1
|
Wei X, Wu J, Peng W, Chen X, Zhang L, Rong N, Yang H, Zhang G, Zhang G, Zhao B, Liu J. The Milk of Cows Immunized with Trivalent Inactivated Vaccines Provides Broad-Spectrum Passive Protection against Hand, Foot, and Mouth Disease in Neonatal Mice. Vaccines (Basel) 2024; 12:570. [PMID: 38932299 PMCID: PMC11209096 DOI: 10.3390/vaccines12060570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a contagious viral infection predominantly affecting infants and young children, caused by multiple enteroviruses, including Enterovirus 71 (EV71), Coxsackievirus A16 (CA16), Coxsackievirus A10 (CA10), and Coxsackievirus A6 (CA6). The high pathogenicity of HFMD has garnered significant attention. Currently, there is no specific treatment or broad-spectrum preventive measure available for HFMD, and existing monovalent vaccines have limited impact on the overall incidence or prevalence of the disease. Consequently, with the emergence of new viral strains driven by vaccine pressure, there is an urgent need to develop strategies for the rapid response and control of new outbreaks. In this study, we demonstrated the broad protective effect of maternal antibodies against three types of HFMD by immunizing mother mice with a trivalent inactivated vaccine targeting EV71, CA16, and CA10, using a neonatal mouse challenge model. Based on the feasibility of maternal antibodies as a form of passive immunization to prevent HFMD, we prepared a multivalent antiviral milk by immunizing dairy cows with the trivalent inactivated vaccine to target multiple HFMD viruses. In the neonatal mouse challenge model, this immunized milk exhibited extensive passive protection against oral infections caused by the three HFMD viruses. Compared to vaccines, this strategy may offer a rapid and broadly applicable approach to providing passive immunity for the prevention of HFMD, particularly in response to the swift emergence and spread of new variants.
Collapse
Affiliation(s)
- Xiaohui Wei
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Jing Wu
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Wanjun Peng
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Xin Chen
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Lihong Zhang
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Na Rong
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Hekai Yang
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Gengxin Zhang
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Gaoying Zhang
- Wuhan Servicebio Technology Co., Ltd., Wuhan 430079, China;
| | - Binbin Zhao
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| | - Jiangning Liu
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China; (X.W.)
| |
Collapse
|
2
|
Sun Y, Zhou J, Nie W, Tian D, Ye Q. Study on the epidemiological characteristics of enterovirus among pediatric patients in Hangzhou, China: A comparison between the pre-COVID-19, COVID-19 pandemic, and post-COVID-19 periods. J Med Virol 2024; 96:e29412. [PMID: 38258311 DOI: 10.1002/jmv.29412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Nonpharmaceutical interventions (NPIs) for coronavirus disease 2019 (COVID-19) not only reduce the prevalence of this disease among children but also influence the transmission of other viruses. This retrospective study investigated the impact of NPIs on human enterovirus (HEV) infection in children diagnosed with hand, foot, and mouth disease (HFMD) or herpangina (HA) in Hangzhou, China. We collected and analyzed the laboratory results and clinical data of children diagnosed with HFMD or HA during the following periods: pre-COVID-19 (January 2019 to December 2019), the COVID-19 pandemic (January 2020 to December 2022), and post-COVID-19 (January to December 2023). A total of 41 742 specimens that met the inclusion criteria were obtained, of which 1998 (4.79%) tested positive for enterovirus. In comparison to those in the pre-COVID-19 period, which had 695 (5.63%) HEV-positive specimens, the numbers dramatically decreased to 69 (1.19%), 398 (5.12%), and 112 (1.58%) in 2020, 2021, and 2022, respectively, but significantly increased to 724 (8.27%) in 2023. Seasonal peaks of infections occurred in May, June, July, and August each year, with the total detection rate ranging from 2019 to 2023 being 9.41% in May, 22.47% in June, 28.23% in July, and 12.16% in August, respectively. The difference in the detection rates of HEV infection between males and females was statistically significant (p < 0.005), with 5.11% (1221/23 898) of males and 4.35% (777/17 844) of females testing positive, resulting in a male-to-female positive ratio of 1.57:1. Among the age groups, 11.25% (378/3360) of the children aged 3-5 years had the highest detection rate, which steadily decreased with increasing or decreasing age. The detection of HEV indicated that >95% of the viruses were other types than the previously commonly reported enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). In conclusion, NPIs for COVID-19 may be effective at reducing the transmission of HEV. However, with the relaxation of NPIs, the detection rate of HEVs increased slowly to a certain extent. Active awareness and surveillance of the epidemiological characteristics of HEV are essential for preventing, controlling, and managing the development of HFMD and HA, as well as contributing to the development of a multivalent HFMD vaccine.
Collapse
Affiliation(s)
- Yanhong Sun
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianming Zhou
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenjian Nie
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dandan Tian
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing Ye
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
3
|
de Campos GM, de La-Roque DGL, Lima ARJ, Zucherato VS, de Carvalho E, de Lima LPO, de Queiroz Cattony Neto P, dos Santos MM, Ciccozzi M, Giovanetti M, Haddad R, Alcantara LCJ, Elias MC, Sampaio SC, Covas DT, Kashima S, Slavov SN. Exploring Viral Metagenomics in Pediatric Patients with Acute Respiratory Infections: Unveiling Pathogens beyond SARS-CoV-2. Microorganisms 2023; 11:2744. [PMID: 38004755 PMCID: PMC10672962 DOI: 10.3390/microorganisms11112744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 11/26/2023] Open
Abstract
The emergence of SARS-CoV-2 and the subsequent pandemic have prompted extensive diagnostic and clinical efforts to mitigate viral spread. However, these strategies have largely overlooked the presence of other respiratory viruses. Acute respiratory diseases in pediatric patients can be caused by a diverse range of viral agents, and metagenomics represents a powerful tool for their characterization. This study aimed to investigate the viral abundance in pediatric patients with acute respiratory symptoms who tested negative for SARS-CoV-2 during the Omicron pandemic wave. To achieve this, viral metagenomics and next-generation sequencing were employed on 96 nasopharyngeal swab samples, which were organized into 12 pools, with each pool consisting of eight individual samples. Metagenomic analysis revealed that the most prevalent viruses associated with acute disease in pediatric patients were respiratory syncytial virus (detected in all pools) and enteroviruses, which are known to cause significant morbidity and mortality in children. Additionally, clinically significant viruses such as mumps orthorubulavirus, human metapneumovirus, influenza A, and a wide array of human herpesviruses (1, 3-7) were identified. These findings highlight the extensive potential of viral metagenomics in identifying viruses other than SARS-CoV-2 that contribute to acute infections in children. Consequently, this methodology should garner clinical attention in terms of differential diagnosis and the development of public policies to address such conditions in the global pediatric population.
Collapse
Affiliation(s)
- Gabriel Montenegro de Campos
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14050-190, Brazil; (G.M.d.C.); (D.G.L.d.L.-R.); (V.S.Z.); (S.K.)
| | - Debora Glenda Lima de La-Roque
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14050-190, Brazil; (G.M.d.C.); (D.G.L.d.L.-R.); (V.S.Z.); (S.K.)
| | - Alex Ranieri Jerônimo Lima
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Victória Simionatto Zucherato
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14050-190, Brazil; (G.M.d.C.); (D.G.L.d.L.-R.); (V.S.Z.); (S.K.)
| | - Eneas de Carvalho
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Loyze Paola Oliveira de Lima
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Pedro de Queiroz Cattony Neto
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Murilo Marconi dos Santos
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, 00128 Rome, Italy;
| | - Marta Giovanetti
- Instututo Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil; (M.G.); (L.C.J.A.)
- Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Rodrigo Haddad
- Campus Ceilândia, University of Brasília, Federal District of Brazil, Brasília 70910-900, Brazil;
| | | | - Maria Carolina Elias
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Sandra Coccuzzo Sampaio
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Dimas Tadeu Covas
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| | - Simone Kashima
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14050-190, Brazil; (G.M.d.C.); (D.G.L.d.L.-R.); (V.S.Z.); (S.K.)
| | - Svetoslav Nanev Slavov
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14050-190, Brazil; (G.M.d.C.); (D.G.L.d.L.-R.); (V.S.Z.); (S.K.)
