1
|
Ma ZH, Nawal Bahoussi A, Tariq Shah P, Guo YY, Dong L, Wu C, Xing L. Phylogeographic dynamics and molecular characteristics of Enterovirus 71 in China. Front Microbiol 2023; 14:1182382. [PMID: 37275165 PMCID: PMC10235518 DOI: 10.3389/fmicb.2023.1182382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Enterovirus 71 (EV71) and coxsackievirus (CV-A16) are the major etiological agents of hand, foot and mouth disease (HFMD). This report reviewed the full-length genomic sequences of EV71 identified in different provinces of China between 1998 and 2019 (a total of 312) in addition to eight worldwide reference genomes to address the genomic evolution and genetic events. The main prevalent EV71 strians in China are C4 genotypes, co-circulating with a few A, B5, C1, and C2 subgenotypes. A new emerging subgenotype in China was identified and classified as B6 genotype. Phylogeographic analysis revealed multiple branches, where a Jiangsu strain 2006-52-9 (GenBank ID: KP266579.1) was linked to different subgenotypes through multiple long mutant branches, including the CV-A16 viruses through the A genotype. Furthermore, identification of 28 natural recombination events suggests that the emergence of new genotypes are associated with intratypic recombination involving EV71 strains and intertypic recombination between EV71 and CV-A16 strains. Compared with the structural proteins, the non-structural proteins of EV71 seem to be highly variable with the highest variable regions of peptidase C3 (3C protein), P2A, and the N-terminus of RNA-dependent RNA polymerase. This study updates the phylogenetic and phylogeographic information of EV71 and provides clues to the emergence of new genotypes of EV71 based on genetics.
Collapse
Affiliation(s)
- Zi-Hui Ma
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
| | | | - Pir Tariq Shah
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Yan-Yan Guo
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Li Dong
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Changxin Wu
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Medical Molecular Cell Biology, Shanxi University, Taiyuan, China
- Shanxi Provincial Key Laboratory for Prevention and Treatment of Major Infectious Diseases, Taiyuan, China
- The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Shanxi University, Taiyuan, China
| | - Li Xing
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Medical Molecular Cell Biology, Shanxi University, Taiyuan, China
- Shanxi Provincial Key Laboratory for Prevention and Treatment of Major Infectious Diseases, Taiyuan, China
- The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Shanxi University, Taiyuan, China
| |
Collapse
|
2
|
Zeng L, Chen M, Wang M, Zhu L, Yan J, Zhang X, Xu J, Zhang S. Enterovirus A Shows Unique Patterns of Codon Usage Bias in Conventional Versus Unconventional Clade. Front Cell Infect Microbiol 2022; 12:941325. [PMID: 35909978 PMCID: PMC9329520 DOI: 10.3389/fcimb.2022.941325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Enterovirus A (EV-A) species cause hand, foot and mouth disease (HFMD), threatening the health of young children. Understanding the mutual codon usage pattern of the virus and its host(s) has fundamental and applied values. Here, through examining multiple codon usage parameters, we found that the codon usage bias among EV-A strains varies and is clade-specific. EVA76, EVA89, EVA90, EVA91 and EVA92, the unconventional clade of EV-A strains, show unique codon usage pattern relative to the two conventional clades, including EVA71, CVA16, CVA6 and CVA10, etc. Analyses of Effective Number of Codon (ENC), Correspondence Analysis (COA) and Parity Rule 2 (PR2), etc., revealed that the codon usage patterns of EV-A strains are shaped by mutation pressure and natural selection. Based on the neutrality analysis, we determined the dominant role of natural selection in the formation of the codon usage bias of EV-A. In addition, we have determined the codon usage compatibility of potential hosts for EV-A strains using codon adaptation index (CAI), relative codon deoptimization index (RCDI) and similarity index (SiD) analyses, and found that EV-A showed host-specific codon adaptation patterns in different clades. Finally, we confirmed that the unique codon usage pattern of the unconventional clade affected protein expression level in human cell lines. In conclusion, we identified novel characteristics of codon usage bias in distinct EV-A clades associated with their host range, transmission and pathogenicity.
