlation to the RT-PCR. With the neutralization test as a reference method, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.2%, 98.7%, 98.7%, and 98.4% for ELISA; 99.1%, 87.8%, 88.1% and 99.1% for IFA; 33.6%, 98.2%, 95.7%, and 56.1% for ICT, respectively. We also compared the recombinant-based western blot with the whole virus-based IFA and ELISA; the data showed a high correlation between these methods, with an overall agreement of >90%. Our results provide a systematic analysis of serologic and molecular methods for evaluating SARS-CoV infection.
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Affiliation(s)
- Ho-Sheng Wu
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Shu-Chun Chiu
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Tsan-Chang Tseng
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Szu-Fong Lin
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Jih-Hui Lin
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Yu-Fen Hsu
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Mei-Ching Wang
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Tsuey-Li Lin
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Wen-Zieh Yang
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Tian-Lin Ferng
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Kai-Hung Huang
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Li-Ching Hsu
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Li-Li Lee
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Jyh-Yuan Yang
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Hour-Young Chen
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Shun-Pi Su
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Shih-Yan Yang
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Ting-Hsiang Lin
- Center for Disease Control, Department of Health, Taiwan, Republic of China
| | - Ih-Jen Su
- Center for Disease Control, Department of Health, Taiwan, Republic of China
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3003
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Abstract
During the global outbreak of severe acute respiratory syndrome (SARS) in 2003, treatment was empiric. We report the case history of the index patient in a hospital outbreak of SARS in Hong Kong. The patient recovered after conventional antimicrobial therapy. Further studies are needed to address treatment of SARS, which has high attack and death rates.
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Affiliation(s)
- Raymond S M Wong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
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3004
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Yang GG, Lin SZ, Liao KW, Lee JJ, Wang LS. SARS-associated coronavirus infection in teenagers. Emerg Infect Dis 2004; 10:382-3. [PMID: 15043016 PMCID: PMC3322917 DOI: 10.3201/eid1002.030485] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
| | | | | | - Jen-Jyh Lee
- Hualien Tzu-Chi Medical Center, Hualien, Taiwan
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3005
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Vu HT, Leitmeyer KC, Le DH, Miller MJ, Nguyen QH, Uyeki TM, Reynolds MG, Aagesen J, Nicholson KG, Vu QH, Bach HA, Plan AJ. Clinical description of a completed outbreak of SARS in Vietnam, February-May 2003. Emerg Infect Dis 2004; 10:334-8. [PMID: 15030707 PMCID: PMC3322907 DOI: 10.3201/eid1002.030761] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We investigated the clinical manifestations and course of all probable severe acute respiratory syndrome (SARS) patients in the Vietnam outbreak. Probable SARS cases were defined by using the revised World Health Organization criteria. We systematically reviewed medical records and undertook descriptive statistical analyses. All 62 patients were hospitalized. On admission, the most prominent symptoms were malaise (82.3%) and fever (79.0%). Cough, chest pain, and shortness of breath were present in approximately one quarter of the patients; 79.0% had lymphopenia; 40.3% had thrombocytopenia; 19.4% had leukopenia; and 75.8% showed changes on chest radiograph. Fever developed on the first day of illness onset, and both respiratory symptoms and radiographic changes occurred on day 4. On average, maximal radiographic changes were observed on day 10, and fevers subsided by day 13. Symptoms on admission were nonspecific, although fever, malaise, and lymphopenia were common. The complications of SARS included invasive intubation and ventilation (11.3%) and death (9.7%).
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3006
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Wu J, Xu F, Zhou W, Feikin DR, Lin CY, He X, Zhu Z, Liang W, Chin DP, Schuchat A. Risk factors for SARS among persons without known contact with SARS patients, Beijing, China. Emerg Infect Dis 2004; 10:210-6. [PMID: 15030685 PMCID: PMC3322931 DOI: 10.3201/eid1002.030730] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Most cases of severe acute respiratory syndrome (SARS) have occurred in close contacts of SARS patients. However, in Beijing, a large proportion of SARS cases occurred in persons without such contact. We conducted a case-control study in Beijing that compared exposures of 94 unlinked, probable SARS patients with those of 281 community-based controls matched for age group and sex. Case-patients were more likely than controls to have chronic medical conditions or to have visited fever clinics (clinics at which possible SARS patients were separated from other patients), eaten outside the home, or taken taxis frequently. The use of masks was strongly protective. Among 31 case-patients for whom convalescent-phase (>21 days) sera were available, 26% had immunoglobulin G to SARS-associated coronavirus. Our finding that clinical SARS was associated with visits to fever clinics supports Beijing's strategy of closing clinics with poor infection-control measures. Our finding that mask use lowered the risk for disease supports the community's use of this strategy.
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Affiliation(s)
- Jiang Wu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Fujie Xu
- World Health Organization–China Office, Beijing, China
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- These authors served as temporary advisors to the World Health Organization–China Office SARS team
| | - Weigong Zhou
- World Health Organization–China Office, Beijing, China
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- These authors served as temporary advisors to the World Health Organization–China Office SARS team
| | - Daniel R. Feikin
- World Health Organization–China Office, Beijing, China
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- These authors served as temporary advisors to the World Health Organization–China Office SARS team
| | - Chang-Ying Lin
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xiong He
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zonghan Zhu
- Beijing Municipal Health Bureau, Beijing, China
| | - Wannian Liang
- Beijing Municipal Health Bureau, Beijing, China
- Beijing Joint SARS Expert Group, Beijing, China
| | | | - Anne Schuchat
- World Health Organization–China Office, Beijing, China
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- These authors served as temporary advisors to the World Health Organization–China Office SARS team
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3007
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Loeb M, McGeer A, Henry B, Ofner M, Rose D, Hlywka T, Levie J, McQueen J, Smith S, Moss L, Smith A, Green K, Walter SD. SARS among critical care nurses, Toronto. Emerg Infect Dis 2004; 10:251-5. [PMID: 15030692 PMCID: PMC3322898 DOI: 10.3201/eid1002.030838] [Citation(s) in RCA: 242] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
To determine factors that predispose or protect healthcare workers from severe acute respiratory syndrome (SARS), we conducted a retrospective cohort study among 43 nurses who worked in two Toronto critical care units with SARS patients. Eight of 32 nurses who entered a SARS patient’s room were infected. The probability of SARS infection was 6% per shift worked. Assisting during intubation, suctioning before intubation, and manipulating the oxygen mask were high-risk activities. Consistently wearing a mask (either surgical or particulate respirator type N95) while caring for a SARS patient was protective for the nurses, and consistent use of the N95 mask was more protective than not wearing a mask. Risk was reduced by consistent use of a surgical mask, but not significantly. Risk was lower with consistent use of a N95 mask than with consistent use of a surgical mask. We conclude that activities related to intubation increase SARS risk and use of a mask (particularly a N95 mask) is protective.
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Affiliation(s)
- Mark Loeb
- Department of Pathology and Molecualr Medicine, McMaster University, Hamilton, Ontario, Canada.
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3008
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Emery SL, Erdman DD, Bowen MD, Newton BR, Winchell JM, Meyer RF, Tong S, Cook BT, Holloway BP, McCaustland KA, Rota PA, Bankamp B, Lowe LE, Ksiazek TG, Bellini WJ, Anderson LJ. Real-time reverse transcription-polymerase chain reaction assay for SARS-associated coronavirus. Emerg Infect Dis 2004; 10:311-6. [PMID: 15030703 PMCID: PMC3322901 DOI: 10.3201/eid1002.030759] [Citation(s) in RCA: 206] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A real-time reverse transcription–polymerase chain reaction (RT-PCR) assay was developed to rapidly detect the severe acute respiratory syndrome–associated coronavirus (SARS-CoV). The assay, based on multiple primer and probe sets located in different regions of the SARS-CoV genome, could discriminate SARS-CoV from other human and animal coronaviruses with a potential detection limit of <10 genomic copies per reaction. The real-time RT-PCR assay was more sensitive than a conventional RT-PCR assay or culture isolation and proved suitable to detect SARS-CoV in clinical specimens. Application of this assay will aid in diagnosing SARS-CoV infection.
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Affiliation(s)
- Shannon L. Emery
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Dean D. Erdman
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael D. Bowen
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bruce R. Newton
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Richard F. Meyer
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Byron T. Cook
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Paul A. Rota
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bettina Bankamp
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Luis E. Lowe
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tom G. Ksiazek
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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3009
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Abstract
Many severe acute respiratory syndrome (SARS) patients have multiple possible incubation periods due to multiple contact dates. Multiple contact dates cannot be used in standard statistical analytic techniques, however. I present a simple spreadsheet-based method that uses multiple contact dates to calculate the possible incubation periods of SARS.