- Center for Scientific Development (CDC), Butantan Institute, São Paulo 05503-900, Brazil; (A.R.J.L.); (E.d.C.); (L.P.O.d.L.); (P.d.Q.C.N.); (M.M.d.S.); (M.C.E.); (S.C.S.); (D.T.C.)
| |
Collapse
|
4
|
Sittikul P, Batty EM, Yodsawat P, Nuanpirom J, Kosoltanapiwat N, Sangket U, Chatchen S, Day NPJ, Thaipadungpanit J. Diversity of Human Enterovirus Co-Circulations in Five Kindergartens in Bangkok between July 2019 and January 2020. Viruses 2023; 15:1397. [PMID: 37376696 DOI: 10.3390/v15061397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Human enterovirus causes various clinical manifestations in the form of rashes, febrile illness, flu-like illness, uveitis, hand-foot-mouth disease (HFMD), herpangina, meningitis, and encephalitis. Enterovirus A71 and coxsackievirus are significant causes of epidemic HFMD worldwide, especially in children aged from birth to five years old. The enterovirus genotype variants causing HFMD epidemics have been reported increasingly worldwide in the last decade. We aim to use simple and robust molecular tools to investigate human enteroviruses circulating among kindergarten students at genotype and subgenotype levels. With the partial 5'-UTR sequencing analysis as a low-resolution preliminary grouping tool, ten enterovirus A71 (EV-A71) and coxsackievirus clusters were identified among 18 symptomatic cases and 14 asymptomatic cases in five kindergartens in Bangkok, Thailand, between July 2019 and January 2020. Two occurrences of a single clone causing an infection cluster were identified (EV-A71 C1-like subgenotype and coxsackievirus A6). Random amplification-based sequencing using MinION (Oxford Nanopore Technology) helped identify viral transmission between two closely related clones. Diverse genotypes co-circulating among children in kindergartens are reservoirs for new genotype variants emerging, which might be more virulent or better at immune escape. Surveillance of highly contagious enterovirus in communities is essential for disease notifications and controls.
Collapse
Affiliation(s)
- Pichamon Sittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Elizabeth M Batty
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LG, UK
| | - Prasert Yodsawat
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
| | - Jiratchaya Nuanpirom
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
| | - Nathamon Kosoltanapiwat
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Unitsa Sangket
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
- Center for Genomics and Bioinformatics Research, Faculty of Science Prince of Songkla University, Songkhla 90110, Thailand
| | - Supawat Chatchen
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LG, UK
| | - Janjira Thaipadungpanit
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| |
Collapse
|
5
|
Hu G, Jin WP, Yang ZH, Lv SY, Wu J, Yu YT, Meng SL, Guo J, Wang ZJ, Shen S. Efficacy of Coxsackievirus A2 vaccine candidates correlating to humoral immunity in mice challenged with a mouse-adapted strain. Vaccine 2022; 40:4716-4725. [PMID: 35760737 DOI: 10.1016/j.vaccine.2022.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 05/06/2022] [Accepted: 06/05/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND In recent years, Coxsackievirus A2 (CV-A2) has become one of the main serotypes of enterovirus species A associated with hand, foot and mouth disease (HFMD) in China. It has also caused HFMD epidemics in many countries all over the world. Currently, there are no effective, preventive vaccines against it. METHODS A CV-A2 strain was isolated in RD cells and then adapted to grow in Vero cells. This is in compliance with guidelines for cell substrates allowed for human vaccines by the Chinese regulatory authority. Groups of newborn Kunming mice were inoculated on day 3 and day 9 using two formulations of candidate vaccines, empty particles and full particles. They were then challenged on day 14 at a lethal dose with a mouse-adapted strain. RESULTS The mice in the control group all died within 14 days post-challenge whereas most of the mice in the candidate vaccine groups survived. It was found that the titers of neutralizing antibodies was dose-dependent in sera of immunized mice. The results also showed that the vaccine candidates stimulated a strong humoral immune response and protected the mice from disease and death. The virus loads in tissues or organs were significantly reduced and pathological changes were either weak or not observed in the immunized groups compared with those in Al(OH)3 control group. Preliminary mapping of the nucleotide and amino acid residues potentially related to cell tropism of the vaccine strain and virulence of the challenge strain was performed. CONCLUSION The results showed that the RD cell-isolated and Vero cell-adapted CV-A2 strain is a promising vaccine candidate. This active immunization-challenge mouse model mimics the vaccination and then exposure to wildtype viruses, compared with passive immunization-challenge model, and is invaluable for efficacy evaluation in studies on multivalent vaccines containing CV-A2 against HFMD.
Collapse
Affiliation(s)
- Gang Hu
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Wei-Ping Jin
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Zhi-Hui Yang
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Shi-Yun Lv
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Jie Wu
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Yu-Ting Yu
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Sheng-Li Meng
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Jing Guo
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Ze-Jun Wang
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China
| | - Shuo Shen
- Wuhan Institute of Biological Products Co. Ltd., No.1 Huangjin Industrial Park Road, Jiangxia District, Wuhan 430207, China.
| |
Collapse
|
6
|
Xie MZ, Chen LY, Yang YN, Cui Y, Zhang SH, Zhao TS, Zhang WX, Du J, Cui FQ, Lu QB. Molecular Epidemiology of Herpangina Children in Tongzhou District, Beijing, China, During 2019-2020. Front Med (Lausanne) 2022; 9:822796. [PMID: 35547223 PMCID: PMC9082675 DOI: 10.3389/fmed.2022.822796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background The changing pattern of pathogen spectrum causing herpangina in the time of coronavirus disease 2019 (COVID-19) pandemic was unknown. The purpose of this study was to investigate the changes on the molecular epidemiology of herpangina children during 2019-2020 in Tongzhou district, Beijing, China. Method From January 2019 to December 2020, children diagnosed with herpangina were recruited by the staff from Tongzhou Center for Disease Control and Prevention (CDC) in Beijing. Viral RNA extraction from pharyngeal swabs was used for enterovirus (EV) detection and the complete VP1 gene was sequenced. The phylogenetic analysis was performed based on all VP1 sequences for EV genotypes. Result A total of 1,331 herpangina children were identified during 2019-2020 with 1,121 in 2019 and 210 in 2020, respectively. The predominant epidemic peak of herpangina children was in summer and autumn of 2019, but not observed in 2020. Compared to the number of herpangina children reported in 2019, it decreased sharply in 2020. Among 129 samples tested in 2019, 61 (47.3%) children were detected with EV, while 22.5% (20/89) were positive in 2020. The positive rate for EV increased since June 2019, peaked at August 2019, and decreased continuously until February 2020. No cases were observed from February to July in 2020, and the positive rate of EV rebounded to previous level since August 2020. Four genotypes, including coxsackievirus A6 (CV-A6, 9.3%), CV-A4 (7.8%), CV-A10 (2.3%) and CV-A16 (10.1%), were identified in 2019, and only three genotypes, including CV-A6 (9.0%), CV-A10 (6.7%) and CV-A16 (1.1%), were identified in 2020. The phylogenetic analysis showed that all CV-A6 strains from Tongzhou located in Group C, and the predominant strains mainly located in C2-C4 subgroups during 2016-2018 and changed into C1 subgroup during 2018-2020. CV-A16 strains mainly located in Group B, which consisting of strains widely distributed around the world. Conclusions The predominant genotypes gradually shifted from CV-A16, CV-A4 and CV-A6 in 2019 to CV-A6 in 2020 under COVID-19 pandemic. Genotype-based surveillance will provide robust evidence and facilitate the development of public health measures.
Collapse
Affiliation(s)
- Ming-Zhu Xie
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Lin-Yi Chen
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Yan-Na Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Disease Control and Prevention, Beijing, China
| | - Yan Cui
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Disease Control and Prevention, Beijing, China
| | - Si-Hui Zhang
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Tian-Shuo Zhao
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Wan-Xue Zhang
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Juan Du
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Fu-Qiang Cui
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
7
|
Ivanova OE, Shakaryan AK, Morozova NS, Vakulenko YA, Eremeeva TP, Kozlovskaya LI, Baykova OY, Shustova EY, Mikhailova YM, Romanenkova NI, Rozaeva NR, Dzhaparidze NI, Novikova NA, Zverev VV, Golitsyna LN, Lukashev AN. Cases of Acute Flaccid Paralysis Associated with Coxsackievirus A2: Findings of a 20-Year Surveillance in the Russian Federation. Microorganisms 2022; 10:microorganisms10010112. [PMID: 35056561 PMCID: PMC8780984 DOI: 10.3390/microorganisms10010112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022] Open
Abstract
Surveillance for acute flaccid paralysis syndrome (AFP) in children under 15 is the backbone of the Global Polio Eradication Initiative. Laboratory examination of stool samples from AFP cases allows the detection of, along with polioviruses, a variety of non-polio enteroviruses (NPEV). The etiological significance of these viruses in the occurrence of AFP cases has been definitively established only for enteroviruses A71 and D68. Enterovirus Coxsackie A2 (CVA2) is most often associated with vesicular pharyngitis and hand, foot and mouth disease. Among 7280 AFP cases registered in Russia over 20 years (2001–2020), CVA2 was isolated only from five cases. However, these included three children aged 3 to 4 years, without overt immune deficiency, immunized with 4–5 doses of poliovirus vaccine in accordance with the National Vaccination Schedule. The disease resulted in persistent residual paralysis. Clinical and laboratory data corresponded to poliomyelitis developing during poliovirus infection. These findings are compatible with CVA2 being the cause of AFP. Molecular analysis of CVA2 from these patients and a number of AFP cases in other countries did not reveal association with a specific phylogenetic group, suggesting that virus genetics is unlikely to explain the pathogenic profile. The overall results highlight the value of AFP surveillance not just for polio control but for studies of uncommon AFP agents.