Collapse
Affiliation(s)
- Liyan Zeng
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Ming Chen
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Min Wang
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Liuyao Zhu
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jingjing Yan
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Xiaoyan Zhang
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- *Correspondence: Shuye Zhang, ; Xiaoyan Zhang, ; Jianqing Xu,
| | - Jianqing Xu
- Shanghai Public Health Clinical center AND Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- *Correspondence: Shuye Zhang, ; Xiaoyan Zhang, ; Jianqing Xu,
| | - Shuye Zhang
- Clinical Center for BioTherapy & Institutes of Biomedical Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
- *Correspondence: Shuye Zhang, ; Xiaoyan Zhang, ; Jianqing Xu,
| |
Collapse
|
3
|
Wang Z, Yu H, Zhuang W, Chen J, Jiang Y, Guo Z, Huang X, Liu Q. Cell pyroptosis in picornavirus and its potential for treating viral infection. J Med Virol 2022; 94:3570-3580. [PMID: 35474513 DOI: 10.1002/jmv.27813] [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: 01/16/2022] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 11/08/2022]
Abstract
Cell pyroptosis has received increased attention due to the associations between innate immunity and disease, and it has become a major focal point recently due to in-depth studies of cancer. With increased research on pyroptosis, scientists have discovered that it has an essential role in viral infections, especially in the occurrence and development of some picornavirus infections. Many picornaviruses, including Coxsackievirus, a71 enterovirus, human rhinovirus, encephalomyocarditis virus, and foot-and-mouth disease virus induce pyroptosis to varying degrees. This review summarized the mechanisms by which these viruses induce cell pyroptosis, which can be an effective defense against pathogen infection. However, excessive inflammasome activation or pyroptosis also can damage the host's health or aggravate disease progression. Careful approaches that acknowledge this dual effect will aid in the exploration of picornavirus infections and the mechanisms that produce the inflammatory response. This information will promote the development of drugs that can inhibit cell pyroptosis and provide new avenues for future clinical treatment. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Zheng Wang
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006.,School of Queen Mary of Nanchang University, Nanchang, China, 330006
| | - Haolin Yu
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006.,School of Ophthalmology and Optometry of Nanchang University, Nanchang, China, 330006
| | - Wenyue Zhuang
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006.,The Second Clinical Medical College, Nanchang University, Nanchang, China, 30006
| | - Jingxuan Chen
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006.,School of Ophthalmology and Optometry of Nanchang University, Nanchang, China, 330006
| | - Yi Jiang
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006.,School of Ophthalmology and Optometry of Nanchang University, Nanchang, China, 330006
| | - Zhicheng Guo
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006
| | - Xiaotian Huang
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006
| | - Qiong Liu
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China, 330006
| |
Collapse
|
4
|
Livingston RA, Harrison CJ, Selvarangan R. Neutralizing Enterovirus D68 Antibodies in Children after 2014 Outbreak, Kansas City, Missouri, USA. Emerg Infect Dis 2022; 28:539-547. [PMID: 35201738 PMCID: PMC8888215 DOI: 10.3201/eid2803.211467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Antibodies to B1, B2, and D clade viruses were detected. Enterovirus D68 (EV-D68) causes severe respiratory illness outbreaks among children, particularly those with asthma. We previously detected neutralizing antibodies against the predominant EV-D68 B1 clade in the 2014 outbreak in serum collected before the outbreak (2012–2013) from persons 24 months to 85 years of age. We recently detected neutralizing antibodies to the 2014 B1, B2, and D clade viruses in serum collected after the 2014 outbreak (April–May 2017) from 300 children 6 months to 18 years of age. B1 virus neutralizing antibodies were found in 100% of patients, even children born after 2014; B2 in 84.6%, and D in 99.6%. In 2017, titers increased with patient age and were higher than titers in 2012–2013 from comparably aged children. Rate of seronegativity was highest (15.3%) for B2 virus. Multivariate analysis revealed an association between asthma and higher titers against B2 and D viruses. EV-D68 seems to have circulated during 2014–2017.