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Affiliation(s)
- Martin I Meltzer
- Office of Surveillance, National Center for Infectious Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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3010
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Chen YC, Huang LM, Chan CC, Su CP, Chang SC, Chang YY, Chen ML, Hung CC, Chen WJ, Lin FY, Lee YT. SARS in hospital emergency room. Emerg Infect Dis 2004; 10:782-8. [PMID: 15200809 PMCID: PMC3323223 DOI: 10.3201/eid1005.030579] [Citation(s) in RCA: 341] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Thirty-one cases of severe acute respiratory syndrome (SARS) occurred after exposure in the emergency room at the National Taiwan University Hospital. The index patient was linked to an outbreak at a nearby municipal hospital. Three clusters were identified over a 3-week period. The first cluster (5 patients) and the second cluster (14 patients) occurred among patients, family members, and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare workers. Six healthcare workers had close contact with SARS patients. Six others, with different working patterns, indicated that they did not have contact with a SARS patient. Environmental surveys found 9 of 119 samples of inanimate objects to be positive for SARS coronavirus RNA. These observations indicate that although transmission by direct contact with known SARS patients was responsible for most cases, environmental contamination with the SARS coronavirus may have lead to infection among healthcare workers without documented contact with known hospitalized SARS patients.
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Affiliation(s)
- Yee-Chun Chen
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Min Huang
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chang-Chuan Chan
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chan-Ping Su
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shan-Chwen Chang
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ying-Ying Chang
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mei-Ling Chen
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Ching Hung
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Jone Chen
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Fang-Yue Lin
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yuan-Teh Lee
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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3011
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Hui RKH, Zeng F, Chan CMN, Yuen KY, Peiris JSM, Leung FCC. Reverse transcriptase PCR diagnostic assay for the coronavirus associated with severe acute respiratory syndrome. J Clin Microbiol 2004; 42:1994-9. [PMID: 15131160 PMCID: PMC404607 DOI: 10.1128/jcm.42.5.1994-1999.2004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2003] [Revised: 10/04/2003] [Accepted: 12/26/2003] [Indexed: 01/15/2023] Open
Abstract
Recent outbreaks of severe acute respiratory syndrome (SARS) have spurred intense research efforts around the world to deal with the serious threat to health posed by this novel coronavirus. A rapid, reliable diagnostic assay is needed for monitoring the spread of the disease. Here we report a method for eliminating false-negative results and increasing test sensitivity, based on the hypothesis that the message encoded by the nucleocapsid (N) gene is the most abundant during viral infection. Nasopharyngeal aspirates and stool samples were obtained from suspected SARS patients with major clinical symptoms and a significant history of close contact with infected patients. Total RNAs were extracted in a 96-well format, together with pig kidney epithelial (PK-15) cells as an internal control for extraction efficiency. PCR inhibitors were removed by ethanol precipitation, and a PCR for the pig beta-actin gene was used as a positive control for all clinical samples. Samples were analyzed by a reverse transcriptase PCR assay. Northern blot analysis was performed to demonstrate differences in subgenomic transcripts of the virus, and a real-time quantitative PCR was employed to compare the sensitivities of two loci (1b and N). The detection rate of the assay reached 44.4% on day 9 after the onset of the disease. The diagnostic PCR amplifying the N gene gave an average of a 26.0% (6.3 to 60.0%) stronger intensity signal than that for the 1b gene. In conclusion, the nucleocapsid gene represents an additional sensitive molecular marker for the diagnosis of the SARS coronavirus and can be further adapted for use in a high-throughput platform assay.
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Affiliation(s)
- Raymond K H Hui
- Department of Zoology, The University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
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3012
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Abstract
Microorganisms are transmitted in hospitals mainly by contact, droplet, and airborne routes. Orthopaedic surgeons have a substantial occupational risk of contracting a blood-borne infection because of frequent handling of sharp instruments and objects during operative procedures. Aerosolization means the formation of aerosols and droplets when blood or other body fluids are mechanically disturbed. Smaller particles (<5 microm) will remain suspended in air. Pathogens that can survive in these small airborne particles may cause infection if they are inhaled. Aerosol-generating procedures in patients with tuberculosis or severe acute respiratory syndrome (SARS) may facilitate airborne transmission. The Hospital Infection Control Practices Advisory Committee and the Centers for Disease Control and Prevention have established guidelines for isolation precautions in hospitals.
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Affiliation(s)
- Kwok Chuen Wong
- Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
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3013
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Abstract
Les infections virales respiratoires communautaires sont fréquentes et le plus souvent bénignes. Beaucoup d'agents différents comme les virus influenza, ou para-influenza, le virus respiratoire syncitial, les rhinovirus, coronavirus, adénovirus et les herpès virus peuvent être isolés chez les patients immunocompétents. Parmi ces virus, le cytomégalovirus (CMV) peut être responsable de pneumonie nosocomiale en réanimation. Le diagnostic des infections virales est difficile car les signes cliniques sont non spécifiques et l'isolement du virus responsable difficile. Cependant, une symptomatologie clinique associant fièvre, myalgies, céphalées, pharyngite est fréquente dans les infections à Inflenza qui peuvent aboutir à des tableaux sévères. Enfin, le virus plus récent responsable d'infection respiratoire est un virus nouvellement découvert de la famille des coronavirus, le SRAS-CoV qui a été responsable d'une épidémie d'infections respiratoires sévères. Les pneumonies virales sont fréquentes mais probablement non diagnostiquées chez les patients immunocompétents. Cependant le diagnostic est nécessaire car pour la plupart des pathogènes il existe un traitement efficace. Le diagnostic repose sur l'histologie mais de nouvelles techniques comme la PCR doivent devenir d'utilisation courante pour améliorer le rendement diagnostique.
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3014
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Schmidt M, Brixner V, Ruster B, Hourfar MK, Drosten C, Preiser W, Seifried E, Roth WK. NAT screening of blood donors for severe acute respiratory syndrome coronavirus can potentially prevent transfusion associated transmissions. Transfusion 2004; 44:470-5. [PMID: 15043560 PMCID: PMC7201871 DOI: 10.1111/j.1537-2995.2004.03269.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND: The severe acute respiratory syndrome (SARS) was first described in February 2003. Close contact with symptomatic patients appears to be the main route of transmission, whereas blood transfusion trans‐ mission could not be ruled out. STUDY DESIGN AND METHODS: A SARS coronavirus (SARS‐CoV) detection kit developed by C. Drosten (Bernhard Nocht Institute, BNI) was used to amplify SARS‐CoV sequences from blood donor samples. We tested 31,151 blood donor samples in minipools of up to 96 samples. To validate the sensitivity of the assay, routine donor minipools (88 ± 8 samples per pool) were spiked with plasma of an imported case of SARS or of a subsequently infected contact person, respectively. Gamma‐irradiated cell culture supernatants of Vero E6 cells, infected with SARS‐CoV, were used as positive controls. RESULTS: None of 31,151 blood donors were positive for the presence of SARS. Two 96‐member plasma pools that were each spiked with 100 µL of plasma of the German index patient or his wife, respectively, were positive. Overall, 0.85 percent of test results had to be considered invalid owing to negative internal controls. CONCLUSION: A real‐time CoV PCR test is able to detect SARS‐CoV in viremic blood donor samples even in the beginning of the disease when patients present minor clinical symptoms. Thus the assay could potentially help to prevent transfusion‐associated SARS‐CoV transmissions.
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Affiliation(s)
- Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross, Johan Wolfgang Goethe University, Frankfurt, Germany.
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3015
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Christian MD, Poutanen SM, Loutfy MR, Muller MP, Low DE. Severe acute respiratory syndrome. Clin Infect Dis 2004; 38:1420-7. [PMID: 15156481 PMCID: PMC7107873 DOI: 10.1086/420743] [Citation(s) in RCA: 151] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2003] [Accepted: 01/22/2004] [Indexed: 12/02/2022] Open
Abstract
The first cases of severe acute respiratory syndrome (SARS) occurred in China in November 2002. The agent causing this illness has been identified as a novel coronavirus, SARS-coronavirus. Since its introduction <1 year ago, this virus has infected 8098 people in 26 countries, killing 774 of them. We present an overview of the epidemiology, clinical presentation, diagnosis, and treatment of SARS based on the current state of knowledge derived from published studies and our own personal experience.