Collapse
Affiliation(s)
- Olga E. Ivanova
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia; (A.K.S.); (T.P.E.); (L.I.K.); (O.Y.B.); (E.Y.S.)
- Department of Organization and Technology of Production of Immunobiological Preparations, Institute for Translational Medicine and Biotechnology, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Correspondence: (O.E.I.); (A.N.L.); Tel.: +7-916-677-2403 (O.E.I.); +7-915-160-7489 (A.N.L.)
| | - Armen K. Shakaryan
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia; (A.K.S.); (T.P.E.); (L.I.K.); (O.Y.B.); (E.Y.S.)
- Pirogov Russian National Research Medical University, 119121 Moscow, Russia
| | - Nadezhda S. Morozova
- Federal Budget Institution of Healthcare of Rospotrebnadzor “Center for Hygiene and Epidemiology in Moscow”, 129626 Moscow, Russia; (N.S.M.); (Y.M.M.)
| | - Yulia A. Vakulenko
- Martsinovsky Institute of Meidcal Parasitology, Tropical and Vector-Borne Diseases, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
| | - Tatyana P. Eremeeva
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia; (A.K.S.); (T.P.E.); (L.I.K.); (O.Y.B.); (E.Y.S.)
| | - Liubov I. Kozlovskaya
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia; (A.K.S.); (T.P.E.); (L.I.K.); (O.Y.B.); (E.Y.S.)
- Department of Organization and Technology of Production of Immunobiological Preparations, Institute for Translational Medicine and Biotechnology, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Olga Y. Baykova
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia; (A.K.S.); (T.P.E.); (L.I.K.); (O.Y.B.); (E.Y.S.)
| | - Elena Y. Shustova
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia; (A.K.S.); (T.P.E.); (L.I.K.); (O.Y.B.); (E.Y.S.)
| | - Yulia M. Mikhailova
- Federal Budget Institution of Healthcare of Rospotrebnadzor “Center for Hygiene and Epidemiology in Moscow”, 129626 Moscow, Russia; (N.S.M.); (Y.M.M.)
| | | | - Nadezhda R. Rozaeva
- Saint-Petersburg Pasteur Institute, 197101 Saint-Petersburg, Russia; (N.I.R.); (N.R.R.)
| | - Natela I. Dzhaparidze
- Federal Budgetary Institution of Healthcare of Rospotrebnadzor “Center for Hygiene and Epidemiology in the Vladimir Region”, 600005 Vladimir, Russia;
| | - Nadezhda A. Novikova
- Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology, 603950 Nizhny Novgorod, Russia; (N.A.N.); (V.V.Z.); (L.N.G.)
| | - Vladimir V. Zverev
- Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology, 603950 Nizhny Novgorod, Russia; (N.A.N.); (V.V.Z.); (L.N.G.)
| | - Lyudmila N. Golitsyna
- Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology, 603950 Nizhny Novgorod, Russia; (N.A.N.); (V.V.Z.); (L.N.G.)
| | - Alexander N. Lukashev
- Martsinovsky Institute of Meidcal Parasitology, Tropical and Vector-Borne Diseases, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
- Correspondence: (O.E.I.); (A.N.L.); Tel.: +7-916-677-2403 (O.E.I.); +7-915-160-7489 (A.N.L.)
| |
Collapse
|
8
|
Singh S, Mane SS, Kasniya G, Cartaya S, Rahman MM, Maheshwari A, Motta M, Dudeja P. Enteroviral Infections in Infants. NEWBORN (CLARKSVILLE, MD.) 2022; 1:297-305. [PMID: 36304567 PMCID: PMC9599990 DOI: 10.5005/jp-journals-11002-0036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Enteroviruses (EVs) are major pathogens in young infants. These viruses were traditionally classified into the following four subgenera: polio, coxsackie A and B, and echoviruses. Now that poliomyelitis seems to be controlled in most parts of the world, coxsackie and echoviruses are gaining more attention because (i) the structural and pathophysiological similarities and (ii) the consequent possibilities in translational medicine. Enteroviruses are transmitted mainly by oral and fecal-oral routes; the clinical manifestations include a viral prodrome including fever, feeding intolerance, and lethargy, which may be followed by exanthema; aseptic meningitis and encephalitis; pleurodynia; myopericarditis; and multi-system organ failure. Laboratory diagnosis is largely based on reverse transcriptase-polymerase chain reaction, cell culture, and serology. Prevention and treatment can be achieved using vaccination, and administration of immunoglobulins and antiviral drugs. In this article, we have reviewed the properties of these viruses, their clinical manifestations, and currently available methods of detection, treatment, and prognosis.
Collapse
Affiliation(s)
- Srijan Singh
- Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Sushant Satish Mane
- Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Gangajal Kasniya
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, New York, United States of America
| | - Sofia Cartaya
- Department of Pediatrics, University of South Florida, Tampa, Florida, United States of America
| | - Mohd Mujibur Rahman
- Department of Neonatology, Institute of Child and Mother Health, Dhaka, Bangladesh
| | - Akhil Maheshwari
- Global Newborn Society, Clarksville, Maryland, United States of America
| | - Mario Motta
- Neonatologia e Terapia Intensiva Neonatale ASST Spedali Civili di Brescia, Italy
| | - Pradeep Dudeja
- Department of Gastroenterology, University of Illinois at Chicago, Illinois, United States of America
| |
Collapse
|
9
|
Ji W, Zhu P, Liang R, Zhang L, Zhang Y, Wang Y, Zhang W, Tao L, Chen S, Yang H, Jin Y, Duan G. Coxsackievirus A2 Leads to Heart Injury in a Neonatal Mouse Model. Viruses 2021; 13:v13081588. [PMID: 34452454 PMCID: PMC8402683 DOI: 10.3390/v13081588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022] Open
Abstract
Coxsackievirus A2 (CVA2) has emerged as an active pathogen that has been implicated in hand, foot, and mouth disease (HFMD) and herpangina outbreaks worldwide. It has been reported that severe cases with CVA2 infection develop into heart injury, which may be one of the causes of death. However, the mechanisms of CVA2-induced heart injury have not been well understood. In this study, we used a neonatal mouse model of CVA2 to investigate the possible mechanisms of heart injury. We detected CVA2 replication and apoptosis in heart tissues from infected mice. The activity of total aspartate transaminase (AST) and lactate dehydrogenase (LDH) was notably increased in heart tissues from infected mice. CVA2 infection also led to the disruption of cell-matrix interactions in heart tissues, including the increases of matrix metalloproteinase (MMP)3, MMP8, MMP9, connective tissue growth factor (CTGF) and tissue inhibitors of metalloproteinases (TIMP)4. Infiltrating leukocytes (CD45+ and CD11b+ cells) were observed in heart tissues of infected mice. Correspondingly, the expression levels of inflammatory cytokines in tissue lysates of hearts, including tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β), IL6 and monocyte chemoattractant protein-1 (MCP-1) were significantly elevated in CVA2 infected mice. Inflammatory signal pathways in heart tissues, including phosphatidylinositol 3-kinase (PI3K)-AKT, mitogen-activated protein kinases (MAPK) and nuclear factor kappa B (NF-κB), were also activated after infection. In summary, CVA2 infection leads to heart injury in a neonatal mouse model, which might be related to viral replication, increased expression levels of MMP-related enzymes and excessive inflammatory responses.
Collapse
Affiliation(s)
- Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Peiyu Zhu
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Ruonan Liang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Liang Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Yu Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Yuexia Wang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Weiguo Zhang
- Department of Immunology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Ling Tao
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China;
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Haiyan Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
- Correspondence: (Y.J.); (G.D.)
