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Wang G, Zhong L, Wang M, Zhou J, Liu S, Miao W, Li L, Liu Y, Guo S, Li H, Wang X, Xie L, Xie M, Fu S, Xuan T, Li F, Yang T, Shao L, Shi M, Li X, Li X, Gao L, Zhai S, Ding J, Wang T, Liu D, Ma G, Wu J, Wan D, Guo J, Zhang X, Wu J, Wang Y, Jin A, Ma L, Yang H, He X, Ma X, Liu H, Ma B, Yang N, Hou X, Xu T, Qin CF, Wang H, Xie P, Wang Z. Peripheral nerve injury associated with JEV infection in high endemic regions, 2016-2020: a multicenter retrospective study in China. Emerg Microbes Infect 2024; 13:2337677. [PMID: 38578315 PMCID: PMC11036900 DOI: 10.1080/22221751.2024.2337677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
Previously, we reported a cohort of Japanese encephalitis (JE) patients with Guillain-Barré syndrome. However, the evidence linking Japanese encephalitis virus (JEV) infection and peripheral nerve injury (PNI) remains limited, especially the epidemiology, clinical presentation, diagnosis, treatment, and outcome significantly differ from traditional JE. We performed a retrospective and multicenter study of 1626 patients with JE recorded in the surveillance system of the Chinese Center for Disease Control and Prevention, spanning the years 2016-2020. Cases were classified into type 1 and type 2 JE based on whether the JE was combined with PNI or not. A comparative analysis was conducted on demographic characteristics, clinical manifestations, imaging findings, electromyography data, laboratory results, and treatment outcomes. Among 1626 laboratory confirmed JE patients, 230 (14%) were type 2 mainly located along the Yellow River in northwest China. In addition to fever, headache, and disturbance of consciousness, type 2 patients experienced acute flaccid paralysis of the limbs, as well as severe respiratory muscle paralysis. These patients presented a greater mean length of stay in hospital (children, 22 years [range, 1-34]; adults, 25 years [range, 0-183]) and intensive care unit (children, 16 years [range, 1-30]; adults, 17 years [range, 0-102]). The mortality rate was higher in type 2 patients (36/230 [16%]) compared to type 1 (67/1396 [5%]). The clinical classification of the diagnosis of JE may play a crucial role in developing a rational treatment strategy, thereby mitigating the severity of the disease and potentially reducing disability and mortality rates among patients.
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Affiliation(s)
- Guowei Wang
- The First Clinical Medical School, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Lianmei Zhong
- Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China
| | - Manxia Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Juan Zhou
- Guangzhou Women and Children’s Medical Center, Guangzhou, People’s Republic of China
| | - Shuting Liu
- Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Wang Miao
- Neuro-Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Leilei Li
- West China Hospital of Sichuan University, Chengdu, People’s Republic of China
| | - Yonghong Liu
- Department of Neurology, Xijing Hospital, The Air Force Medical University, Xi’an, People’s Republic of China
| | - Shougang Guo
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Haining Li
- Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Xiaoming Wang
- The Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Liuqing Xie
- Meishan People’s Hospital, Meishan, People’s Republic of China
| | - Min Xie
- Chengdu Seventh People’s Hospital, Chengdu, People’s Republic of China
| | - Shihong Fu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Tingting Xuan
- The First Clinical Medical School, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Fan Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Tingting Yang
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
- Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, People’s Republic of China
| | - Lufei Shao
- Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Mingfang Shi
- Department of Pediatrics, Yibin Hospital, Children's Hospital of Chongqing Medical University, Yibin, People’s Republic of China
| | - Xiaocong Li
- The First Clinical Medical School, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Xiaoling Li
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Li Gao
- Baoji Central Hospital, Baoji, People’s Republic of China
| | - Shaopeng Zhai
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Jia Ding
- The First People’s Hospital of Tianshui, Tianshui, People’s Republic of China
| | - Tianhong Wang
- The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
| | - Dayong Liu
- The Affiliated Hospital of Gansu Medical College, Pingliang, People’s Republic of China
| | - Guosheng Ma
- Gansu Provincial People’s Hospital, Lanzhou, People’s Republic of China
| | - Jiang Wu
- The First People’s Hospital of Longnan, Longnan, People’s Republic of China
| | - Dongjun Wan
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou, People’s Republic of China
| | - Junlin Guo
- Qingyang People's Hospital, Qingyang, People’s Republic of China
| | - Xinbo Zhang
- Department of Neurology, Xijing Hospital, The Air Force Medical University, Xi’an, People’s Republic of China
| | - Jinxia Wu
- Department of Pediatrics, Yibin Hospital, Children's Hospital of Chongqing Medical University, Yibin, People’s Republic of China
| | - Yinxu Wang
- The Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Ansong Jin
- The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Lei Ma
- Emergency Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Huan Yang
- Emergency Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Xuexian He
- Cerebrospinal Fluid Laboratory, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Xiaona Ma
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
- Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, People’s Republic of China
| | - Huijuan Liu
- Department of Infectious Diseases, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Boya Ma
- Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Ningai Yang
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
- Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, People’s Republic of China
| | - Xiaolin Hou
- Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Ting Xu
- General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Cheng-feng Qin
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Huanyu Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Peng Xie
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, Chongqing, People’s Republic of China
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhenhai Wang
- Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
- Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, People’s Republic of China
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Sistrom M, Andrews H, Edwards DL. Comparative genomics of Japanese encephalitis virus shows low rates of recombination and a small subset of codon positions under episodic diversifying selection. PLoS Negl Trop Dis 2024; 18:e0011459. [PMID: 38295106 PMCID: PMC10861042 DOI: 10.1371/journal.pntd.0011459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/12/2024] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
Orthoflavivirus japonicum (JEV) is the dominant cause of viral encephalitis in the Asian region with 100,000 cases and 25,000 deaths reported annually. The genome is comprised of a single polyprotein that encodes three structural and seven non-structural proteins. We collated a dataset of 349 complete genomes from a number of public databases, and analysed the data for recombination, evolutionary selection and phylogenetic structure. There are low rates of recombination in JEV, subsequently recombination is not a major evolutionary force shaping JEV. We found a strong overall signal of purifying selection in the genome, which is the main force affecting the evolutionary dynamics in JEV. There are also a small number of genomic sites under episodic diversifying selection, especially in the envelope protein and non-structural proteins 3 and 5. Overall, these results support previous analyses of JEV evolutionary genomics and provide additional insight into the evolutionary processes shaping the distribution and adaptation of this important pathogenic arbovirus.