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Affiliation(s)
| | - Susan M. Poutanen
- Toronto Medical Laboratories & Mount Sinai Hospital Department of Microbiology, Toronto, Ontario
- Departments of Laboratory Medicine and Pathobiology, Toronto, Ontario
| | - Mona R. Loutfy
- Department of Medicine, McGill University, Montreal, Quebec
| | - Matthew P. Muller
- Toronto Medical Laboratories & Mount Sinai Hospital Department of Microbiology, Toronto, Ontario
- Medicine, University of Toronto, Toronto, Ontario
| | - Donald E. Low
- Toronto Medical Laboratories & Mount Sinai Hospital Department of Microbiology, Toronto, Ontario
- Departments of Laboratory Medicine and Pathobiology, Toronto, Ontario
- Medicine, University of Toronto, Toronto, Ontario
- Reprints or correspondence: Dr. Donald E. Low, Mount Sinai Hospital, 600 University Ave., Rm. 1487, Toronto, Ontario, Canada M5G 1X5 ()
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3016
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He R, Dobie F, Ballantine M, Leeson A, Li Y, Bastien N, Cutts T, Andonov A, Cao J, Booth TF, Plummer FA, Tyler S, Baker L, Li X. Analysis of multimerization of the SARS coronavirus nucleocapsid protein. Biochem Biophys Res Commun 2004; 316:476-83. [PMID: 15020242 PMCID: PMC7111152 DOI: 10.1016/j.bbrc.2004.02.074] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2004] [Indexed: 12/20/2022]
Abstract
Severe Acute Respiratory Syndrome (SARS), an emerging disease characterized by atypical pneumonia, has recently been attributed to a novel coronavirus. The genome of SARS Coronavirus (SARS-CoV) has recently been sequenced, and a number of genes identified, including that of the nucleocapsid protein (N). It is noted, however, that the N protein of SARS-CoV (SARS-CoV N) shares little homology with nucleocapsid proteins of other members of the coronavirus family [Science 300 (2003) 1399; Science 300 (2003) 1394]. N proteins of other coronavirus have been reported to be involved in forming the viral core and also in the packaging and transcription of the viral RNA. As data generated from some viral systems other than coronaviruses suggested that viral N–N self-interactions may be necessary for subsequent formation of the nucleocapsid and assembly of the viral particles, we decided to investigate SARS-CoV N–N interaction. By using mammalian two-hybrid system and sucrose gradient fractionations, a homotypic interaction of N, but not M, was detected by the two-hybrid analysis. The mammalian two-hybrid assay revealed an approximately 50-fold increase in SEAP activity (measurement of protein–protein interaction) in N–N interaction compared to that observed in either M–M or mock transfection. Furthermore, mutational analyses characterized that a serine/arginine-rich motif (SSRSSSRSRGNSR) between amino acids 184 and 196 is crucial for N protein oligomerization, since deletion of this region completely abolished the N protein self-multimerization. Finally, the full-length nucleocapsid protein expressed and purified from baculovirus system was found to form different levels of higher order structures as detected by Western blot analysis of the fractionated proteins. Collectively, these results may aid us in elucidating the mechanism pertaining to formation of viral nucleocapsid core, and designing molecular approaches to intervene SARS-CoV replication.
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Affiliation(s)
- Runtao He
- National Microbiology Laboratory, Health Canada, 1015 Arlington St., Winnipeg, MB, Canada R3E 3R2.
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3017
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Bressler AM, Nolte FS. Preclinical evaluation of two real-time, reverse transcription-PCR assays for detection of the severe acute respiratory syndrome coronavirus. J Clin Microbiol 2004; 42:987-91. [PMID: 15004042 PMCID: PMC356893 DOI: 10.1128/jcm.42.3.987-991.2004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We verified the analytical performance characteristics of a previously described real-time reverse transcription-PCR (RT-PCR) assay targeting the open reading frame (ORF) 1b region of the severe acute respiratory syndrome coronavirus (SARS-CoV) with RNA transcripts. We then compared it to a novel nucleocapsid gene real-time RT-PCR assay with genomic RNA. The assays differed only in the primer and probe sequences and final concentrations. A commercially available armored RNA (Ambion, Austin, Tex.) was evaluated as positive control for the ORF 1b assay. The analytical sensitivity, reproducibility, amplification efficiency, and dynamic range of the assays were similar. Both were specific for SARS-CoV as determined by testing against human CoV 229E and OC43, specimens from patients without SARS, and by BLAST searches of GenBank for primer and probe sequence homology. The armored RNA was found to be a suitable positive control for the ORF 1b assay that could be reliably recovered and amplified from a variety of clinical specimens.
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Affiliation(s)
- Adam M Bressler
- Department of Medicine (Infectious Diseases), and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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3018
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Zhu G, Chen HW. Monophyletic relationship between severe acute respiratory syndrome coronavirus and group 2 coronaviruses. J Infect Dis 2004; 189:1676-8. [PMID: 15116304 PMCID: PMC7109970 DOI: 10.1086/382892] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2003] [Accepted: 10/22/2003] [Indexed: 11/15/2022] Open
Abstract
Although primary genomic analysis has revealed that severe acute respiratory syndrome coronavirus (SARS CoV) is a new type of coronavirus, the different protein trees published in previous reports have provided no conclusive evidence indicating the phylogenetic position of SARS CoV. To clarify the phylogenetic relationship between SARS CoV and other coronaviruses, we compiled a large data set composed of 7 concatenated protein sequences and performed comprehensive analyses, using the maximum-likelihood, Bayesian-inference, and maximum-parsimony methods. All resulting phylogenetic trees displayed an identical topology and supported the hypothesis that the relationship between SARS CoV and group 2 CoVs is monophyletic. Relationships among all major groups were well resolved and were supported by all statistical analyses.
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Affiliation(s)
- Guan Zhu
- Department of Veterinary Pathobiology, Texas A and M University, College Station, Texas 77843, USA.
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3019
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Bisht H, Roberts A, Vogel L, Bukreyev A, Collins PL, Murphy BR, Subbarao K, Moss B. Severe acute respiratory syndrome coronavirus spike protein expressed by attenuated vaccinia virus protectively immunizes mice. Proc Natl Acad Sci U S A 2004; 101:6641-6. [PMID: 15096611 PMCID: PMC404098 DOI: 10.1073/pnas.0401939101] [Citation(s) in RCA: 331] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The spike protein (S), a membrane component of severe acute respiratory syndrome coronavirus (SARS-CoV) is anticipated to be an important component of candidate vaccines. We constructed recombinant forms of the highly attenuated modified vaccinia virus Ankara (MVA) containing the gene encoding full-length SARS-CoV S with and without a C-terminal epitope tag called MVA/S-HA and MVA/S, respectively. Cells infected with MVA/Sor MVA/S-HA synthesized a 200-kDa protein, which was recognized by antibody raised against a synthetic peptide of SARS-CoV S or the epitope tag in Western blot analyses. Further studies indicated that S was N-glycosylated and migrated in SDS polyacrylamide gels with an apparent mass of approximately 160 kDa after treatment with peptide N-glycosidase F. The acquisition of resistance to endoglycosidase H indicated trafficking of S to the medial Golgi compartment, and confocal microscopy showed that S was transported to the cell surface. Intranasal or intramuscular inoculations of BALB/c mice with MVA/S produced serum antibodies that recognized the SARS S in ELISA and neutralized SARS-CoV in vitro. Moreover, MVA/S administered by either route elicited protective immunity, as shown by reduced titers of SARS-CoV in the upper and lower respiratory tracts of mice after challenge. Passive transfer of serum from mice immunized with MVA/S to naïve mice also reduced the replication of SARS-CoV in the respiratory tract after challenge, demonstrating a role for antibody to S in protection. The attenuated nature of MVA and the ability of MVA/S to induce neutralizing antibody that protects mice support further development of this candidate vaccine.
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Affiliation(s)
- Himani Bisht
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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3020
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Chan HLY, Leung WK, To KF, Chan PKS, Lee N, Wu A, Tam JSL, Sung JJY. Retrospective analysis of liver function derangement in severe acute respiratory syndrome. Am J Med 2004; 116:566-7. [PMID: 15063822 PMCID: PMC7119395 DOI: 10.1016/j.amjmed.2003.11.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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3021
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Liu X, Shi Y, Li P, Li L, Yi Y, Ma Q, Cao C. Profile of antibodies to the nucleocapsid protein of the severe acute respiratory syndrome (SARS)-associated coronavirus in probable SARS patients. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2004; 11:227-8. [PMID: 14715574 PMCID: PMC321358 DOI: 10.1128/cdli.11.1.227-228.2004] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Profiles of antibodies to the nucleocapsid protein of the severe acute respiratory syndrome (SARS)-associated coronavirus in 445 probable SARS patients and 3,749 healthy people or non-SARS patients were analyzed by antigen-capturing enzyme-linked immunosorbent assay. Antinucleocapsid antibodies were elucidated in 17.5% of the probable SARS patients 1 to 7 days after the onset of symptoms and in 80% of the patients 8 to 14 days after the onset. About 90% of the probable SARS patients were positive 15 or more days after illness. Antibody titers increased up to 70 days, and high antibody titers were maintained at least for another 3 months. Of the healthy people and non-SARS patients, only seven (0.187%) were weakly positive.
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Affiliation(s)
- Xuan Liu
- Beijing Institute of Biotechnology, Beijing 100850, Peoples Republic of China
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3022
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Yang ZY, Kong WP, Huang Y, Roberts A, Murphy BR, Subbarao K, Nabel GJ. A DNA vaccine induces SARS coronavirus neutralization and protective immunity in mice. Nature 2004; 428:561-4. [PMID: 15024391 PMCID: PMC7095382 DOI: 10.1038/nature02463] [Citation(s) in RCA: 552] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2004] [Accepted: 03/08/2004] [Indexed: 02/07/2023]
Abstract
Public health measures have successfully identified and contained outbreaks of the severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV)1,2,3,4,5, but concerns remain over the possibility of future recurrences. Finding a vaccine for this virus therefore remains a high priority. Here, we show that a DNA vaccine encoding the spike (S) glycoprotein of the SARS-CoV induces T cell and neutralizing antibody responses, as well as protective immunity, in a mouse model. Alternative forms of S were analysed by DNA immunization. These expression vectors induced robust immune responses mediated by CD4 and CD8 cells, as well as significant antibody titres, measured by enzyme-linked immunosorbent assay. Moreover, antibody responses in mice vaccinated with an expression vector encoding a form of S that includes its transmembrane domain elicited neutralizing antibodies. Viral replication was reduced by more than six orders of magnitude in the lungs of mice vaccinated with these S plasmid DNA expression vectors, and protection was mediated by a humoral but not a T-cell-dependent immune mechanism. Gene-based vaccination for the SARS-CoV elicits effective immune responses that generate protective immunity in an animal model.