Collapse
|
5
|
Cheng YW, Chuang YC, Huang SW, Liu CC, Wang JR. An auto-antibody identified from phenotypic directed screening platform shows host immunity against EV-A71 infection. J Biomed Sci 2022; 29:10. [PMID: 35130884 PMCID: PMC8822709 DOI: 10.1186/s12929-022-00794-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/01/2022] [Indexed: 02/08/2023] Open
Abstract
Background Enterovirus A71 (EV-A71) is a neurotropic virus which may cause severe neural complications, especially in infants and children. The clinical manifestations include hand-foot-and-mouth disease, herpangina, brainstem encephalitis, pulmonary edema, and other severe neurological diseases. Although there are some vaccines approved, the post-marketing surveillance is still unavailable. In addition, there is no antiviral drugs against EV-A71 available. Methods In this study, we identified a novel antibody that could inhibit viral growth through a human single chain variable fragment (scFv) library expressed in mammalian cells and panned by infection with lethal dose of EV-A71. Results We identified that the host protein α-enolase (ENO1) is the target of this scFv, and anti-ENO1 antibody was found to be more in mild cases than severe EV-A71 cases. Furthermore, we examined the antiviral activity in a mouse model. We found that the treatment of the identified 07-human IgG1 antibody increased the survival rate after virus challenge, and significantly decreased the viral RNA and the level of neural pathology in brain tissue. Conclusions Collectively, through a promising intracellular scFv library expression and screening system, we found a potential scFv/antibody which targets host protein ENO1 and can interfere with the infection of EV-A71. The results indicate that the usage and application of this antibody may offer a potential treatment against EV-A71 infection.
Collapse
Affiliation(s)
- Yu-Wei Cheng
- The Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan.,Leadgene Biomedical, Inc., Tainan, Taiwan
| | - Yung-Chun Chuang
- Leadgene Biomedical, Inc., Tainan, Taiwan.,Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Wen Huang
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Tainan, Taiwan
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
| | - Jen-Ren Wang
- The Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan. .,Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan. .,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan.
| |
Collapse
|
6
|
Ji H, Fan H, Ai J, Shi C, Bi J, Chen YH, Lu XP, Chen QH, Tian JM, Bao CJ, Zhang XF, Jin Y. Neurocognitive Deficits and Sequelae Following Severe hand, foot, and mouth disease from 2009 to 2017, in JiangSu Province, China: A Long-Term Follow-Up Study. Int J Infect Dis 2021; 115:245-255. [PMID: 34910955 DOI: 10.1016/j.ijid.2021.11.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND To evaluate the long-term sequela and cognitive profile resulting from severe hand, foot and mouth disease (HFMD) with central nervous system (CNS) involvement. METHODS Two-hundred-and-ninety-four HFMD cases were included in a retrospective follow-up study. Physical examination were conducted. The Chinese Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) was used to assess intelligence. RESULTS Fifty-eight mild HFMD cases and 99 severe HFMD cases with mild CNS involvement did not present any neurological sequelae. While the sequelae incidence of severe HFMD with more severe CNS complications were 50.0%. The proportion of full scale intelligence quotient (FSIQ) impairment was 45.0%. In the 2:6-3:11 age group, severe HFMD with more severe CNS complications and lower maternal education level were risk factors for verbal comprehension disorder. Urban-rural residence and lower paternal education level were risk factors for FSIQ disorder. Furthermore, in the 4:0-6:11 age group, severe HFMD with more severe CNS complication was a risk factor for visual spatial disorder and fluid reasoning disorder. Lower paternal education level was a risk factor for FSIQ disorder. CONCLUSION Early assessment and intervention among severe HFMD patients with more severe CNS involvement at a very young age will prove beneficial for their future performance.
