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Fan C, Yang Y, Zhan S, Sun X, Fu C. The Effectiveness and Impact of the Enterovirus 71 Vaccine on the Onset of Hand, Foot, and Mouth Disease in Children Aged ≤5 Years: A 7-Year Study. J Infect 2024:106244. [PMID: 39121970 DOI: 10.1016/j.jinf.2024.106244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Affiliation(s)
- Chenlu Fan
- The Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, No. 548, Binwen Rd, Hangzhou, China 310053; Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, National Medical Products Administration, No. 74, Zhongshan 3 Rd, Guangzhou, China 510080
| | - Yingying Yang
- The Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, No. 548, Binwen Rd, Hangzhou, China 310053; Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, National Medical Products Administration, No. 74, Zhongshan 3 Rd, Guangzhou, China 510080
| | - Siyi Zhan
- The Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, No. 548, Binwen Rd, Hangzhou, China 310053; Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, National Medical Products Administration, No. 74, Zhongshan 3 Rd, Guangzhou, China 510080
| | - Xiu Sun
- The Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, No. 548, Binwen Rd, Hangzhou, China 310053; Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, National Medical Products Administration, No. 74, Zhongshan 3 Rd, Guangzhou, China 510080
| | - Chuanxi Fu
- The Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, No. 548, Binwen Rd, Hangzhou, China 310053; Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, National Medical Products Administration, No. 74, Zhongshan 3 Rd, Guangzhou, China 510080.
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Sun T, Li D, Dai X, Meng C, Li Y, Cheng C, Ji W, Zhu P, Chen S, Yang H, Jin Y, Zhang W, Duan G. Local immune dysregulation and subsequent inflammatory response contribute to pulmonary edema caused by Enterovirus infection in mice. J Med Virol 2023; 95:e28454. [PMID: 36597906 DOI: 10.1002/jmv.28454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/15/2022] [Accepted: 01/01/2023] [Indexed: 01/05/2023]
Abstract
Pulmonary edema that comes on suddenly is the leading cause of mortality in hand-foot-and-mouth disease (HFMD) patients; however, its pathogenesis is still largely unclear. A range of research suggest immunopathogenesis during the occurrence of pulmonary edema in severe HFMD patients. Herein, to investigate the potential mechanism of immune dysregulation in the development of pulmonary edema upon Enterovirus (EV) infection, we established mouse infection models for Enteroviruses (EVs) including Coxsackievirus (CV) A6, Enterovirus A71 (EVA71), and CVA2 exhibiting a high incidence of pulmonary edema. We found that EVs infection induced an immune system disorder by reducing the numbers of pulmonary and circulatory T cells, B cells, macrophages, and monocytes and increasing the numbers of lung neutrophils, myeloid-derived suppressor cells (MDSCs), and activated T cells. In addition, the concentrations of C-X-C motif chemokine ligand 1 (CXCL-1), tumor necrosis factor-alpha, monocyte chemoattractant protein-1, and interleukin 6 were increased in EV-infected lungs. Moreover, we found that EVs replication in mice lungs lead to apoptosis of lung cells and degradation of tight junction proteins. In conclusion, EVs infection likely triggered a complexed immune defense mechanism and caused dysregulation of innate immune cells (MDSCs, neutrophils, monocytes, and macrophages) and adaptive cellular immunity (B cells, T cells). This dysregulation increased the release of cytokines and other inflammatory factors from activated immune-related cells and caused lung barrier damage and pulmonary edema.