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Affiliation(s)
- Zhi-yong Yang
- Vaccine Research Center, NIAID, National Institutes of Health, Building 40, Room 4502, MSC-3005, 40 Convent Drive, Bethesda, Maryland 20892-3005 USA
| | - Wing-pui Kong
- Vaccine Research Center, NIAID, National Institutes of Health, Building 40, Room 4502, MSC-3005, 40 Convent Drive, Bethesda, Maryland 20892-3005 USA
| | - Yue Huang
- Vaccine Research Center, NIAID, National Institutes of Health, Building 40, Room 4502, MSC-3005, 40 Convent Drive, Bethesda, Maryland 20892-3005 USA
| | - Anjeanette Roberts
- Laboratory of Infectious Diseases, NIAID, National Institutes of Health, MSC-8007, 50 South Drive, Bethesda, Maryland 20892-8007 USA
| | - Brian R. Murphy
- Laboratory of Infectious Diseases, NIAID, National Institutes of Health, MSC-8007, 50 South Drive, Bethesda, Maryland 20892-8007 USA
| | - Kanta Subbarao
- Laboratory of Infectious Diseases, NIAID, National Institutes of Health, MSC-8007, 50 South Drive, Bethesda, Maryland 20892-8007 USA
| | - Gary J. Nabel
- Vaccine Research Center, NIAID, National Institutes of Health, Building 40, Room 4502, MSC-3005, 40 Convent Drive, Bethesda, Maryland 20892-3005 USA
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3023
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Toney JH, Navas-Martín S, Weiss SR, Koeller A. Sabadinine: a potential non-peptide anti-severe acute-respiratory-syndrome agent identified using structure-aided design. J Med Chem 2004; 47:1079-80. [PMID: 14971887 DOI: 10.1021/jm034137m] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A novel human coronavirus has been reported to be the causative agent of severe acute respiratory syndrome (SARS). Since replication of HcoVs depends on extensive proteolytic processing, the main proteinase, 3CLpro, is an attractive drug target for anti-SARS agents. We have employed molecular docking of a chemical database into the active site of 3CLpro to search for non-peptidyl inhibitors. One compound was identified to be the natural product sabadinine, isolated from a historical herbal remedy.
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Affiliation(s)
- Jeffrey H Toney
- Department of Chemistry and Biochemistry, Montclair State University, 1 Normal Avenue, Upper Montclair, New Jersey 07043, USA.
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3024
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Yeh SH, Wang HY, Tsai CY, Kao CL, Yang JY, Liu HW, Su IJ, Tsai SF, Chen DS, Chen PJ. Characterization of severe acute respiratory syndrome coronavirus genomes in Taiwan: molecular epidemiology and genome evolution. Proc Natl Acad Sci U S A 2004; 101:2542-7. [PMID: 14983045 PMCID: PMC356986 DOI: 10.1073/pnas.0307904100] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Since early March 2003, the severe acute respiratory syndrome (SARS) coronavirus (CoV) infection has claimed 346 cases and 37 deaths in Taiwan. The epidemic occurred in two stages. The first stage caused limited familial or hospital infections and lasted from early March to mid-April. All cases had clear contact histories, primarily from Guangdong or Hong Kong. The second stage resulted in a large outbreak in a municipal hospital, and quickly spread to northern and southern Taiwan from late April to mid-June. During this stage, there were some sporadic cases with untraceable contact histories. To investigate the origin and transmission route of SARS-CoV in Taiwan's epidemic, we conducted a systematic viral lineage study by sequencing the entire viral genome from ten SARS patients. SARS-CoV viruses isolated from Taiwan were found closely related to those from Guangdong and Hong Kong. In addition, all cases from the second stage belonged to the same lineage after the municipal hospital outbreak, including the patients without an apparent contact history. Analyses of these full-length sequences showed a positive selection occurring during SARS-CoV virus evolution. The mismatch distribution indicated that SARS viral genomes did not reach equilibrium and suggested a recent introduction of the viruses into human populations. The estimated genome mutation rate was approximately 0.1 per genome, demonstrating possibly one of the lowest rates among known RNA viruses.
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Affiliation(s)
- Shiou-Hwei Yeh
- Division of Molecular and Genomic Medicine, National Health Research Institutes, Taipei 115, Taiwan
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3025
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Abstract
Severe acute respiratory syndrome (SARS) is a highly infective disease caused by a newly identified coronavirus. We described the clinical course of the first long-term hemodialysis patient who developed SARS in the literature, and our experience in performing hemodialysis for this patient. Such patients may present with a less typical clinical picture, making diagnosis difficult. In this patient, the course of disease and duration of viral shedding was apparently prolonged, thus highlighting the need for increased infection control. Despite worsening the anemia in renal failure patients by causing hemolysis, ribavirin is well tolerated after dosage adjustment. Difficulties of diagnosis, infection control, and treatment of SARS in renal failure patients are discussed in this report.
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Affiliation(s)
- Bonnie Ching-Ha Kwan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China
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3026
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Sui J, Li W, Murakami A, Tamin A, Matthews LJ, Wong SK, Moore MJ, Tallarico ASC, Olurinde M, Choe H, Anderson LJ, Bellini WJ, Farzan M, Marasco WA. Potent neutralization of severe acute respiratory syndrome (SARS) coronavirus by a human mAb to S1 protein that blocks receptor association. Proc Natl Acad Sci U S A 2004; 101:2536-41. [PMID: 14983044 PMCID: PMC356985 DOI: 10.1073/pnas.0307140101] [Citation(s) in RCA: 475] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Effective prophylaxis and antiviral therapies are urgently needed in the event of reemergence of the highly contagious and often fatal severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) infection. We have identified eight recombinant human single-chain variable region fragments (scFvs) against the S1 domain of spike (S) protein of the SARS-CoV from two nonimmune human antibody libraries. One scFv 80R efficiently neutralized SARS-CoV and inhibited syncytia formation between cells expressing the S protein and those expressing the SARS-CoV receptor angiotensin-converting enzyme 2 (ACE2). Mapping of the 80R epitope showed it is located within the N-terminal 261-672 amino acids of S protein and is not glycosylation-dependent. 80R scFv competed with soluble ACE2 for association with the S1 domain and bound S1 with high affinity (equilibrium dissociation constant, Kd=32.3 nM). A human IgG1 form of 80R bound S1 with a 20-fold higher affinity of 1.59 nM comparable to that of ACE2 (Kd=1.70 nM), and neutralized virus 20-fold more efficiently than the 80R scFv. These data suggest that the 80R human monoclonal antibody may be a useful viral entry inhibitor for the emergency prophylaxis and treatment of SARS, and that the ACE2-binding site of S1 could be an attractive target for subunit vaccine and drug development.
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Affiliation(s)
- Jianhua Sui
- Department of Cancer Immunology and AIDS, Dana-Farber Cancer Institute, Boston, MA 02115, USA
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3027
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Fouchier RAM, Hartwig NG, Bestebroer TM, Niemeyer B, de Jong JC, Simon JH, Osterhaus ADME. A previously undescribed coronavirus associated with respiratory disease in humans. Proc Natl Acad Sci U S A 2004; 101:6212-6. [PMID: 15073334 PMCID: PMC395948 DOI: 10.1073/pnas.0400762101] [Citation(s) in RCA: 418] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The etiology of acute respiratory tract illnesses is sometimes unclear due to limitations of diagnostic tests or the existence of as-yet-unidentified pathogens. Here we describe the identification and characterization of a not previously recognized coronavirus obtained from an 8-mo-old boy suffering from pneumonia. This coronavirus replicated efficiently in tertiary monkey kidney cells and Vero cells, in contrast to human coronaviruses (HCoV) 229E and OC43. The entire cDNA genome sequence of the previously undescribed coronavirus was determined, revealing that it is most closely related to porcine epidemic diarrhea virus and HCoV 229E. The maximum amino acid sequence identity between ORFs of the newly discovered coronavirus and related group 1 coronaviruses ranged from 43% to 67%. Real-time RT-PCR assays were designed to test for the prevalence of the previously undescribed coronavirus in humans. Using these tests, the virus was detected in four of 139 individuals (3%) who were suffering from respiratory illness with unknown etiology. All four patients suffered from fever, runny nose, and dry cough, and all four had underlying or additional morbidity. Our data will enable the development of diagnostic tests to study the prevalence and clinical impact of this virus in humans in more detail. Moreover, it will be important to discriminate this previously undescribed coronavirus from HCoV 229E and OC43 and the severe acute respiratory syndrome coronavirus.
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Affiliation(s)
- Ron A M Fouchier
- Department of Virology, Erasmus Medical Center, and CoroNovative B.V., Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.