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Affiliation(s)
- Mark Sistrom
- Department of Industry, Trade and Tourism, Berrimah Veterinary Laboratories, Darwin, Australia
- Research Institute for the Environment and Livelihoods, Faculty of Science and Technology, Charles Darwin University, Casuarina, Australia
| | - Hannah Andrews
- Department of Industry, Trade and Tourism, Berrimah Veterinary Laboratories, Darwin, Australia
| | - Danielle L. Edwards
- Research Institute for the Environment and Livelihoods, Faculty of Science and Technology, Charles Darwin University, Casuarina, Australia
- Department of Natural Sciences, Museum and Art Gallery of the Northern Territory, Darwin, Australia
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Dong HL, He MJ, Wang QY, Cui JZ, Chen ZL, Xiong XH, Zhang LC, Cheng H, Xiong GQ, Hu A, Lu YY, Cheng CL, Meng ZX, Zhu C, Zhao G, Liu G, Chen HP. Rapid Generation of Recombinant Flaviviruses Using Circular Polymerase Extension Reaction. Vaccines (Basel) 2023; 11:1250. [PMID: 37515065 PMCID: PMC10383701 DOI: 10.3390/vaccines11071250] [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: 05/26/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The genus Flavivirus is a group of arthropod-borne single-stranded RNA viruses, which includes important human and animal pathogens such as Japanese encephalitis virus (JEV), Zika virus (ZIKV), Dengue virus (DENV), yellow fever virus (YFV), West Nile virus (WNV), and Tick-borne encephalitis virus (TBEV). Reverse genetics has been a useful tool for understanding biological properties and the pathogenesis of flaviviruses. However, the conventional construction of full-length infectious clones for flavivirus is time-consuming and difficult due to the toxicity of the flavivirus genome to E. coli. Herein, we applied a simple, rapid, and bacterium-free circular polymerase extension reaction (CPER) method to synthesize recombinant flaviviruses in vertebrate cells as well as insect cells. We started with the de novo synthesis of the JEV vaccine strain SA-14-14-2 in Vero cells using CPER, and then modified the CPER method to recover insect-specific flaviviruses (ISFs) in mosquito C6/36 cells. Chimeric Zika virus (ChinZIKV) based on the Chaoyang virus (CYV) backbone and the Culex flavivirus reporter virus expressing green fluorescent protein (CxFV-GFP) were subsequently rescued in C6/36 cells. CPER is a simple method for the rapid generation of flaviviruses and other potential RNA viruses. A CPER-based recovery system for flaviviruses of different host ranges was established, which would facilitate the development of countermeasures against flavivirus outbreaks in the future.
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Affiliation(s)
- Hao-Long Dong
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Mei-Juan He
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Qing-Yang Wang
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Jia-Zhen Cui
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Zhi-Li Chen
- Academy of Military Medical Sciences, Beijing 100071, China
| | | | | | - Hao Cheng
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Guo-Qing Xiong
- Institutes of Physical Science and Information Technology, Anhui University, Hefei 230000, China
| | - Ao Hu
- Institutes of Physical Science and Information Technology, Anhui University, Hefei 230000, China
| | - Yuan-Yuan Lu
- Institutes of Physical Science and Information Technology, Anhui University, Hefei 230000, China
| | - Chun-Lin Cheng
- School of Life Science, Hebei University, Baoding 071000, China
| | - Zhi-Xin Meng
- School of Life Science, Hebei University, Baoding 071000, China
| | - Chen Zhu
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Guang Zhao
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Gang Liu
- Academy of Military Medical Sciences, Beijing 100071, China
| | - Hui-Peng Chen
- Academy of Military Medical Sciences, Beijing 100071, China
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