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Affiliation(s)
- Tiantian Sun
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Dong Li
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinchen Dai
- Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China
| | - Caiyun Meng
- Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China
| | - Yi Li
- Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China
| | - Cheng Cheng
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Peiyu Zhu
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haiyan Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Weiguo Zhang
- Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China.,Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan, China
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Cheng FF, Zhang BB, Cao ML, Zhang Q, Chen QH, Hui ZF, Tian JM, Yan WH. Clinical characteristics of 68 children with atypical hand, foot, and mouth disease caused by coxsackievirus A6: a single-center retrospective analysis. Transl Pediatr 2022; 11:1502-1509. [PMID: 36247893 PMCID: PMC9561509 DOI: 10.21037/tp-22-352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) caused by coxsackievirus A6 (CV-A6) has become prevalent in many parts of the world. It is commonly referred to as atypical HFMD which more likely to present as bullous lesions. Compared with traditional HFMD, its misdiagnosis rate is relatively high, which brings difficulties to clinical diagnosis. We retrospectively analyze the clinical characteristics of children with HFMD with bullous lesions caused by CV-A6. METHODS The study included 68 children with atypical HFMD caused by CV-A6 who were hospitalized from 2018 to 2020. Data of the children including age, sex, month of HFMD onset, the morphologies and distribution of rashes, the details of fever, the presence or absence of onychomadesis, and laboratory test results were analyzed and compared between an infant group (<1 year), a toddler group (1-<3 years), and a preschool group (3-<6 years). RESULTS Of the 68 children, 67 were younger than 5 years old, with a male to female ratio of 1.62:1. The disease peaked in the period from June to September. With 75.0% of the infant group had more than three kinds of rashes; 95.0% of the preschool group had rashes in more than five locations. These differences were statistically significant (P<0.05). All children had fever. The peak fever in the toddler group was lower (P=0.033). No critical cases were observed in any of the groups. Of the 61 children who were successfully followed up, 68.9% developed onychomadesis within 2-3 weeks. The proportion of cases with abnormal liver function was 83.3%, 41.7%, and 10.0% in the infant, toddler, and preschool groups (P<0.001). The proportion of cases with increased serum creatine kinase MB isoenzyme (CK-MB) were significantly higher in the toddler group (P<0.05). CONCLUSIONS Atypical HFMD caused by CV-A6 infection usually occurred in children under 5 years old. The morphologies of the rashes in the infant group changed more, while the rashes in the preschool group was more widely distributed. The incidence of critical cases was low. More than half of the cases can develop onychomadesis in the recovery period. Organ damage was relatively mild in the preschool group.
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Affiliation(s)
- Fang-Fang Cheng
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Bing-Bing Zhang
- Neurology Department, Children's Hospital of Soochow University, Suzhou, China
| | - Meng-Lu Cao
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Qian Zhang
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Qing-Hui Chen
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Zhao-Fang Hui
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Jian-Mei Tian
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Wen-Hua Yan
- Cardiovascular Department, Children's Hospital of Soochow University, Suzhou, China
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An Outbreak of Coxsackievirus A6 Infection in Adults of a Collective Unit, China, 2019. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:6607294. [PMID: 36065442 PMCID: PMC9440842 DOI: 10.1155/2022/6607294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/20/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
Outbreaks/epidemics caused by coxsackievirus A6 (CVA6) have been reported continuously since 2008. However, outbreaks of ocular conjunctival hemorrhage caused by CVA6 in adults in a collective unit have not been reported. Methods. The epidemiological investigations were carried out according to the monitoring program, and the clinical data were collected from the treated hospitals. The nasopharyngeal swab specimens were collected to extract the total nucleic acid (DNA/RNA). The pathogen was determined using nucleic acid detection kits for 22 respiratory pathogens. The VP1 gene of this pathogen was amplified and sequenced. Sequence alignment and analysis were performed using BioEdit 7.0. The gene phylogenetic tree was constructed with MEGA4.0. Results. The factory emerged patients in succession from February 14 and reached the peak on the 18th. A total of 19 workers had symptoms in this factory up to March 31, 2019, giving an attack rate of 8.26%. The main symptoms were rash, ocular conjunctival hemorrhage, fever, and sore throat. The laboratory results showed that coxsackievirus A6 was the main pathogen causing this outbreak. The risk of taking a bath in the bathroom was 7.37 times higher than that of not taking a bath (95% confidence interval (CI): 1.67–32.79). Conclusion. This manuscript further enriched the infection-related information of CVA6, which was helpful to better identify and deal with the epidemic in the future.