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3028
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Subbarao K, McAuliffe J, Vogel L, Fahle G, Fischer S, Tatti K, Packard M, Shieh WJ, Zaki S, Murphy B. Prior infection and passive transfer of neutralizing antibody prevent replication of severe acute respiratory syndrome coronavirus in the respiratory tract of mice. J Virol 2004; 78:3572-7. [PMID: 15016880 PMCID: PMC371090 DOI: 10.1128/jvi.78.7.3572-3577.2004] [Citation(s) in RCA: 342] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Following intranasal administration, the severe acute respiratory syndrome (SARS) coronavirus replicated to high titers in the respiratory tracts of BALB/c mice. Peak replication was seen in the absence of disease on day 1 or 2, depending on the dose administered, and the virus was cleared within a week. Viral antigen and nucleic acid were detected in bronchiolar epithelial cells during peak viral replication. Mice developed a neutralizing antibody response and were protected from reinfection 28 days following primary infection. Passive transfer of immune serum to naïve mice prevented virus replication in the lower respiratory tract following intranasal challenge. Thus, antibodies, acting alone, can prevent replication of the SARS coronavirus in the lung, a promising observation for the development of vaccines, immunotherapy, and immunoprophylaxis regimens.
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Affiliation(s)
- Kanta Subbarao
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
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3029
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Abstract
The outbreak of severe acute respiratory syndrome (SARS) has drawn enormous attention and caused fear worldwide since early 2003. The disease appears to be under control now; however, the possible return of SARS must be emphasized. Although many clinical experiments have been reported, the treatment of SARS is largely anecdotal, and so far no treatment consensus has been reached. We summarize 14 clinical reports and attempt to assess the effectiveness of various treatment regimens. A combination treatment of steroids and ribavirin was widely used empirically from the outset of the epidemic. In general, the use of steroids for SARS seemed beneficial, but the optimal timing, dosage, and duration of treatment have not yet been determined. On the other hand, ribavirin administration apparently reduced neither the rate of intratracheal intubation nor that of mortality. Moreover, significant toxicity, such as hemolytic anemia, has been attributed to ribavirin. A few preliminary trials and in vitro data suggest the possibility of treating SARS with interferon. Other agents, including the HIV protease inhibitor glycyrrhizin and convalescent plasma, remain to be evaluated.
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Affiliation(s)
- Takeshi Fujii
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Japan.
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3030
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Stadler K, Masignani V, Eickmann M, Becker S, Abrignani S, Klenk HD, Rappuoli R. SARS--beginning to understand a new virus. Nat Rev Microbiol 2004; 1:209-18. [PMID: 15035025 PMCID: PMC7097337 DOI: 10.1038/nrmicro775] [Citation(s) in RCA: 364] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A new infectious disease, called severe acute respiratory syndrome (SARS), appeared in southern China in 2002. During the period from November 2002 to the summer of 2003, the World Health Organization recorded 8098 probable SARS cases and 774 deaths in 29 countries. A previously unknown coronavirus was isolated from FRhK-4 and Vero E6 cells inoculated with clinical specimens from patients. A virus with close homology to SARS-CoV was isolated from palm civets and racoon dogs, which are used as food in southern China In less than a month from the first indication that a coronavirus might be implicated in the disease, the nucleotide sequence of the virus was available, and diagnostic tests were set up. The phylogenetic analysis of the SARS-CoV genome revealed that the virus is distinct from the three known groups of coronaviruses and represents an early split-off from group 2. The development of antiviral drugs or vaccines is being investigated. Viral enzymes essential for virus replication, such as the RNA-dependent RNA polymerase (RdRp), the 3C-like cystein protease (3Clpro) and the helicases are the most attractive targets for antiviral molecules. Of the possible vaccine targets, the spike (S) protein represents the most promising one. So far, β-interferon is the only licensed drug available, which has been reported to interfere with virus replication in vitro. Should SARS return during the next winter, we will still need to rely mostly on quarantine measures to contain it.
The 114-day epidemic of the severe acute respiratory syndrome (SARS) swept 29 countries, affected a reported 8,098 people, left 774 patients dead and almost paralysed the Asian economy. Aggressive quarantine measures, possibly aided by rising summer temperatures, successfully terminated the first eruption of SARS and provided at least a temporal break, which allows us to consolidate what we have learned so far and plan for the future. Here, we review the genomics of the SARS coronavirus (SARS-CoV), its phylogeny, antigenic structure, immune response and potential therapeutic interventions should the SARS epidemic flare up again.
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Affiliation(s)
- Konrad Stadler
- IRIS, Chiron S.r.l., Via Fiorentina 1, Siena, 53100 Italy
| | - Vega Masignani
- IRIS, Chiron S.r.l., Via Fiorentina 1, Siena, 53100 Italy
| | - Markus Eickmann
- Institute of Virology, University of Marburg, Marburg, 35037 Germany
| | - Stephan Becker
- Institute of Virology, University of Marburg, Marburg, 35037 Germany
| | | | - Hans-Dieter Klenk
- Institute of Virology, University of Marburg, Marburg, 35037 Germany
| | - Rino Rappuoli
- IRIS, Chiron S.r.l., Via Fiorentina 1, Siena, 53100 Italy
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3031
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Abstract
Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus, called the SARS coronavirus (SARS‐CoV). Over 95% of well characterized cohorts of SARS have evidence of recent SARS‐CoV infection. The genome of SARS‐CoV has been sequenced and it is not related to any of the previously known human or animal coronaviruses. It is probable that SARS‐CoV was an animal virus that adapted to human‐human transmission in the recent past. The virus can be found in nasopharyngeal aspirate, urine and stools of SARS patients. Second generation reverse transcriptase polymerase chain reaction assays are able to detect SARS‐CoV in nasopharyngeal aspirates of approximately 80% of patients with SARS within the first 3 days of illness. Seroconversion for SARS‐CoV using immunofluorescence on infected cells is an excellent method of confirming the diagnosis, but antibody responses only appear around day 10 of the illness. Within the first 10 days the histological picture is that of acute phase diffuse alveolar damage (DAD) with a mixture of inflammatory infiltrate, oedema and hyaline membrane formation. Desquamation of pneumocytes is prominent and consistent. After 10 days of illness the picture changes to one of organizing DAD with increased fibrosis, squamous metaplasia and multinucleated giant cells. The role of cytokines in the pathogenesis of SARS is still unclear.
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Affiliation(s)
- John Nicholls
- Department of Pathology, the University of Hong Kong, China.
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3032
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Wang W, Ruan S. Simulating the SARS outbreak in Beijing with limited data. J Theor Biol 2004; 227:369-79. [PMID: 15019504 PMCID: PMC7134597 DOI: 10.1016/j.jtbi.2003.11.014] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2003] [Revised: 11/03/2003] [Accepted: 11/06/2003] [Indexed: 11/23/2022]
Abstract
We propose a mathematical model to simulate the SARS outbreak in Beijing. The model consists of six subpopulations, namely susceptible, exposed, quarantined, suspect, probable and removed, as China started to report SARS cases as suspect and probable separately from April 27 and cases transferred from suspect class to probable class from May 2. By simplifying the model to a two-compartment suspect-probable model and a single-compartment probable model and using limited data, we are able to simulate the SARS outbreak in Beijing. We estimate that the reproduction number varies from 1.0698 to 3.2524 and obtain certain important epidemiological parameters.
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Affiliation(s)
- Wendi Wang
- Department of Mathematics, Southwest Normal University, Chongqing 400715, PR China
| | - Shigui Ruan
- Department of Mathematics, University of Miami, Coral Gables, FL 33124-4250, USA
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3033
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Lang ZW, Zhang LJ, Zhang SJ, Meng X, Li JQ, Song CZ, Sun L, Zhou YS, Dwyer DE. A clinicopathological study of three cases of severe acute respiratory syndrome (SARS). Pathology 2004; 35:526-31. [PMID: 14660106 PMCID: PMC7131316 DOI: 10.1080/00313020310001619118] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aims The severe acute respiratory syndrome (SARS) caused a large outbreak of atypical pneumonia in Beijing, China from early March 2003. We report the pathological features from three patients who died of SARS. Methods Autopsies were performed on three patients who died 9–15 days after the onset of the illness, and the clinical and laboratory features reviewed. Tissue sections were stained with haematoxylin and eosin (H&E), and in situ reverse transcriptase polymerase chain reaction (RT–PCR) on lung sections was performed using SARS coronavirus-specific primers. Results The typical gross pathological change in the lungs was diffuse haemorrhage on the lung surface. Histopathological examination revealed serous, fibrinous and haemorrhagic inflammation in most pulmonary alveoli, with capillary engorgement and some capillary microthrombosis. The pulmonary alveoli were thickened with interstitial mononuclear inflammatory infiltrates, diffuse alveolar damage, desquamation of pneumocytes and hyaline-membrane formation; fibrinoid material and erythrocytes were present in alveolar spaces. There were thromboemboli in some bronchial arterioles. Haemorrhagic necrosis and reduced numbers of lymphocytes were observed in lymph nodes and spleen. In situ RT–PCR detected SARS coronavirus RNA in type II alveolar cells, interstitial cells and bronchiolar epithelial cells from all three patients Conclusions Severe immunological damage in lung tissue is responsible for the clinical features of SARS.