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
- Henan Key Laboratory of Molecular Medicine, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (Y.J.); (G.D.)
| |
Collapse
|
10
|
Sousa IP, Oliveira MDLA, Burlandy FM, Machado RS, Oliveira SS, Tavares FN, Gomes-Neto F, da Costa EV, da Silva EE. Molecular characterization and epidemiological aspects of non-polio enteroviruses isolated from acute flaccid paralysis in Brazil: a historical series (2005-2017). Emerg Microbes Infect 2021; 9:2536-2546. [PMID: 33179584 PMCID: PMC7717866 DOI: 10.1080/22221751.2020.1850181] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Due to the advanced stage of polio eradication, the possible role of non-polio enteroviruses (NPEVs) associated to acute flaccid paralysis (AFP) cases has been highlighted. In this study, we described epidemiological aspects of NPEVs infections associated to AFP and explore the viral genetic diversity, information still scarce in Brazil. From 2005 to 2017, 6707 stool samples were collected in the scope of the Brazilian Poliomyelitis Surveillance Program. NPEVs were isolated in 359 samples (5.3%) and 341 (94.9%) were genotyped. About 46 different NPEV types were identified with the following detection pattern EV-B > EV-A > EV-C. The major EV-types were CVA2, CV4, EV-A71, CVB3, CVB5, E6, E7, E11, CVA13 and EV-C99, which corresponds to 51.6% of the total. Uncommon types, such as CVA12, EV-90 and CVA11, were also identified. Different E6 genogroups were observed, prevailing the GenIII, despite periods of co-circulation, and replacement of genogroups along time. CVA2 sequences were classified as genotype C and data suggested its dispersion in South-American countries. CVA13 viruses belonged to cluster B and Venezuelan viruses composed a new putative cluster. This study provides extensive information on enterovirus diversity associated with AFP, reinforcing the need of tailoring current surveillance strategies to timely monitor emergence/re-emergence of NPEVs.
Collapse
Affiliation(s)
- Ivanildo P Sousa
- Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Fernanda M Burlandy
- Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Raiana S Machado
- Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Silas S Oliveira
- Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fernando N Tavares
- Laboratório de Referência Regional em Enteroviroses, Seção de Virologia, Instituto Evandro Chagas, Ananindeua, Brazil
| | - Francisco Gomes-Neto
- Laboratório de Toxinologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eliane V da Costa
- Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Edson E da Silva
- Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|
11
|
Thammasonthijarern N, Kosoltanapiwat N, Nuprasert W, Sittikul P, Sriburin P, Pan-Ngum W, Maneekan P, Hataiyusuk S, Hattasingh W, Thaipadungpanit J, Chatchen S. Molecular Epidemiological Study of Hand, Foot, and Mouth Disease in a Kindergarten-Based Setting in Bangkok, Thailand. Pathogens 2021; 10:pathogens10050576. [PMID: 34068676 PMCID: PMC8150733 DOI: 10.3390/pathogens10050576] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/22/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a contagious childhood illness and annually affects millions of children aged less than 5 years across the Asia–Pacific region. HFMD transmission mainly occurs through direct contact (person-to-person) and indirect contact with contaminated surfaces and objects. Therefore, public health measures to reduce the spread of HFMD in kindergartens and daycare centers are essential. Based on the guidelines by the Department of Disease Control, a school closure policy for HFMD outbreaks wherein every school in Thailand must close when several HFMD classrooms (more than two cases in each classroom) are encountered within a week, was implemented, although without strong supporting evidence. We therefore conducted a prospective cohort study of children attending five kindergartens during 2019 and 2020. We used molecular genetic techniques to investigate the characteristics of the spreading patterns of HFMD in a school-based setting in Bangkok, Thailand. These analyses identified 22 index cases of HFMD (symptomatic infections) and 25 cases of enterovirus-positive asymptomatic contacts (24 students and one teacher). Enterovirus (EV) A71 was the most common enterovirus detected, and most of the infected persons (8/12) developed symptoms. Other enteroviruses included coxsackieviruses (CVs) A4, CV-A6, CV-A9, and CV-A10 as well as echovirus. The pattern of the spread of HFMD showed that 45% of the subsequent enteroviruses detected in each outbreak possessed the same serotype as the first index case. Moreover, we found a phylogenetic relationship among enteroviruses detected among contact and index cases in the same kindergarten. These findings confirm the benefit of molecular genetic assays to acquire accurate data to support school closure policies designed to control HFMD infections.
Collapse
Affiliation(s)
- Nipa Thammasonthijarern
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Nathamon Kosoltanapiwat
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Warisa Nuprasert
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pichamon Sittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pimolpachr Sriburin
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wirichada Pan-Ngum
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pannamas Maneekan
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Somboon Hataiyusuk
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Weerawan Hattasingh
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Janjira Thaipadungpanit
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Supawat Chatchen
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| |
Collapse
|
12
|
Ye YZ, Dou YL, Hao JH, Zhou L, Lin AW, Wang SN, Deng JK, Lei M, Luo RP, Liao YN, Chen Y, Long YY, Chen BQ, Yang Z, Gan L, Nong GM, Yan WL, Yu H. Efficacy and safety of interferon α-2b spray for herpangina in children: A randomized, controlled trial. Int J Infect Dis 2021; 107:62-68. [PMID: 33878461 DOI: 10.1016/j.ijid.2021.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The treatment of acute herpangina is inconsistent. We aim to evaluate the effectiveness and safety of interferon α-2b spray versus Ribavirin for this disease. METHODS A randomized, controlled trial was conducted in eight hospitals in China between 2016 and 2018. 668 patients (1-7 years old) were randomized into an experimental group (treated with Interferon α-2b spray) or control group (received Ribavirin Aerosol). Body temperature returning to normal within 72 h and remaining so for 24 h was the primary outcome; release of oral herpes and adverse events were the secondary outcomes. RESULTS (1) The average age of onset was 2.5 years old. (2) After 72 h treatment, body temperature of 98.5% patients in experimental group and 94.3% in control group returned to normal and remained so for 24 h (P = 0.004). The differences were greater at 48 h treatment (95.2% vs. 85.9%, P < 0.001) and at 24 h (77.5% vs. 66.5%, P = 0.001). (3) The rate of improved oral herpes in the experimental group was higher than that in control group (46.7% vs.37.1%, P = 0.011). No adverse reaction occurred. CONCLUSIONS Local application of recombinant interferon α-2b spray showed better efficacy for acute herpangina in children. It was safe for use.
Collapse
Affiliation(s)
- Ying-Zi Ye
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Ya-Lan Dou
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Jian-Hua Hao
- Department of Internal Medicine, Children's Hospital of Kaifeng City, Kaifeng, China
| | - Li Zhou
- Department of Internal Medicine, Children's Hospital of Kaifeng City, Kaifeng, China
| | - Ai-Wei Lin
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Shao-Ning Wang
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Ji-Kui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Min Lei
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Ru-Ping Luo
- Department of Infectious Diseases, Hunan Children's Hospital, Changsha, China
| | - Yi-Nan Liao
- Department of Infectious Diseases, Hunan Children's Hospital, Changsha, China
| | - Yan Chen
- Department of Pediatrics Internal Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yuan-Yuan Long
- Department of Pediatrics Internal Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Bi-Quan Chen
- Department of Infectious Diseases, Anhui Provincial Children'S Hospital, Hefei, China
| | - Zhi Yang
- Department of Infectious Diseases, Anhui Provincial Children'S Hospital, Hefei, China
| | - Lu Gan
- Department of Pediatrics, Changhai Hospital, Shanghai, China
| | - Guang-Min Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei-Li Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China.
| | - Hui Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
| |
Collapse
|
13
|
Epidemical and etiological study on hand, foot and mouth disease following EV-A71 vaccination in Xiangyang, China. Sci Rep 2020; 10:20909. [PMID: 33262488 PMCID: PMC7708472 DOI: 10.1038/s41598-020-77768-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/12/2020] [Indexed: 12/29/2022] Open
Abstract
Coxsackievirus A6 (CV-A6) and Coxsackievirus A10 (CV-A10) have been emerging as the prevailing serotypes and overtaking Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) in most areas as main pathogens of hand, foot and mouth disease (HFMD) in China since 2013. To investigate whole etiological spectrum following EV-A71 vaccination of approximate 40,000 infants and young children in Xiangyang, enteroviruses were serotyped in 4415 HFMD cases from October 2016 to December 2017 using Real Time and conventional PCR and cell cultures. Of the typeable 3201 specimen, CV-A6 was the predominant serotype followed by CV-A16, CV-A10, CV-A5, CV-A2 and EV-A71 with proportions of 59.54%, 15.31%, 11.56%, 4.56%, 3.78% and 3.03%, respectively. Other 12 minor serotypes were also detected. The results demonstrated that six major serotypes of enteroviruses were co-circulating, including newly emerged CV-A2 and CV-A5. A dramatic decrease of EV-A71 cases was observed, whereas the total cases remained high. Multivalent vaccines against major serotypes are urgently needed for control of HFMD.