Collapse
Affiliation(s)
- Hong Ji
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China 210009; Medical School of Nanjing University, Nanjing 210093, China
| | - Huan Fan
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China 210009
| | - Jing Ai
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China 210009
| | - Chao Shi
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi 214023, China
| | - Jun Bi
- Xuzhou Municipal Center for Disease Control and Prevention, Xuzhou 221006, China
| | - Yin-Hua Chen
- Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Xiao-Peng Lu
- Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Qin-Hui Chen
- Children's Hospital of Soochow University, Nanjing 211166, China
| | - Jian-Mei Tian
- Children's Hospital of Soochow University, Nanjing 211166, China
| | - Chang-Jun Bao
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China 210009
| | - Xue-Feng Zhang
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China 210009.
| | - Yu Jin
- Medical School of Nanjing University, Nanjing 210093, China; Children's Hospital of Nanjing Medical University, Nanjing 210008, China.
| |
Collapse
|
7
|
Kang N, Gao H, He L, Liu Y, Fan H, Xu Q, Yang S. Ginsenoside Rb1 is an immune-stimulatory agent with antiviral activity against enterovirus 71. JOURNAL OF ETHNOPHARMACOLOGY 2021; 266:113401. [PMID: 32980486 DOI: 10.1016/j.jep.2020.113401] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/04/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE According to the theory of traditional Chinese medicine, the main pathogenesis of severe hand, foot and mouth disease (HFMD) is that the heat and wet poisons are deeply trapped in the viscera, which causes the deficiency of Qi and Yin in the patient's body. Ginsenoside Rb1 (Rb1) is the most abundant triterpenoid saponin in Panax quinquefolius L., which has the function of Qi-invigorating and Yin-nourishing. Enterovirus 71 (EV71) is one of the causative pathogens of HFMD, especially the form associated with some lethal complications. Therefore, the therapeutic effect of Rb1 on this disease caused by EV71 infection is worth exploring. AIM OF THE STUDY We explored the effective antiviral activities of Rb1 against EV71 in vitro and in vivo and investigated its preliminary antiviral mechanisms. MATERIAL AND METHODS EV71-infected two-day-old suckling mice model was employed to detect the antiviral effects of Rb1 in vivo. To detect the antiviral effects of Rb1 in vitro, cytopathic effect (CPE) reduction assay was performed in EV71-infected Rhabdomyosarcoma (RD) cells. Interferon (IFN)-β interference experiment was employed to detect the antiviral mechanism of Rb1. RESULTS In this paper, we first found that Rb1 exhibited strong antiviral activities in EV71-infected suckling mice when compared to those of ribavirin. Administration of Rb1 reduced the CPE of EV71-infected RD cells in a dose-dependent manner. Moreover, EV71-induced viral protein-1 (VP-1) expression was significantly reduced by Rb1 administration in vitro and in vivo. Furthermore, Rb1 treatment could induce high cellular and humoral immune responses in vivo. Meanwhile, Rb1 contributed to the enhanced Type I IFN responses and IFN-β knockdown reversed the antiviral activity of Rb1 in vitro. CONCLUSION In summary, our findings suggest that Rb1 is an immune-stimulatory agent and provide an insight into therapeutic potentials of Rb1 for the treatment of EV71 infection.
Collapse
Affiliation(s)
- Naixin Kang
- College of Pharmaceutical Science, Soochow University, Suzhou, 215123, China.
| | - Hongwei Gao
- College of Pharmacy, Guangxi University of Chinese Medicine, Nanning, 530000, China.
| | - Luan He
- College of Pharmaceutical Science, Soochow University, Suzhou, 215123, China.
| | - Yanli Liu
- College of Pharmaceutical Science, Soochow University, Suzhou, 215123, China.
| | - Handong Fan
- Institute of Aging Research, School of Medicine, Hangzhou Normal University, Hangzhou, 310036, China.
| | - Qiongming Xu
- College of Pharmaceutical Science, Soochow University, Suzhou, 215123, China; College of Pharmacy, Guangxi University of Chinese Medicine, Nanning, 530000, China.
| | - Shilin Yang
- College of Pharmaceutical Science, Soochow University, Suzhou, 215123, China.