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Affiliation(s)
- Zhen-Wei Lang
- Department of Pathology, Beijing Youan Hospital, Capital University of Medical Sciences, Beijing 100-054, China.
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3034
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Abstract
PURPOSE OF REVIEW This review provides an update on new data about the etiology, clinical characteristics, outcomes, and prevention of community-acquired pneumonia. The impact of severe acute respiratory syndrome in older persons is also addressed. RECENT FINDINGS Streptococcus pneumoniae remains the most important cause of community-acquired pneumonia in the very elderly (80 years and over). Pneumococcus is also an important etiologic agent of pneumonia in residents of long-term care facilities. Clinical signs and symptoms of community-acquired pneumonia are less distinct in this group compared with younger patients. New data about influenza immunization reveal better mucosal immunity with the intranasal vaccine compared with the intramuscular vaccine. A review of clinical trial evidence differs from observational studies that demonstrate a clear benefit of the polysaccharide pneumococcal vaccine in the elderly. The prospect of severe acute respiratory syndrome in older adults is the most important new issue to emerge, as older adults are at increased risk from complications and death. SUMMARY There are many challenges in preventing and managing community-acquired pneumonia in the elderly. S. pneumoniae remains the most important cause. The clinical presentation of pneumonia in the very elderly can be nonspecific. Given the safety profile of the vaccine and supportive observational evidence, public health policymakers should continue to support use of the polysaccharide pneumococcal vaccine. However, research into new vaccine strategies, including use of conjugate or common antigen vaccines, is a priority.
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Affiliation(s)
- Mark Loeb
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
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3035
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Affiliation(s)
- Radford G Davis
- Center for Food Security and Public Health, Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
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3036
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3037
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Zhang Y, Li T, Fu L, Yu C, Li Y, Xu X, Wang Y, Ning H, Zhang S, Chen W, Babiuk LA, Chang Z. Silencing SARS-CoV Spike protein expression in cultured cells by RNA interference. FEBS Lett 2004; 560:141-6. [PMID: 14988013 PMCID: PMC7127813 DOI: 10.1016/s0014-5793(04)00087-0] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2003] [Revised: 01/08/2004] [Accepted: 01/12/2004] [Indexed: 01/19/2023]
Abstract
The severe acute respiratory syndrome (SARS) has been one of the most epidemic diseases threatening human health all over the world. Based on clinical studies, SARS‐CoV (the SARS‐associated coronavirus), a novel coronavirus, is reported as the pathogen responsible for the disease. To date, no effective and specific therapeutic method can be used to treat patients suffering from SARS‐CoV infection. RNA interference (RNAi) is a process by which the introduced small interfering RNA (siRNA) could cause the degradation of mRNA with identical sequence specificity. The RNAi methodology has been used as a tool to silence genes in cultured cells and in animals. Recently, this technique was employed in anti‐virus infections in human immunodeficiency virus and hepatitis C/B virus. In this study, RNAi technology has been applied to explore the possibility for prevention of SARS‐CoV infection. We constructed specific siRNAs targeting the S gene in SARS‐CoV. We demonstrated that the siRNAs could effectively and specifically inhibit gene expression of Spike protein in SARS‐CoV‐infected cells. Our study provided evidence that RNAi could be a tool for inhibition of SARS‐CoV.
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Affiliation(s)
- Yuanjiang Zhang
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Tieshi Li
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Ling Fu
- The Institute of Microbiology and Epidemiology, AMMS, Beijing, PR China
| | - Changming Yu
- The Institute of Microbiology and Epidemiology, AMMS, Beijing, PR China
| | - Yinghua Li
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Xialian Xu
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Yinyin Wang
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Hongxiu Ning
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Shuping Zhang
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
| | - Wei Chen
- The Institute of Microbiology and Epidemiology, AMMS, Beijing, PR China
| | - Lorne A Babiuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, SK, Canada
| | - Zhijie Chang
- Institute of Biomedicine, Tsinghua University, Beijing, PR China
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3038
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Navas-Martín S, Weiss SR. Coronavirus replication and pathogenesis: Implications for the recent outbreak of severe acute respiratory syndrome (SARS), and the challenge for vaccine development. J Neurovirol 2004; 10:75-85. [PMID: 15204926 PMCID: PMC7095027 DOI: 10.1080/13550280490280292] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2003] [Accepted: 12/10/2003] [Indexed: 12/28/2022]
Abstract
A novel coronavirus has been recently identified as the causative agent of the severe acute respiratory syndrome (SARS) outbreak that has accounted for more than 8000 infected people worldwide. This review will discuss current knowledge on coronavirus replication, pathogenesis, evolution, and vaccine strategies, as well as the most recent findings on SARS coronavirus.
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Affiliation(s)
- Sonia Navas-Martín
- Department of Microbiology, University of Pennsylvania, School of Medicine, 36th Street and Hamilton Walk, 19104-6076 Philadelphia, PA USA
| | - Susan R. Weiss
- Department of Microbiology, University of Pennsylvania, School of Medicine, 36th Street and Hamilton Walk, 19104-6076 Philadelphia, PA USA
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3039
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Abstract
Since important agents of viral nosocomial infections like hepatitis B and C viruses and norovirus do not replicate sufficiently in cell culture systems, disinfectants with suspected efficacy against these viruses must be evaluated by different methods. Besides molecular approaches and indirect tests, the use of surrogate viruses with similar biophysical properties and genomic structure allows the assessment of virucidal efficacy of chemical disinfectants in quantitative suspension tests. Furthermore, insights into the survival of these viruses in the environment are possible. In recent years, duck hepatitis B virus and bovine viral diarrhoea virus have been tested as surrogates for hepatitis B and C viruses. Feline calicivirus serves as a surrogate for the group of norovirus. By including these viruses in inactivation experiments, valuable data from suspension tests can be derived on the virucidal efficacy of chemical disinfectants. Even in vivo tests using fingerpads of adult volunteers can be performed with these animal viruses without risk of infection. In contrast to in vitro examinations, the results of these tests allow use recommendations of chemical disinfectants for outbreak situations and daily routine disinfection.
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Affiliation(s)
- J Steinmann
- Mikrolab GmbH, Norderoog 2, D-28259 Bremen, Germany.
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3040
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Tse GMK, Hui PK, Ma TKF, Lo AWI, To KF, Chan WY, Chow LTC, Ng HK. Sputum cytology of patients with severe acute respiratory syndrome (SARS). J Clin Pathol 2004; 57:256-9. [PMID: 14990595 PMCID: PMC1770235 DOI: 10.1136/jcp.2003.012948] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome (SARS) is a newly described form of atypical pneumonia linked to a novel coronavirus. AIMS To review the sputum cytology of 15 patients who fulfilled the World Health Organisation clinical criteria for SARS in an attempt to evaluate whether early diagnosis is feasible with routine sputum examination. METHODS All sputum samples from patients with SARS from the four major hospitals in Hong Kong were reviewed; abnormalities were sought in the cellular component, including abnormal numbers and morphology of the component cells compared with those from age matched controls taken over the same period one year ago. RESULTS Fifteen sputum samples from patients were compared with 25 control samples. In the patients with SARS, loose aggregates of macrophages were seen more frequently in the sputum. These macrophages frequently showed morphological changes, such as cytoplasmic foaminess, vacuole formation, and nuclear changes (including multinucleation and a ground glass appearance) when compared with the control samples. CONCLUSIONS The cytological features of SARS are non-specific, but the observation of any of the described features should prompt further investigations, especially in patients with suspicious clinical features.
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Affiliation(s)
- G M K Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Chinese University of Hong Kong, Ngan Shing Street, NT, Hong Kong ROC.
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3041
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Tse GMK, To KF, Chan PKS, Lo AWI, Ng KC, Wu A, Lee N, Wong HC, Mak SM, Chan KF, Hui DSC, Sung JJY, Ng HK. Pulmonary pathological features in coronavirus associated severe acute respiratory syndrome (SARS). J Clin Pathol 2004; 57:260-5. [PMID: 14990596 PMCID: PMC1770245 DOI: 10.1136/jcp.2003.013276] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome (SARS) became a worldwide outbreak with a mortality of 9.2%. This new human emergent infectious disease is dominated by severe lower respiratory illness and is aetiologically linked to a new coronavirus (SARS-CoV). METHODS Pulmonary pathology and clinical correlates were investigated in seven patients who died of SARS in whom there was a strong epidemiological link. Investigations include a review of clinical features, morphological assessment, histochemical and immunohistochemical stainings, ultrastructural study, and virological investigations in postmortem tissue. RESULTS Positive viral culture for coronavirus was detected in most premortem nasopharyngeal aspirate specimens (five of six) and postmortem lung tissues (two of seven). Viral particles, consistent with coronavirus, could be detected in lung pneumocytes in most of the patients. These features suggested that pneumocytes are probably the primary target of infection. The pathological features were dominated by diffuse alveolar damage, with the presence of multinucleated pneumocytes. Fibrogranulation tissue proliferation in small airways and airspaces (bronchiolitis obliterans organising pneumonia-like lesions) in subpleural locations was also seen in some patients. CONCLUSIONS Viable SARS-CoV could be isolated from postmortem tissues. Postmortem examination allows tissue to be sampled for virological investigations and ultrastructural examination, and when coupled with the appropriate lung morphological changes, is valuable to confirm the diagnosis of SARS-CoV, particularly in clinically unapparent or suspicious but unconfirmed cases.