Collapse
|
14
|
Zhao TS, Du J, Li HJ, Cui Y, Liu Y, Yang Y, Cui F, Lu QB. Molecular epidemiology and clinical characteristics of herpangina children in Beijing, China: a surveillance study. PeerJ 2020; 8:e9991. [PMID: 33088614 PMCID: PMC7568857 DOI: 10.7717/peerj.9991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/28/2020] [Indexed: 11/20/2022] Open
Abstract
Background Herpangina is a highly infectious disease, which is usually prevalent in preschool children. Methods This study analyzed the clinical and pathogenic characteristics of herpangina children to demonstrate the epidemiology of herpangina. Clinical manifestations, laboratory indicators and pharyngeal swabs were collected from children with herpangina who were monitored by Tongzhou Center for Disease Control and Prevention in Beijing, 2008. Utilizing pharyngeal swabs, virus extraction and amplification were performed for nucleotide identification and sequencing. The phylogenetic analysis was conducted based on all sequences amplified in this study and strains retrieved from GenBank. Results Among 190 children with herpangina, 69.0% (131/190) were positive for enterovirus. Eight genotypes were identified, mainly including CV-A6 (39/131), CV-A4 (25/131), CV-A10 (24/131). The phylogenetic analysis showed one CV-A6 strain of Tongzhou was imported from Japan. CV-A10 strains were clustered into five groups (A-E). The dominant cluster of CV-A10 was Group E6 between 2009 and 2013, and converted to Group E5 after 2013. CV-A6 was the predominant pathogen causing herpangina in Tongzhou in 2018, followed by CV-A4 and CV-A10. Conclusions The circulation of coxsackievirus had spatiotemporal cluster. In controlling the transmission of herpangina, the surveillance and reporting system should be enhanced.
Collapse
Affiliation(s)
- Tian-Shuo Zhao
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Juan Du
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Hong-Jun Li
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Control and Prevention, Beijing, China
| | - Yan Cui
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Control and Prevention, Beijing, China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Yanna Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Control and Prevention, Beijing, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
15
|
Kua JA, Pang J. The epidemiological risk factors of hand, foot, mouth disease among children in Singapore: A retrospective case-control study. PLoS One 2020; 15:e0236711. [PMID: 32780749 PMCID: PMC7418981 DOI: 10.1371/journal.pone.0236711] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/11/2020] [Indexed: 01/16/2023] Open
Abstract
The incidence of hand, foot, and mouth disease (HFMD) is increasing over the years despite current prevention and control policies in Singapore. A retrospective case-control study was conducted among parents whose children attended childcare centres in Singapore to assess the epidemiological risk factors associated with HFMD among children below 7 years old. Parents of 363 children with HFMD (as cases) and 362 children without HFMD (as controls) were enrolled from 22 childcare centres. Data of potential risk factors were collected through a standardised self-administered questionnaire from parents which include demographics and hygiene practices. Multivariate analysis were adjusted for age group, parent’s education level, mother's age, HFMD-infected siblings, and preschool admission period. Child’s age between 1.5 and 4.9 years, child who had been in childcare for more than 1.9years, having HFMD-infected siblings, two or more children in a family, higher educated parents, parents who had HFMD episode previously, wash toys with soap once every two to three weeks, sanitise toys once every two to three weeks, out-sourced cleaner in childcare centre, no domestic helper at home and more than 22 children in a classroom were independent risk factors of HFMD. These evidence provide crucial implications to guide more effective prevention and control of HFMD in Singapore.
Collapse
Affiliation(s)
- Jo Ann Kua
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Junxiong Pang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
- * E-mail:
| |
Collapse
|
16
|
Chen C, Xia Y, Zhu S, Xu F, Sun Y, Lu H, Gao M, Yang Z, Mao Z, Ge Q, Miao Z, Zhu H, Yao P. Muscle destruction caused by coxsackievirus A10 in gerbils: Construction of a novel animal model for antiviral evaluation. Virus Res 2020; 286:198067. [PMID: 32553610 DOI: 10.1016/j.virusres.2020.198067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/13/2020] [Accepted: 06/13/2020] [Indexed: 12/20/2022]
Abstract
The morbidity and mortality of coxsackievirus A10 (CVA10)-associated hand, foot, and mouth disease (HFMD) have been increasing in recent years, while few studies on the vaccine and animal model of CVA10 have been reported. Here, we first established a CVA10-infected gerbil model and employed it to evaluate the immunoprotective effect of an inactivated CVA10 vaccine. The results showed that gerbils up to the age of 14 days were fully susceptible to CVA10, and all died within five days post-infection by intraperitoneal inoculation. Lethargy, wasting, hind-limb paralysis, and even death could be observed in the CVA10-infected gerbils. Pathological examination suggested that CVA10 has a strong tropism toward muscle tissue, and muscle bundle fracture and muscular fibers necrosis were observed in the limb muscles. Additionally, active immunization results showed that gerbils immunized with the inactivated CVA10 vaccine were 100 % protected from lethal CVA10 challenge. The antisera from vaccinated gerbils also showed high neutralizing titers against CVA10. Based on these results, the CVA10-infected gerbil model was a suitable tool for analyzing the pathogenesis of CVA10 and assessing the protective efficacy of CVA10 candidate vaccines.
Collapse
Affiliation(s)
- Chen Chen
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yong Xia
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuirong Zhu
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Fang Xu
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yisheng Sun
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hangjing Lu
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Meng Gao
- Zhejiang Pukang Biotechnology Co., LTD., Hangzhou, China
| | - Zhangnv Yang
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zian Mao
- Zhejiang Pukang Biotechnology Co., LTD., Hangzhou, China
| | - Qiong Ge
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ziping Miao
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - HanPing Zhu
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
| | - Pingping Yao
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
| |
Collapse
|
17
|
Guo WP, Chen GQ, Xie GC, Du LY, Tang Q. Mosaic genome of Human Coxsackievirus A4 associated with herpangina and HFMD in Yancheng, China, 2016 and 2018. Int J Infect Dis 2020; 96:538-540. [PMID: 32439540 DOI: 10.1016/j.ijid.2020.05.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To better understand the spectrums of pathogens causing herpangina and circulation of Coxsackievirus A4 in Yancheng, China. METHODS Stool samples from herpangina and HFMD cases were collected. Real Time PCR Kits was used to identify Enterovirus 71, CV-A16 and CV-A6, and nested reverse transcription PCR (nRT-PCR) to detect the other enterovirus types. Complete VP1 and genome sequence of CV-A4 were amplified by using nRT-PCR. Genetic, phylogenetic and recombination analysis were performed. RESULTS Co-circulation of three recombinant CV-A4 groups, including one novel (C2 lineage), was identified in Yancheng, China, 2016 and 2018. One was the major causative agent of herpangina, and another two were responsible for HFMD. Phylogenetic and recombination analysis indicated that the non-structural region of their genome originated from the same ancestry and subsequently adaptation. C2 lineage of CV-A4 group may be introduced from countries outside China and its genome occurred recombination in China. CONCLUSION Novel recombinant CV-A4 was mainly associated with herpanginain in Yancheng, 2018, China. C2 lineage of CV-A4 group with recombinant non-structural region was also identified in HFMD patients.