| |
Collapse
|
8
|
Inhibition of Enterovirus A71 by a Novel 2-Phenyl-Benzimidazole Derivative. Viruses 2021; 13:v13010058. [PMID: 33406781 PMCID: PMC7823780 DOI: 10.3390/v13010058] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 02/07/2023] Open
Abstract
Enterovirus A71 (EV-A71) infection has emerged as a significant public health concern at the global level. Epidemic events of EV-A71 have been reported worldwide, and this succession of outbreaks has heightened concern that EV-A71 may become a public health threat. In recent years, widespread A71 enterovirus also occurred in European countries. EV-A71 infection causes hand-foot-mouth disease (HFMD), herpangina, and fever. However, it can sometimes induce a variety of neurological complications, including encephalitis, aseptic meningitis, pulmonary edema, and acute flaccid paralysis. We identified new benzimidazole derivatives and described theirin vitrocytotoxicity and broad-spectrum anti-enterovirus activity. Among them, derivative 2b resulted in interesting activity against EV-A71, and therefore it was selected for further investigations. Compound 2b proved to be able to protect cell monolayers from EV-A71-induced cytopathogenicity, with an EC50 of 3 µM. Moreover, Vero-76 cells resulted in being significantly protected from necrosis and apoptosis when treated with 2b at 20 and 80 µM. Compound 2b reduced viral adsorption to Vero-76 cells, and when evaluated in a time-of-addition assay, the derivative had the highest effect when added during the infection period. Moreover, derivative 2b reduced viral penetration into host cells. Besides, 2b did not affect intestinal monolayers permeability, showing no toxic effects. A detailed insight into the efficacy of compound 2b against EV-A71 showed a dose-dependent reduction in the viral titer, also at low concentrations. Mechanism of action investigations suggested that our derivative can inhibit viral endocytosis by reducing viral attachment to and penetration into host cells. Pharmacokinetic and toxicity predictions validated compound 2b as a good candidate for furtherin vivoassays.
Collapse
|
9
|
Donadu MG, Trong Le N, Viet Ho D, Quoc Doan T, Tuan Le A, Raal A, Usai M, Marchetti M, Sanna G, Madeddu S, Rappelli P, Diaz N, Molicotti P, Carta A, Piras S, Usai D, Thi Nguyen H, Cappuccinelli P, Zanetti S. Phytochemical Compositions and Biological Activities of Essential Oils from the Leaves, Rhizomes and Whole Plant of Hornstedtia bella Škorničk. Antibiotics (Basel) 2020; 9:antibiotics9060334. [PMID: 32570731 PMCID: PMC7344524 DOI: 10.3390/antibiotics9060334] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 12/26/2022] Open
Abstract
The rapid emergence of drug-resistant strains and novel viruses have motivated the search for new anti-infectious agents. In this study, the chemical compositions and cytotoxicity, as well as the antibacterial, antifungal, antitrichomonas, and antiviral activities of essential oils from the leaves, rhizomes, and whole plant of Hornstedtia bella were investigated. The GC/MS analysis showed that β-pinene, E-β-caryophyllene, and α-humulene were found at high concentrations in the essential oils. The essential oils exhibited (i) inhibition against Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis with minimum inhibitory concentrations (MIC) and minimum lethal concentration (MLC) values from 1 to 4% (v/v); (ii) MIC and MLC values from 2 to 16% (v/v) in Candida tropicalis and Candida parapsilosis; (iii) MIC and MLC values from 4 to 16% in Enterococcus faecalis; and (iv) MIC and MLC values from 8 to greater than or equal to 16% (v/v) in the remaining strains, including Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Candida albicans, and Candida glabrata. In antitrichomonas activity, the leaves and whole-plant oils of Hornstedtia bella possessed IC50, IC90, and MLC values of 0.008%, 0.016%, and 0.03% (v/v), respectively, whilst those of rhizomes oil had in turn, 0.004%, 0.008%, and 0.016% (v/v).Besides, the leaf oil showed a weak cytotoxicity against Vero 76 and MRC-5; meanwhile, rhizomes and whole-plant oils did not exert any toxic effects on cell monolayers. Finally, these oils were not active against EV-A71.