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Affiliation(s)
- G M-K Tse
- Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing Street, Shatin, NT, Hong Kong SAR, China
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3042
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Chen Z, Pei D, Jiang L, Song Y, Wang J, Wang H, Zhou D, Zhai J, Du Z, Li B, Qiu M, Han Y, Guo Z, Yang R. Antigenicity analysis of different regions of the severe acute respiratory syndrome coronavirus nucleocapsid protein. Clin Chem 2004; 50:988-95. [PMID: 15054081 PMCID: PMC7108132 DOI: 10.1373/clinchem.2004.031096] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: The widespread threat of severe acute respiratory syndrome (SARS) to human health has made urgent the development of fast and accurate analytical methods for its early diagnosis and a safe and efficient antiviral vaccine for preventive use. For this purpose, we investigated the antigenicity of different regions of the SARS coronavirus (SARS-CoV) nucleocapsid (N) protein. Methods: The cDNA for full-length N protein and its various regions from the SARS-CoV was cloned and expressed in Escherichia coli. After purification, all of the protein fragments were printed on glass slides to fabricate a protein microarray and then probed with the sera from SARS patients to determine the reactivity of these protein fragments. Results: The full-length protein and two other fragments reacted with all 52 sera tested. Four important regions with possible epitopes were identified and named as EP1 (amino acids 51–71), EP2 (134–208), EP3 (249–273), and EP4 (349–422), respectively. EP2 and EP4 possessed linear epitopes, whereas EP1 and EP2 were able to form conformational epitopes that could react with most (>80%) of the tested sera. EP3 and EP4 also formed conformational epitopes, and antibodies against these epitopes existed in all 52 of the sera tested. Conclusion: The N protein is a highly immunogenic protein of the SARS-CoV. Conformational epitopes are important for this protein, and antigenicity of the COOH terminus is higher than that of the NH2 terminus. The N protein is a potential diagnostic antigen and vaccine candidate for SARS-CoV.
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Affiliation(s)
- Zeliang Chen
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Decui Pei
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Lingxiao Jiang
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Yajun Song
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Jin Wang
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Hongxia Wang
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Dongsheng Zhou
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Junhui Zhai
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Zongmin Du
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Bei Li
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Maofeng Qiu
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Yanping Han
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Zhaobiao Guo
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
| | - Ruifu Yang
- Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing 100071, China
- Address correspondence to this author at: Institute of Microbiology and Epidemiology, Academy of Military Medical Science, 20, Dongdajie, Fengtai District, Beijing 100071, People’s Republic of China. Fax 86-10-83820748; e-mail
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3043
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Boon A, Plotkin S, Rimmelzwaan G, Osterhaus A. Viral vaccine meeting held in Barcelona, October 25-28, 2003. Vaccine 2004; 22:1327-34. [PMID: 15098545 PMCID: PMC7131708 DOI: 10.1016/j.vaccine.2004.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A.C.M Boon
- Institute of Virology, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - S Plotkin
- University of Pennsylvania, Philadelphia, PA, USA
| | - G.F Rimmelzwaan
- Institute of Virology, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - A.D.M.E Osterhaus
- Institute of Virology, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, The Netherlands
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3044
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Narayanan K, Kim KH, Makino S. Characterization of N protein self-association in coronavirus ribonucleoprotein complexes. Virus Res 2004; 98:131-40. [PMID: 14659560 PMCID: PMC7125804 DOI: 10.1016/j.virusres.2003.08.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Mouse hepatitis virus (MHV) nucleocapsid (N) protein binds to the large, single-stranded, positive-sense viral genomic RNA to form a helical nucleocapsid structure in mature virions. In addition N protein binds the intracellular form of the genomic RNA, all of the MHV subgenomic mRNAs, and expressed non-MHV RNA transcripts to form ribonucleoprotein (RNP) complexes in infected cells. Among the intracellular viral RNP complexes, only the genomic RNP complex is packaged into virus particles. The present study demonstrated that N protein in the MHV virion nucleocapsid and in the intracellular genome-length RNP complex that bound to viral envelope M protein was tightly self-associated such that its association was retained even after extensive RNase A-treatment of the RNP complexes. The RNase A-resistant tight N protein association in the virion nucleocapsid was not mediated by an intermolecular disulfide bridge between N proteins. In contrast, N protein association in the majority of the intracellular RNP complexes was susceptible to RNase A-treatment. Because the RNP complexes that specifically interact with the M protein are selectively packaged into MHV particles, the present data suggested that there was a distinct difference between N protein association in viral genomic RNP complexes that undergo packaging into virus particles and the subgenomic RNP complexes that are not packaged into MHV particles.
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Affiliation(s)
- Krishna Narayanan
- Department of Microbiology and Immunology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555-1019, USA
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3045
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Choy WY, Lin SG, Chan PKS, Tam JSL, Lo YMD, Chu IMT, Tsai SN, Zhong MQ, Fung KP, Waye MMY, Tsui SKW, Ng KO, Shan ZX, Yang M, Wu YL, Lin ZY, Ngai SM. Synthetic peptide studies on the severe acute respiratory syndrome (SARS) coronavirus spike glycoprotein: perspective for SARS vaccine development. Clin Chem 2004; 50:1036-42. [PMID: 15044316 PMCID: PMC7108158 DOI: 10.1373/clinchem.2003.029801] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The S (spike) protein of the etiologic coronavirus (CoV) agent of severe acute respiratory syndrome (SARS) plays a central role in mediating viral infection via receptor binding and membrane fusion between the virion and the host cell. We focused on using synthetic peptides for developing antibodies against SARS-CoV, which aimed to block viral invasion by eliciting an immune response specific to the native SARS-CoV S protein. METHODS Six peptide sequences corresponding to the surface regions of SARS-CoV S protein were designed and investigated by use of combined bioinformatics and structural analysis. These synthetic peptides were used to immunize both rabbits and monkeys. Antisera collected 1 week after the second immunization were analyzed by ELISA and tested for antibody specificity against SARS-CoV by immunofluorescent confocal microscopy. RESULTS Four of our six synthetic peptides (S2, S3, S5, and S6) elicited SARS-CoV-specific antibodies, of which S5 (residues 788-820) and S6 (residues 1002-1030) exhibited immunogenic responses similar to those found in a parallel investigation using truncated recombinant protein analogs of the SARS-CoV S protein. This suggested that our S5 and S6 peptides may represent two minimum biologically active sequences of the immunogenic regions of the SARS-CoV S protein. CONCLUSIONS Synthetic peptides can elicit specific antibodies to SARS-CoV. The study provides insights for the future development of SARS vaccine via the synthetic-peptide-based approach.
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Affiliation(s)
- Wai-Yan Choy
- Molecular Biotechnology Program, Department of Biology and Department of Biochemistry, and Departments of
| | - Shu-Guang Lin
- Research Center of Medical Sciences, Guangdong Provincial People’s Hospital, Guangdong, China
| | | | | | | | | | | | - Ming-Qi Zhong
- Molecular Biotechnology Program, Department of Biology and Department of Biochemistry, and Departments of
| | - Kwok-Pui Fung
- Biochemistry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Mary Miu-Yee Waye
- Biochemistry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | | | - Zhi-Xin Shan
- Research Center of Medical Sciences, Guangdong Provincial People’s Hospital, Guangdong, China
| | - Min Yang
- Research Center of Medical Sciences, Guangdong Provincial People’s Hospital, Guangdong, China
| | - Yi-Long Wu
- Research Center of Medical Sciences, Guangdong Provincial People’s Hospital, Guangdong, China
| | - Zhan-Yi Lin
- Research Center of Medical Sciences, Guangdong Provincial People’s Hospital, Guangdong, China
| | - Sai-Ming Ngai
- Molecular Biotechnology Program, Department of Biology and Department of Biochemistry, and Departments of
- Biology, and
- Address correspondence to this author at: Department of Biology, The Chinese University of Hong Kong, Shatin, Hong Kong. Fax 852-26035646; e-mail
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3046
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3047
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Chu CM, Cheng VCC, Hung IFN, Wong MML, Chan KH, Chan KS, Kao RYT, Poon LLM, Wong CLP, Guan Y, Peiris JSM, Yuen KY. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax 2004; 59:252-6. [PMID: 14985565 PMCID: PMC1746980 DOI: 10.1136/thorax.2003.012658] [Citation(s) in RCA: 1102] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The clinical response of patients with severe acute respiratory syndrome (SARS) to a combination of lopinavir/ritonavir and ribavirin was examined after establishing the in vitro antiviral susceptibility of the SARS associated coronavirus to a panel of antiviral agents. METHODS The in vitro susceptibility of the prototype of SARS associated coronavirus to a panel of nucleoside analogues and protease inhibitors currently licensed for clinical use was studied. Forty one patients with SARS followed for 3 weeks were treated with a combination of lopinavir/ritonavir and ribavirin. The clinical progress and virological outcomes were monitored and compared with 111 patients treated with ribavirin only who served as historical controls. RESULTS In vitro antiviral activity against SARS associated coronavirus was demonstrated for lopinavir and ribavirin at concentrations of 4 micro g/ml and 50 micro g/ml, respectively, only at 48 hours. The adverse clinical outcome (ARDS or death) was significantly lower in the treatment group than in the historical controls (2.4% v 28.8%, p<0.001) at day 21 after the onset of symptoms. The adverse outcome remained significantly lower in the treatment group than in the controls-both those diagnosed early (p<0.001) and those diagnosed later in the course of the epidemic (p = 0.002)-but there was no significant difference in adverse outcome rates between the two time periods (p = 0.548). No time related difference in outcome was observed in the control groups. A reduction in steroid usage and nosocomial infections was seen in patients initially treated with lopinavir/ritonavir, and these patients had a decreasing viral load and rising peripheral lymphocyte count. Multivariate analysis showed that age, hepatitis B carrier status, and lack of treatment with this antiviral combination were independent predictors of an adverse outcome. Lopinavir/ritonavir treatment was associated with a better outcome even when adjusted for baseline lactate dehydrogenase level. CONCLUSIONS The apparent favourable clinical response with lopinavir/ritonavir and ribavirin supports further randomised placebo controlled trials in patients with SARS.