Collapse
Affiliation(s)
- Wen-Ping Guo
- Department of Pathogenic Biology, College of Basic Medicine, Chengde Medical University, Chengde, Hebei, China.
| | - Guo-Qing Chen
- Yancheng Center for Disease Control and Prevention, Yancheng, Jiangsu, China.
| | - Guang-Cheng Xie
- Department of Pathogenic Biology, College of Basic Medicine, Chengde Medical University, Chengde, Hebei, China.
| | - Luan-Ying Du
- Department of Pathogenic Biology, College of Basic Medicine, Chengde Medical University, Chengde, Hebei, China.
| | - Quan Tang
- Yancheng Center for Disease Control and Prevention, Yancheng, Jiangsu, China.
| |
Collapse
|
18
|
Yu H, Li XW, Liu QB, Deng HL, Liu G, Jiang RM, Deng JK, Ye YZ, Hao JH, Chen YH, Nong GM, Shen ZB, Liu CS, Zou YX, Wu JZ, Wu XD, Chen BQ, Luo RP, Lin AW, Chen Y, Liu XD. Diagnosis and treatment of herpangina: Chinese expert consensus. World J Pediatr 2020; 16:129-134. [PMID: 31347021 DOI: 10.1007/s12519-019-00277-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 06/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Herpangina is a common infectious disease in childhood caused by an enterovirus. This consensus is aiming to standardize and improve herpangina prevention and clinical diagnosis. METHODS The Subspecialty Group of Infectious Diseases, the Society of Pediatric, Chinese Medical Association and Nation Medical Quality Control Center for Infectious Diseases gathered 20 experts to develop the consensus, who are specialized in diagnosis and treatment of herpangina. RESULTS The main pathogenic serotypes of herpangina include Coxsackievirus-A, Enterovirus-A and Echovirus. Its diagnosis can be rendered on the basis of history of epidemiology, typical symptoms, characteristic pharyngeal damage and virological tests. The treatment is mainly symptomatic, and incorporates topical oral spray with antiviral drugs. The course of herpangina generally lasts 4-6 days with a good prognosis. CONCLUSION The consensus could provide advices and references for the diagnosis, treatment and management of herpangina in children.
Collapse
Affiliation(s)
- Hui Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
| | - Xing-Wang Li
- Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Quan-Bo Liu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hui-Ling Deng
- Department of Infectious Diseases, The Children's Hospital of Xi'an, Xi'an, China
| | - Gang Liu
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Rong-Meng Jiang
- Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Ji-Kui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Ying-Zi Ye
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Jian-Hua Hao
- Department of Internal Medicine, Children's Hospital of Kaifeng City, Kaifeng, China
| | - Ying-Hu Chen
- Department of Infectious Diseases, The Children's Hospital-Zhejiang University School of Medicine, Hangzhou, China
| | - Guang-Min Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Zhao-Bo Shen
- Pneumology Department, Henan Children's Hospital, Henan, China
| | - Chang-Shan Liu
- Department of Pediatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ying-Xue Zou
- Department of Infectious Diseases, Tianjin Children's Hospital, Tianjin, China
| | - Jin-Zhun Wu
- Department of Pediatric Pneumology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Xing-Dong Wu
- Department of Pediatrics, Xiamen Maternal and Child Health Care Hospital, Xiamen, China
| | - Bi-Quan Chen
- Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei, China
| | - Ru-Ping Luo
- Department of Infectious Diseases, Hunan Children's Hospital, Hunan, China
| | - Ai-Wei Lin
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Shandong, China
| | - Yan Chen
- Department of Pediatrics Internal Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xiao-Dong Liu
- Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital Capital Medical University, Beijing, China
| |
Collapse
|
19
|
Zhang S, Yu X, Meng X, Huo W, Su Y, Liu J, Liu Y, Zhang J, Wang S, Yu J. Coxsackievirus A6 Induces Necroptosis for Viral Production. Front Microbiol 2020; 11:42. [PMID: 32117097 PMCID: PMC7011610 DOI: 10.3389/fmicb.2020.00042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a febrile exanthematous disease with typical or atypical symptoms. Typical HFMD is usually caused by enterovirus 71 (EV71) or coxsackievirus A16, while atypical HFMD is usually caused by coxsackievirus A6 (CA6). In recent years, worldwide outbreaks of CA6-associated HFMD have dramatically increased, although the pathogenic mechanism of CA6 is still unclear. EV71 has been established to induce caspase-dependent apoptosis, but in this study, we demonstrate that CA6 infection promotes a distinct pathway of cell death that involves loss of cell membrane integrity. Necrostatin-1, an inhibitor of necroptosis, blocks the cell death induced by CA6 infection, but Z-DEVD-FMK, an inhibitor of caspase-3, has no effect on CA6-induced cell death. Furthermore, CA6 infection up-regulates the expression of the necroptosis signaling molecule RIPK3. Importantly, necrostatin-1 inhibits CA6 viral production, as assessed by its ability to inhibit levels of VP1 protein and genomic RNA and infectious particles. CA6-induced necroptosis is not dependent on the generation of reactive oxygen species; however, viral 3D protein can directly bind RIPK3, which is suggestive of a direct mechanism of necroptosis induction. Therefore, these results indicate that CA6 induces a mechanism of RIPK3-dependent necroptosis for viral production that is distinct from the mechanism of apoptosis induced by typical HFMD viruses.
Collapse
Affiliation(s)
- Shuxia Zhang
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Xiaoyan Yu
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Xiangling Meng
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Wenbo Huo
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Ying Su
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Jinming Liu
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Yumeng Liu
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, China
| | - Jun Zhang
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Shaohua Wang
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Jinghua Yu
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| |
Collapse
|
20
|
Genetic characterization of VP1 of coxsackieviruses A2, A4, and A10 associated with hand, foot, and mouth disease in Vietnam in 2012-2017: endemic circulation and emergence of new HFMD-causing lineages. Arch Virol 2020; 165:823-834. [PMID: 32008121 DOI: 10.1007/s00705-020-04536-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/23/2019] [Indexed: 12/15/2022]
Abstract
While conducting sentinel surveillance of hand, foot, and mouth disease (HFMD) in Vietnam, we found a sudden increase in the prevalence of coxsackievirus A10 (CV-A10) in 2016 and CV-A2 and CV-A4 in 2017, the emergence of which has been reported recently to be associated with various clinical manifestations in other countries. However, there have been only a limited number of molecular studies on those serotypes, with none being conducted in Vietnam. Therefore, we sequenced the entire VP1 genes of CV-A10, CV-A4, and CV-A2 strains associated with HFMD in Vietnam between 2012 and 2017. Phylogenetic analysis revealed a trend of endemic circulation of Vietnamese CV-A10, CV-A4, and CV-A2 strains and the emergence of thus-far undescribed HFMD-causing lineages of CV-A4 and CV-A2. The Vietnamese CV-A10 strains belonged to a genotype comprising isolates from patients with HFMD from several other countries; however, most of the Vietnamese strains were grouped into a local lineage. Recently, emerging CV-A4 strains in Vietnam were grouped into a unique lineage within a genotype comprising strains isolated from patients with acute flaccid paralysis from various countries. New substitutions were detected in the putative BC and HI loops in the Vietnamese CV-A4 strains. Except for one strain, Vietnamese CV-A2 isolates were grouped into a unique lineage of a genotype that includes strains from various countries that are associated with other clinical manifestations. Enhanced surveillance is required to monitor their spread and to specify their roles as etiological agents of HFMD or "HFMD-like" diseases, especially for CV-A4 and CV-A2. Further studies including whole-genome sequencing should be conducted to fully understand the evolutionary changes occurring in these newly emerging strains.
Collapse
|
21
|
Minhas S, Sajjad A, Kashif M, Taj F, Waddani HA, Khurshid Z. Oral Ulcers Presentation in Systemic Diseases: An Update. Open Access Maced J Med Sci 2019; 7:3341-3347. [PMID: 31949540 PMCID: PMC6953949 DOI: 10.3889/oamjms.2019.689] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Diagnosis of oral ulceration is always challenging and has been the source of difficulty because of the remarkable overlap in their clinical presentations. AIM The objective of this review article is to provide updated knowledge and systemic approach regarding oral ulcers diagnosis depending upon clinical picture while excluding the other causative causes. METHODS For this, specialised databases and search engines involving Science Direct, Medline Plus, Scopus, PubMed and authentic textbooks were used to search topics related to the keywords such as oral ulcer, oral infections, vesiculobullous lesion, traumatic ulcer, systematic disease and stomatitis. Associated articles published from 1995 to 2019 in both dental and medical journals including the case reports, case series, original articles and reviews were considered. RESULTS The compilation of the significant data reveals that ulcers can be classified according to (i) duration of onset, (ii) number of ulcers and (iii) etiological factors. Causation of oral ulcers varies from slight trauma to underlying systemic diseases and malignancies. CONCLUSION Oral manifestations must be acknowledged for precise diagnosis and appropriate treatment.