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Du M, Jing W, Liu M, Liu J. The Global Trends and Regional Differences in Incidence of Dengue Infection from 1990 to 2019: An Analysis from the Global Burden of Disease Study 2019. Infect Dis Ther 2021; 10:1625-1643. [PMID: 34173959 PMCID: PMC8234762 DOI: 10.1007/s40121-021-00470-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Dengue, as a neglected tropical disease, brings a heavy socioeconomic burden. To provide tailored global prevention strategies, we analyzed the global trends and regional differences in incidence of dengue infection from 1990 to 2019. METHODS We obtained data on annual dengue episodes and incidence rates, which reflected the epidemic status of dengue infection from the 2019 Global Burden of Disease (GBD) Study. The changes in dengue episodes and estimated annual percentage changes (EAPCs) of the age-standardized incidence rate (ASR) were calculated to quantify the temporal trends of dengue infection. RESULTS Globally, dengue ASR increased by 1.70% (95% CI 1.62%-1.78%) per year from 1990 to 2011; subsequently, it decreased by 0.41% (95% CI 0.20%-0.62%) per year from 2011 to 2019. However, the global number of dengue episodes increased steadily by 85.47% from 30.67 million in 1990 to 56.88 million in 2019. Against the global trend of decreasing ASR from 2011 to 2019, an increasing trend was reported in Oceania (EAPC 11.01, 95% CI 8.79-13.27), East Asia (EAPC 4.84, 95% CI 2.70-7.03) and Southeast Asia (EAPC 0.38, 95% CI 0.13-0.62). For socio-demographic index (SDI) regions, ASR continued to have an increasing trend in the middle (EAPC 0.26, 95% CI 0.07-0.45) and high-middle (EAPC 1.70, 95% CI 0.98-2.42) SDI regions from 2011 to 2019. In contrast to the global peak age of dengue incidence rate (10 to 25 years), the dengue incidence rate of older people (> 65 years) was higher than in other age groups in low and low-middle SDI regions. Additionally, the proportions of dengue episodes in the > 70-year-old age group increased in 2019 (using the baseline in 1990 or 2011) in most GBD regions. CONCLUSIONS Global dengue episodes have increased tremendously in 3 decades. Although global dengue ASR decreased in the last decade, it is still increasing in hyperendemic regions including Oceania, East Asia and Southeast Asia, and also in the middle and high-middle SDI regions. More attention should be paid to the elderly because of the higher dengue incidence rate among them in low and low-middle SDI regions and the increased proportions of dengue episodes among the elderly in most GBD regions. Therefore, more efforts should be undertaken to develop targeted prevention strategies for crucial regions and older populations.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Wenzhan Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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Kamau E, Nguyen D, Celma C, Blomqvist S, Horby P, Simmonds P, Harvala H. Seroprevalence and Virologic Surveillance of Enterovirus 71 and Coxsackievirus A6, United Kingdom, 2006-2017. Emerg Infect Dis 2021; 27:2261-2268. [PMID: 34423767 PMCID: PMC8386771 DOI: 10.3201/eid2709.204915] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Enterovirus A71 (EV-A71) and coxsackievirus A6 (CVA6) cause hand, foot and mouth disease (HFMD) and are occasionally linked to severe neurologic complications and large outbreaks worldwide. We estimated EV-A71 and CVA6 seroprevalence using cross-sectional age-stratified samples collected in 2006, 2011, and 2017. Seroprevalences of EV-A71 and CVA6 increased from 32% and 54% at 6-11 months to >75% by 10 years of age. Antibody titers declined after 20 years, which could indicate infrequent re-exposure in older populations. Age profiles for acquiring infections and mean titers were comparable in the 3 testing years, despite the marked increase in incidence of CVA6-related HFMD from 2010. The uncoupling of changes in disease severity from the infection kinetics of CVA6 as we inferred from the seroprevalence data, rather than incidence of infection over the 11-year study period, provides further evidence for a change in its pathogenicity.
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Zhou G, Feng YM, Li ZC, Tao LY, Kong WS, Xie RF, Zhou X. Fingerprinting and Determination of Hepatotoxic Constituents in Polygoni Multiflori Radix Praeparata of Different Producing Places by HPLC. J Chromatogr Sci 2021; 60:440-449. [PMID: 34240129 DOI: 10.1093/chromsci/bmab086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 04/08/2021] [Indexed: 12/18/2022]
Abstract
Polygoni Multiflori Radix Praeparata (PMRP) is used as Chinese herbal medicine with long history. However, reports about PMRP hepatotoxicity have increased recently, and producing area might be one reason. This article aims to figure out the relationship between producing area and hepatotoxic ingredients in PMRP. HPLC fingerprint for PMRP was established and the contents of gallic acid, trans-stilbene glycoside (TSG), emodin-8-O-β-D-glucoside (EG), emodin and physcion were determined. Clustering heatmap was implemented by TCMNPAS software,and principal component analysis was implemented by SPSS and SIMCA-P software. Hepatotoxic constituents' contents of PMRP from separate producing area were different. PMRP from Guangxi had the highest content of gallic acid, TSG, EG, emodin and physcion, followed by Hubei, Guangdong, Guizhou, Yunnan. PMRP from Henan had the lowest contents of hepatotoxic components. Hepatotoxic components' contents of PMRP in southern were higher than central China. This study carried out a preliminary qualitative and quantitative investigation on the PMRP from different producing places, which provided a basis for safe medication of PMRP.