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Affiliation(s)
- C M Chu
- Department of Microbiology and Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
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3048
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Shi J, Wei Z, Song J. Dissection study on the severe acute respiratory syndrome 3C-like protease reveals the critical role of the extra domain in dimerization of the enzyme: defining the extra domain as a new target for design of highly specific protease inhibitors. J Biol Chem 2004; 279:24765-73. [PMID: 15037623 PMCID: PMC7982319 DOI: 10.1074/jbc.m311744200] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The severe acute respiratory syndrome (SARS) 3C-like protease consists of two distinct folds, namely the N-terminal chymotrypsin fold containing the domains I and II hosting the complete catalytic machinery and the C-terminal extra helical domain III unique for the coronavirus 3CL proteases. Previously the functional role of this extra domain has been completely unknown, and it was believed that the coronavirus 3CL proteases share the same enzymatic mechanism with picornavirus 3C proteases, which contain the chymotrypsin fold but have no extra domain. To understand the functional role of the extra domain and to characterize the enzyme-substrate interactions by use of the dynamic light scattering, circular dichroism, and NMR spectroscopy, we 1) dissected the full-length SARS 3CL protease into two distinct folds and subsequently investigated their structural and dimerization properties and 2) studied the structural and binding interactions of three substrate peptides with the entire enzyme and its two dissected folds. The results lead to several findings; 1) although two dissected parts folded into the native-like structures, the chymotrypsin fold only had weak activity as compared with the entire enzyme, and 2) although the chymotrypsin fold remained a monomer within a wide range of protein concentrations, the extra domain existed as a stable dimer even at a very low concentration. This observation strongly indicates that the extra domain contributes to the dimerization of the SARS 3CL protease, thus, switching the enzyme from the inactive form (monomer) to the active form (dimer). This discovery not only separates the coronavirus 3CL protease from the picornavirus 3C protease in terms of the enzymatic mechanism but also defines the dimerization interface on the extra helical domain as a new target for design of the specific protease inhibitors. Furthermore, the determination of the preferred solution conformation of the substrate peptide S1 together with the NMR differential line-broadening and transferred nuclear Overhauser enhancement study allows us to pinpoint the bound structure of the S1 peptide.
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Affiliation(s)
- Jiahai Shi
- Department of Biochemistry, National University of Singapore, 10 Kent Ridge Crescent, Singapore 119260
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3049
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van der Hoek L, Pyrc K, Jebbink MF, Vermeulen-Oost W, Berkhout RJM, Wolthers KC, Wertheim-van Dillen PME, Kaandorp J, Spaargaren J, Berkhout B. Identification of a new human coronavirus. Nat Med 2004; 10:368-73. [PMID: 15034574 PMCID: PMC7095789 DOI: 10.1038/nm1024] [Citation(s) in RCA: 1249] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Accepted: 03/08/2004] [Indexed: 02/07/2023]
Abstract
Three human coronaviruses are known to exist: human coronavirus 229E (HCoV-229E), HCoV-OC43 and severe acute respiratory syndrome (SARS)-associated coronavirus (SARS-CoV). Here we report the identification of a fourth human coronavirus, HCoV-NL63, using a new method of virus discovery. The virus was isolated from a 7-month-old child suffering from bronchiolitis and conjunctivitis. The complete genome sequence indicates that this virus is not a recombinant, but rather a new group 1 coronavirus. The in vitro host cell range of HCoV-NL63 is notable because it replicates on tertiary monkey kidney cells and the monkey kidney LLC-MK2 cell line. The viral genome contains distinctive features, including a unique N-terminal fragment within the spike protein. Screening of clinical specimens from individuals suffering from respiratory illness identified seven additional HCoV-NL63-infected individuals, indicating that the virus was widely spread within the human population.
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Affiliation(s)
- Lia van der Hoek
- Department of Human Retrovirology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ The Netherlands
| | - Krzysztof Pyrc
- Department of Human Retrovirology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ The Netherlands
| | - Maarten F Jebbink
- Department of Human Retrovirology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ The Netherlands
| | - Wilma Vermeulen-Oost
- Public Health Laboratory, Municipal Health Service, Nieuwe Achtergracht 100, Amsterdam, 1018 WT The Netherlands
| | - Ron J M Berkhout
- Public Health Laboratory, Municipal Health Service, Nieuwe Achtergracht 100, Amsterdam, 1018 WT The Netherlands
| | - Katja C Wolthers
- Department of Human Retrovirology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ The Netherlands
| | - Pauline M E Wertheim-van Dillen
- Department of Medical Microbiology/Clinical Virology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ The Netherlands
| | - Jos Kaandorp
- Pediatric Department, Slotervaart Hospital, Louwesweg 6, Amsterdam, 1066 EC The Netherlands
| | - Joke Spaargaren
- Public Health Laboratory, Municipal Health Service, Nieuwe Achtergracht 100, Amsterdam, 1018 WT The Netherlands
| | - Ben Berkhout
- Department of Human Retrovirology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ The Netherlands
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3050
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Liu S, Xiao G, Chen Y, He Y, Niu J, Escalante CR, Xiong H, Farmar J, Debnath AK, Tien P, Jiang S. Interaction between heptad repeat 1 and 2 regions in spike protein of SARS-associated coronavirus: implications for virus fusogenic mechanism and identification of fusion inhibitors. Lancet 2004; 363:938-47. [PMID: 15043961 PMCID: PMC7140173 DOI: 10.1016/s0140-6736(04)15788-7] [Citation(s) in RCA: 406] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Studies on the fusion-inhibitory peptides derived from the heptad repeat 1 and 2 (HR1 and HR2) regions of the HIV-1 envelope glycoprotein gp41 provided crucial information on the viral fusogenic mechanism. We used a similar approach to study the fusogenic mechanism of severe-acute-respiratory-syndrome-associated coronavirus (SARS-CoV). METHODS We tested the inhibitory activity against infection of two sets of peptides corresponding to sequences of SARS-CoV spike protein HR1 and HR2 regions and investigated the interactions between the HR1 and HR2 peptides by surface plasmon resonance, sedimentation equilibration analysis, circular dichroism, native polyacrylamide-gel electrophoresis, size exclusion high-performance liquid chromatography, and computer-aided homology modelling and molecule docking analysis. FINDINGS One peptide, CP-1, derived from the HR2 region, inhibited SARS-CoV infection in the micromolar range. CP-1 bound with high affinity to a peptide from the HR1 region, NP-1. CP-1 alone had low alpha-helicity and self-associated to form a trimer in phosphate buffer (pH 7.2). CP-1 and NP-1 mixed in equimolar concentrations formed a six-helix bundle, similar to the fusogenic core structure of HIV-1 gp41. INTERPRETATION After binding to the target cell, the transmembrane spike protein might change conformation by association between the HR1 and HR2 regions to form an oligomeric structure, leading to fusion between the viral and target-cell membranes. At the prefusion intermediate state, CP-1 could bind to the HR1 region and interfere with the conformational changes, resulting in inhibition of SARS-CoV fusion with the target cells. CP-1 might be modifiable to increase its anti-SARS-CoV activity and could be further developed as an antiviral agent for treatment or prophylaxis of SARS-CoV infection.
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Affiliation(s)
- Shuwen Liu
- Lindsley F Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Gengfu Xiao
- Modern Virology Research Center, Wuhan University, Wuhan, China
| | - Yibang Chen
- Mount Sinai School of Medicine, New York, NY, USA
| | - Yuxian He
- Lindsley F Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Jinkui Niu
- Mount Sinai School of Medicine, New York, NY, USA
| | | | - Huabao Xiong
- Mount Sinai School of Medicine, New York, NY, USA
| | - James Farmar
- Lindsley F Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Asim K Debnath
- Lindsley F Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Po Tien
- Modern Virology Research Center, Wuhan University, Wuhan, China
| | - Shibo Jiang
- Lindsley F Kimball Research Institute, New York Blood Center, New York, NY, USA
- Correspondence to: Dr Shibo Jiang, Lindsley F Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY 10021, US
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