Collapse
Affiliation(s)
- Sadia Minhas
- Department of Oral Pathology, Akhtar Saeed Dental College, Lahore, Pakistan
| | - Aneequa Sajjad
- Department of Oral Pathology, Akhtar Saeed Dental College, Lahore, Pakistan
| | - Muhammad Kashif
- Department of Oral Pathology, Bakhtawar Amin Medical & Dental College, Multan, Pakistan
| | - Farooq Taj
- Department of Prosthetic, Khyber Medical University Institute of Dental Sciences, Kohat, Pakistan
| | - Hamed Al Waddani
- Department of Medicine and Surgery, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa Governorate, Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa Governorate, Saudi Arabia
| |
Collapse
|
22
|
Ji T, Guo Y, Lv L, Wang J, Shi Y, Yu Q, Zhang F, Tong W, Ma J, Zeng H, Zhao H, Zhang Y, Han T, Song Y, Yan D, Yang Q, Zhu S, Zhang Y, Xu W. Emerging recombination of the C2 sub-genotype of HFMD-associated CV-A4 is persistently and extensively circulating in China. Sci Rep 2019; 9:13668. [PMID: 31541120 PMCID: PMC6754396 DOI: 10.1038/s41598-019-49859-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/23/2019] [Indexed: 12/31/2022] Open
Abstract
Sporadic outbreaks caused by coxsackievirus A4 (CV-A4) have been reported worldwide. To further elucidate the detailed genetic characteristics and evolutionary recombination events of CV-A4, virus samples from nationwide hand, foot and mouth disease (HFMD) surveillance, encompassing 27 out of the 31 provinces in China, were investigated. Comprehensive and systematic phylogenetic analyses were performed by using 29 complete genomes, 142 complete CV-A4 VP1 sequences. Four genotypes (A, B, C and D) and five sub-genotypes (C1-C5) were re-identified based on the complete VP1 sequences. C2 is the predominant sub-genotype of CV-A4 associated with HFMD and has evolved into 3 clusters. Cluster 1 is a major cluster that has been persistently and extensively circulating in China since 2006 and has been associated with all severe cases. All the sequences showed high homology with the CV-A4 prototype in the P1 region, while higher identities with CV-A5, CV-14 and CV-16 in the P2 and P3 regions. Recombination analysis revealed that C2 had two specific genetic recombination patterns with other EV-A prototypes in the 5'-UTR and 3D region compared with C5. These recombination patterns might be associated with the increased transmissibility of C2 viruses, which were obtained due to their persistent and extensive circulation in populations.
Collapse
Affiliation(s)
- Tianjiao Ji
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Yue Guo
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Likun Lv
- Tianjin Municipal Center for Disease Control and Prevention, Tianjin Municipal, People's Republic of China
| | - Jianxing Wang
- Shandong Center for Disease Control and Prevention, Shandong Province, People's Republic of China
| | - Yong Shi
- Jiangxi Center for Disease Control and Prevention, Nanchang, Jiangxi Province, People's Republic of China
| | - Qiuli Yu
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei Province, People's Republic of China
| | - Fan Zhang
- Hunan Center for Disease Control and Prevention, Changsha, Hunan Province, People's Republic of China
| | - Wenbin Tong
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, People's Republic of China
| | - Jiangtao Ma
- Ningxia Center for Disease Control and Prevention, Yinchuan, Ningxia Province, People's Republic of China
| | - Hanri Zeng
- Guangdong Center for Disease Control and Prevention, Guangzhou, Guangdong Province, People's Republic of China
| | - Hua Zhao
- Chongqing Center for Disease Control and Prevention, Chongqing Municipal, People's Republic of China
| | - Yong Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Taoli Han
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Yang Song
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Dongmei Yan
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Qian Yang
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Shuangli Zhu
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China
| | - Yan Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China.
| | - Wenbo Xu
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention), Beijing, People's Republic of China.
| |
Collapse
|
23
|
Liu Q, Dan H, Zhao X, Chen H, Chen Y, Zhang N, Mo Z, Liu H. Construction and characterization of an infectious cDNA clone of coxsackievirus A 10. Virol J 2019; 16:98. [PMID: 31387601 PMCID: PMC6685229 DOI: 10.1186/s12985-019-1201-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/18/2019] [Indexed: 01/07/2023] Open
Abstract
Background Coxsackievirus A10 (CA10) constitutes one of the four major pathogens causing hand, foot and mouth disease in infants. Infectious clones are of great importance for studying viral gene functions and pathogenic mechanism. However, there is no report on the construction of CA10 infectious clones. Methods The whole genome of CA10 derived from a clinical isolate was amplified into two fragments and ligated into a linearized plasmid vector in one step by In-Fusion Cloning. The obtained CA10 cDNA clones and plasmids encoding T7 RNA polymerase were co-transfected into 293 T cells to rescue CA10 virus. The rescued virus was identified by SDS-PAGE, Western blotting and transmission electron microscopic. One-day-old ICR mice were intracerebrally inoculated with the CA10 virus and clinical symptoms were observed. Multiple tissues of moribund mice were harvested for analysis of pathogenic changes and viral distribution by using H&E staining, real-time PCR and immunohistochemical staining. Results CA10 viruses were rescued from the constructed cDNA clone and reached a maximum titer of 108.125TCID50/mL after one generation in RD cells. The virus exhibited similar physical and chemical properties to those of the parental virus. It also showed high virulence and the ability to induce death of neonatal ICR mice. Severe necrotizing myositis, intestinal villus interstitial edema and severe alveolar shrinkage were observed in infected mice. The viral antigen and the maximum amount of viral RNA were detected in limb skeletal muscles, which suggested that the limb skeletal muscles were the most likely site of viral replication. Conclusion Infectious clones of CA10 were successfully constructed for the first time, which will facilitate the establishment of standardized neonatal mouse models infected with CA10 for the evaluation of vaccines and antiviral drugs, as well as preservation and sharing of model strains.
Collapse
Affiliation(s)
- Qiliang Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.,College of Bio-technology, Guilin Medical University, Guilin, Guangxi, China
| | - Hanliang Dan
- College of Laboratory Medicine, Guilin Medical University, Guilin, Guangxi, China
| | - Xiaoping Zhao
- College of Laboratory Medicine, Guilin Medical University, Guilin, Guangxi, China
| | - Huoying Chen
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Yongbei Chen
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Ning Zhang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Zhijing Mo
- College of Bio-technology, Guilin Medical University, Guilin, Guangxi, China.
| | - Hongbo Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China. .,Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, China.
| |
Collapse
|
24
|
Molecular epidemiology of enterovirus from children with herpangina or hand, foot, and mouth disease in Hangzhou, 2016. Arch Virol 2019; 164:2565-2571. [DOI: 10.1007/s00705-019-04356-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/28/2019] [Indexed: 12/24/2022]
|
25
|
Miao J, Guo X, Liu W, Yang D, Shen Z, Qiu Z, Chen X, Zhang K, Hu H, Yin J, Yang Z, Li J, Jin M. Total coliforms as an indicator of human enterovirus presence in surface water across Tianjin city, China. BMC Infect Dis 2018; 18:542. [PMID: 30382895 PMCID: PMC6211496 DOI: 10.1186/s12879-018-3438-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/08/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Enteric viruses in surface water pose considerable risk to morbidity in populations living around water catchments and promote outbreaks of waterborne diseases. However, due to poor understanding of the correlation between water quality and the presence of human enteric viruses, the failure to assess viral contamination through alternative viral indicators makes it difficult to control disease transmission. METHODS We investigated the occurrence of Enteroviruses (EnVs), Rotaviruses (HRVs), Astroviruses (AstVs), Noroviruses GII (HuNoVs GII) and Adenoviruses (HAdVs) from Jinhe River over 4 years and analyzed their correlation with physicochemical and bacterial parameters in water samples. RESULTS The findings showed that all target viruses were detected in water at frequencies of 91.7% for HAdVs, 81.3% for HuNoVs GII, 79.2% for EnVs and AstVs, and 70.8% for HRVs. These viruses had a seasonal pattern, which showed that EnVs were abundant in summer but rare in winter, while HAdVs, HRVs, AstVs, and HuNoVs GII exhibited opposite seasonal trends. Pearson correlation analysis showed that total coliforms (TC) was significantly positively correlated with EnVs concentrations while no consistent significant correlations were observed between bacterial indices and viruses that precipitate acute gastroenteritis. CONCLUSIONS Taken together, the findings provide insights into alternative viral indicators, suggesting that TC is a potentially promising candidate for assessment of EnVs contamination. However, it failed to predict the presence of HAdVs, HRVs, AstVs, and HuNoVs GΙΙ in surface water across the city of Tianjin.