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Affiliation(s)
- Gui Zhou
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, South Wanping Road, Xuhui District, Shanghai 200032, China
| | - Yi-Ming Feng
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, South Wanping Road, Xuhui District, Shanghai 200032, China
| | - Zhi-Cheng Li
- Pudong Hospital, Fudan University, Gongwei Road, Pudong New District, Shanghai 201300, China
| | - Li-Yu Tao
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Zhangheng Road, Pudong New District, Shanghai 201203, China
| | - Wei-Song Kong
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, South Wanping Road, Xuhui District, Shanghai 200032, China
| | - Rui-Fang Xie
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, South Wanping Road, Xuhui District, Shanghai 200032, China
| | - Xin Zhou
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, South Wanping Road, Xuhui District, Shanghai 200032, China
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Wang F, Qiang X, Jiang S, Shao J, Fang B, Zhou L. The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease-a retrospective study. BMC Infect Dis 2021; 21:208. [PMID: 33632141 PMCID: PMC7905911 DOI: 10.1186/s12879-021-05889-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is an acute infectious disease caused by human enterovirus 71 (EV71), coxsackievirus, or echovirus, which is particularly common in preschool children. Severe HFMD is prone to cause pulmonary edema before progressing to respiratory and circulatory failure; thus hemodynamic monitoring and fluid management are important to the treatment process. METHODS We did a review of young patients who had been successfully treated in our department for severe HFMD, which had been caused by EV71. A total of 20 patients met the inclusion criteria. Eight cases were monitored by the pulse indicator continuous cardiac output (PiCCO) technique, and fluid management was administered according to its parameters. With regard to the treatment with PiCCO monitoring, patients were divided into two groups: the PiCCO group (8 patients) and the control group (12 patients). The groups were then compared comprehensively to evaluate whether PiCCO monitoring could improve patients' clinical outcomes. RESULTS After analysis, the findings informed that although PiCCO failed to shorten the length of ICU stay, reduce the days of vasoactive drug usage, or lower the number of cases which required mechanical ventilation, PiCCO did reduce the incidence of fluid overload (p = 0.085) and shorten the days of mechanical ventilation (p = 0.028). After effective treatment, PiCCO monitoring indicated that the cardiac index (CI) increased gradually(p < 0.0001), in contrast to their pulse (P, p < 0.0001), the extra vascular lung water index (EVLWI, p < 0.0001), the global end diastolic volume index (GEDVI, p = 0.0043), and the systemic vascular resistance index (SVRI, p < 0.0001), all of which decreased gradually. CONCLUSION Our study discovered that PiCCO hemodynamic monitoring in young children with severe HFMD has some potential benefits, such as reducing fluid overload and the duration of mechanical ventilation. However, whether it can ameliorate the severity of the disease, reduce mortality, or prevent multiple organ dysfunction remain to be further investigated.
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Affiliation(s)
- Fengyun Wang
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China
| | - Xinhua Qiang
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China
| | - Suhua Jiang
- Department of Pediatric Intensive Care Units, The First People's Hospital of Foshan, Foshan, China
| | - Jingsong Shao
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China
| | - Bin Fang
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.
| | - Lixin Zhou
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.
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Wo X, Yuan Y, Xu Y, Chen Y, Wang Y, Zhao S, Lin L, Zhong X, Wang Y, Zhong Z, Zhao W. TAR DNA-Binding Protein 43 is Cleaved by the Protease 3C of Enterovirus A71. Virol Sin 2021; 36:95-103. [PMID: 32696397 PMCID: PMC7973337 DOI: 10.1007/s12250-020-00262-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/01/2020] [Indexed: 12/13/2022] Open
Abstract
Enterovirus A71 (EV-A71) is one of the etiological pathogens leading to hand, foot, and mouth disease (HFMD), which can cause severe neurological complications. The neuropathogenesis of EV-A71 infection is not well understood. The mislocalization and aggregation of TAR DNA-binding protein 43 (TDP-43) is the pathological hallmark of amyotrophic lateral sclerosis (ALS). However, whether TDP-43 was impacted by EV-A71 infection is unknown. This study demonstrated that TDP-43 was cleaved during EV-A71 infection. The cleavage of TDP-43 requires EV-A71 replication rather than the activated caspases due to viral infection. TDP-43 is cleaved by viral protease 3C between the residues 331Q and 332S, while mutated TDP-43 (Q331A) was not cleaved. In addition, mutated 3C which lacks the protease activity failed to induce TDP-43 cleavage. We also found that TDP-43 was translocated from the nucleus to the cytoplasm, and the mislocalization of TDP-43 was induced by viral protease 2A rather than 3C. Taken together, we demonstrated that TDP-43 was cleaved by viral protease and translocated to the cytoplasm during EV-A71 infection, implicating the possible involvement of TDP-43 in the pathogenesis of EV-A71infection.
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Affiliation(s)
- Xiaoman Wo
- Department of Cell Biology, Harbin Medical University, Harbin, 150081, China
| | - Yuan Yuan
- Department of Cell Biology, Harbin Medical University, Harbin, 150081, China
| | - Yong Xu
- Department of Cell Biology, Harbin Medical University, Harbin, 150081, China
| | - Yang Chen
- Department of Microbiology, Harbin Medical University, Harbin, 150081, China
| | - Yao Wang
- Department of Cell Biology, Harbin Medical University, Harbin, 150081, China
| | - Shuoxuan Zhao
- Department of Cell Biology, Harbin Medical University, Harbin, 150081, China
| | - Lexun Lin
- Department of Microbiology, Harbin Medical University, Harbin, 150081, China
| | - Xiaoyan Zhong
- Department of Microbiology, Harbin Medical University, Harbin, 150081, China
| | - Yan Wang
- Department of Microbiology, Harbin Medical University, Harbin, 150081, China
| | - Zhaohua Zhong
- Department of Microbiology, Harbin Medical University, Harbin, 150081, China.
| | - Wenran Zhao
- Department of Cell Biology, Harbin Medical University, Harbin, 150081, China.
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Chen L, Xu SJ, Yao XJ, Yang H, Zhang HL, Meng J, Zeng HR, Huang XH, Zhang RL, He YQ. Molecular epidemiology of enteroviruses associated with severe hand, foot and mouth disease in Shenzhen, China, 2014-2018. Arch Virol 2020; 165:2213-2227. [PMID: 32666145 PMCID: PMC7360124 DOI: 10.1007/s00705-020-04734-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/13/2020] [Indexed: 12/15/2022]
Abstract
In this study, we investigated the epidemiology and molecular characteristics of enteroviruses associated with severe hand, foot and mouth disease (HFMD) in Shenzhen, China, during 2014-2018. A total of 137 fecal specimens from patients with severe HFMD were collected. Enterovirus (EV) types were determined using real-time reverse transcription polymerase chain reaction (RT-PCR), RT nested PCR, and sequencing. Sequences were analyzed using bioinformatics programs. Of 137 specimens tested, 97 (70.8%), 12 (8.8%), and 10 (7.3%) were positive for EV-A71, coxsackievirus A6 (CVA6), and CVA16, respectively. Other pathogens detected included CVA2 (2.9%, 4/137), CVA10 (2.9%, 4/137), CVA5 (0.7%, 1/137), echovirus 6 (E6) (0.7%, 1/137) and E18 (0.7%, 1/137). The most frequent complication in patients with proven EV infections was myoclonic jerk, followed by aseptic encephalitis, tachypnea, and vomiting. The frequencies of vomiting and abnormal eye movements were higher in EV-A71-infected patients than that in CVA6-infected or CVA16-infected patients. Molecular phylogeny based on the complete VP1 gene revealed no association between the subgenotype of the virus and disease severity. Nevertheless, 12 significant mutations that were likely to be associated with virulence or the clinical phenotype were observed in the 5’UTR, 2Apro, 2C, 3A, 3Dpol and 3’UTR of CVA6. Eight significant mutations were observed in the 5’UTR, 2B, 3A, 3Dpol and 3’UTR of CVA16, and 10 significant mutations were observed in the 5’UTR, VP1, 3A and 3Cpro of CVA10. In conclusion, EV-A71 is still the main pathogen causing severe HFMD, although other EV types can also cause severe complications. Potential virulence or phenotype-associated sites were identified in the genomes of CVA6, CVA16, and CVA10.
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Affiliation(s)
- Long Chen
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
| | - Shao-Jian Xu
- District Key Laboratory for Infectious Disease Prevention and Control, Longhua District Center for Disease Control and Prevention, Shenzhen, 518109, China
| | - Xiang-Jie Yao
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Hong Yang
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Hai-Long Zhang
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Jun Meng
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Han-Ri Zeng
- Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xu-He Huang
- Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Ren-Li Zhang
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Ya-Qing He
- Major Infectious Disease Control Key Laboratory and Shenzhen Public Service Platform of Pathogenic Microorganisms Repository, Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
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