Collapse
Affiliation(s)
- Jing Miao
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Xuan Guo
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
- Research Institution of Chemical Defense, Beijing, 102205 China
| | - Weili Liu
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Dong Yang
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Zhiqiang Shen
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Zhigang Qiu
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Xiang Chen
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Kunming Zhang
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Hui Hu
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Jing Yin
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Zhongwei Yang
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Junwen Li
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| | - Min Jin
- Tianjin Institute of Environmental & Operational Medcine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin, 300050 China
| |
Collapse
|
26
|
Yang Q, Gu X, Zhang Y, Wei H, Li Q, Fan H, Xu Y, Li J, Tan Z, Song Y, Yan D, Ji T, Zhu S, Xu W. Persistent circulation of genotype D coxsackievirus A2 in mainland of China since 2008. PLoS One 2018; 13:e0204359. [PMID: 30235342 PMCID: PMC6147602 DOI: 10.1371/journal.pone.0204359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/06/2018] [Indexed: 11/30/2022] Open
Abstract
Coxsackievirus A2 (CV-A2) has emerged as an important etiological agent in the hand, foot, and mouth disease and herpangina pathogen spectrum because of its high global prevalence. In the present study, we investigated the evolutionary dynamics of CV-A2 circulating in China. We analyzed a total of 163 entire VP1 sequences of CV-A2, including 74 sequences generated from the present study and 89 sequences collected from the GenBank database. Phylogenetic analysis based on the entire VP1 nucleotide sequences confirmed the persistent circulation of the predominant genotype D in mainland of China since 2008. Cluster analysis grouped the sequences into two distinct clusters, clusters 1 and 2, with most grouped under cluster 2. After 2012, cluster 1 was gradually replaced by cluster 2. Results of Bayesian Markov chain Monte Carlo analysis suggested that multiple lineages of genotype D were transmitted in mainland of China at an estimated evolutionary rate of 6.32×10−3 substitutions per site per year, which is consistent with the global evolutionary rate of CV-A2 (5.82×10−3 substitutions per site per year). Continuous transmission and evolution of CV-A2 resulted in the genetic polymorphism.
Collapse
Affiliation(s)
- Qian Yang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Xinrui Gu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
- RCSC National Training Center, Beijing, People's Republic of China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Haiyan Wei
- Henan Center for Disease Control and Prevention, Zhengzhou, People's Republic of China
| | - Qi Li
- Hebei Center for Disease Control and Prevention, Shijiazhuang, People's Republic of China
| | - Huan Fan
- Jiangsu Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Yi Xu
- Shaanxi Center for Disease Control and Prevention, Xi'an, People's Republic of China
| | - Jie Li
- Beijing Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Zhaolin Tan
- Tianjin Center for Disease Control and Prevention, Tianjin, People's Republic of China
| | - Yang Song
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Dongmei Yan
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Tianjiao Ji
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
- Medical School, Anhui University of Science and Technology, Huainan, People’s Republic of China
- * E-mail:
| |
Collapse
|
27
|
Wang Z, Wang Y, Wang S, Meng X, Song F, Huo W, Zhang S, Chang J, Li J, Zheng B, Liu Y, Zhang Y, Zhang W, Yu J. Coxsackievirus A6 Induces Cell Cycle Arrest in G0/G1 Phase for Viral Production. Front Cell Infect Microbiol 2018; 8:279. [PMID: 30159255 PMCID: PMC6104138 DOI: 10.3389/fcimb.2018.00279] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 07/25/2018] [Indexed: 11/13/2022] Open
Abstract
Recent epidemiological data indicate that outbreaks of hand, foot, and mouth disease (HFMD), which can be categorized according to its clinical symptoms as typical or atypical, have markedly increased worldwide. A primary causative agent for typical HFMD outbreaks, enterovirus 71 (EV71), has been shown to manipulate the cell cycle in S phase for own replication; however, it is not clear whether coxsackievirus (CVA6), the main agent for atypical HFMD, also regulates the host cell cycle. In this study, we demonstrate for the first time that CVA6 infection arrests the host cell cycle in G0/G1-phase. Furthermore, synchronization in G0/G1 phase, but not S phase or G2/M phase, promotes viral production. To investigate the mechanism of cell cycle arrest induced by CVA6 infection, we analyzed cell cycle progression after cell cycle synchronization at G0/G1 or G2/M. Our results demonstrate that CVA6 infection promotes G0/G1 phase entry from G2/M phase, and inhibits G0/G1 exit into S phase. In line with its role to arrest cells in G0/G1 phase, the expression of cyclinD1, CDK4, cyclinE1, CDK2, cyclinB1, CDK1, P53, P21, and P16 is regulated by CVA6. Finally, the non-structural proteins of CVA6, RNA-dependent RNA polymerase 3D and protease 3C , are demonstrated to be responsible for the G0/G1-phase arrest. These findings suggest that CVA6 infection arrested cell cycle in G0/G1-phase via non-structural proteins 3D and 3C, which may provide favorable environments for virus production.
Collapse
Affiliation(s)
- Zengyan Wang
- Department of Internal Medicine, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Yue Wang
- Chemistry of Traditional Chinese Medicine, College of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Shaohua Wang
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiangling Meng
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin Univrsity, Changchun, China
| | - Fengmei Song
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin Univrsity, Changchun, China
| | - Wenbo Huo
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin Univrsity, Changchun, China
| | - Shuxia Zhang
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin Univrsity, Changchun, China
| | - Junliang Chang
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Jingliang Li
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Baisong Zheng
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Yanqiu Liu
- Academy of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Yahong Zhang
- Key Laboratory of Natural Medicines and Immunotechnology of Henan Province, Henan University, Kaifeng, China
| | - Wenyan Zhang
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Jinghua Yu
- Institute of Virology and AIDS Research, The First Hospital of Jilin University, Jilin University, Changchun, China
| |
Collapse
|
28
|
MODERN METHODS OF DIAGNOSIS OF ENTEROVIRUS INFECTION IN THE MOUTH. WORLD OF MEDICINE AND BIOLOGY 2018. [DOI: 10.26724/2079-8334-2018-1-63-178-180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
29
|
Protective Efficacies of Formaldehyde-Inactivated Whole-Virus Vaccine and Antivirals in a Murine Model of Coxsackievirus A10 Infection. J Virol 2017; 91:JVI.00333-17. [PMID: 28424287 DOI: 10.1128/jvi.00333-17] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/13/2017] [Indexed: 01/20/2023] Open
Abstract
Coxsackievirus A10 (CVA10) is one of the major pathogens associated with hand, foot, and mouth disease (HFMD). CVA10 infection can cause herpangina and viral pneumonia, which can be complicated by severe neurological sequelae. The morbidity and mortality of CVA10-associated HFMD have been increasing in recent years, particularly in the pan-Pacific region. There are limited studies, however, on the pathogenesis and immunology of CVA10-associated HFMD infections, and few antiviral drugs or vaccines have been reported. In the present study, a cell-adapted CVA10 strain was employed to inoculate intramuscularly 5-day-old ICR mice, which developed significant clinical signs, including reduced mobility, lower weight gain, and quadriplegia, with significant pathology in the brain, hind limb skeletal muscles, and lungs of infected mice in the moribund state. The severity of illness was associated with abnormally high expression of the proinflammatory cytokine interleukin 6 (IL-6). Antiviral assays demonstrated that ribavirin and gamma interferon administration could significantly inhibit CVA10 replication both in vitro and in vivo In addition, formaldehyde-inactivated CVA10 whole-virus vaccines induced immune responses in adult mice, and maternal neutralizing antibodies could be transmitted to neonatal mice, providing protection against CVA10 clinical strains. Furthermore, high-titer antisera were effective against CVA10 and could relieve early clinical symptoms and improve the survival rates of CVA10-challenged neonatal mice. In summary, we present a novel murine model to study CVA10 pathology that will be extremely useful in developing effective antivirals and vaccines to diminish the burden of HFMD-associated disease.IMPORTANCE Hand, foot, and mouth disease cases in infancy, arising from coxsackievirus A10 (CVA10) infections, are typically benign, resolving without any significant adverse events. Severe disease and fatalities, however, can occur in some children, necessitating the development of vaccines and antiviral therapies. The present study has established a newborn-mouse model of CVA10 that, importantly, recapitulates many aspects of human disease with respect to the neuropathology and skeletal muscle pathology. We found that high levels of the proinflammatory cytokine interleukin 6 correlated with disease severity and that ribavirin and gamma interferon could decrease viral titers in vitro and in vivo Whole-virus vaccines produced immune responses in adult mice, and immunized mothers conferred protection on neonates against challenge from CVA10 clinical strains. Passive immunization with high-titer antisera could also improve survival rates in newborn animals.
Collapse
|