Collapse
Affiliation(s)
- Matthew Gavino Donadu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
- Department of Chemistry and Pharmacy, University of Sassari, 07100 Sassari, Italy; (M.U.); (A.C.); (S.P.)
| | - Nhan Trong Le
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam; (N.T.L.); (D.V.H.); (T.Q.D.)
| | - Duc Viet Ho
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam; (N.T.L.); (D.V.H.); (T.Q.D.)
| | - Tuan Quoc Doan
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam; (N.T.L.); (D.V.H.); (T.Q.D.)
| | - Anh Tuan Le
- Mientrung Institute for Scientific Research, VAST, Hue 49000, Vietnam;
| | - Ain Raal
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, 50900 Tartu, Estonia;
| | - Marianna Usai
- Department of Chemistry and Pharmacy, University of Sassari, 07100 Sassari, Italy; (M.U.); (A.C.); (S.P.)
| | - Mauro Marchetti
- Institute of Biomolecular Chemistry (CNR), Li Punti, 07100 Sassari, Italy;
| | - Giuseppina Sanna
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (G.S.); (S.M.)
| | - Silvia Madeddu
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (G.S.); (S.M.)
| | - Paola Rappelli
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
| | - Nicia Diaz
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
| | - Paola Molicotti
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
| | - Antonio Carta
- Department of Chemistry and Pharmacy, University of Sassari, 07100 Sassari, Italy; (M.U.); (A.C.); (S.P.)
| | - Sandra Piras
- Department of Chemistry and Pharmacy, University of Sassari, 07100 Sassari, Italy; (M.U.); (A.C.); (S.P.)
| | - Donatella Usai
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
- Correspondence: (D.U.); (H.T.N.)
| | - Hoai Thi Nguyen
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam; (N.T.L.); (D.V.H.); (T.Q.D.)
- Correspondence: (D.U.); (H.T.N.)
| | - Piero Cappuccinelli
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
| | - Stefania Zanetti
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (M.G.D.); (P.R.); (N.D.); (P.M.); (P.C.); (S.Z.)
| |
Collapse
|
10
|
Liu J, Zhao B, Xue L, Wu J, Xu Y, Liu Y, Qin C. Immunization with a fusion protein vaccine candidate generated from truncated peptides of human enterovirus 71 protects mice from lethal enterovirus 71 infections. Virol J 2020; 17:58. [PMID: 32321526 PMCID: PMC7178760 DOI: 10.1186/s12985-020-01328-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 04/10/2020] [Indexed: 01/25/2023] Open
Abstract
Background Prophylactic vaccines are critical in preventing hand, foot, and mouth disease (HFMD) primarily caused by human enterovirus 71 (EV71) infection. Children aged less than 5 years are especially susceptible to EV71 infections. In addition to the development of vaccines containing the inactivated virus, those containing virus-like particles (VLPs) with repeated antigens also constitute an effective preventive strategy for EV71 infections, with safety and productivity advantages. We previously developed a fusion protein composed with truncated peptides of the EV71 capsid protein, which assembled into spherical particles. This study aimed to assess the immunoprotective effects of this fusion protein as a vaccine candidate in a mouse model of EV71 infection. Methods To evaluate the protective effect of fusion protein vaccine candidate, neonatal mice born by immunized female mice, as well as normal neonatal mice immunized twice were infected with EV71 virus. Whereafter, the survival rates, clinical scores and viral loads were measured. Results The high dosage and booster immunization helped induce specific serum antibodies with high neutralization titers, which were transferred to neonatal mice, thereby facilitating effective resistance towards EV71 infection. An active immune response was also observed in neonatal mice which generated following immunization. Conclusions The present results suggest that this fusion protein is a suitable vaccine candidate in treating EV71 infections.
Collapse
Affiliation(s)
- Jiangning Liu
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, Institute of Laboratory Animal Science, CAMS&PUMC, Beijing, 100021, People's Republic of China
| | - Binbin Zhao
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, Institute of Laboratory Animal Science, CAMS&PUMC, Beijing, 100021, People's Republic of China
| | - Ling Xue
- National Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, 100190, People's Republic of China.,University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Jing Wu
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, Institute of Laboratory Animal Science, CAMS&PUMC, Beijing, 100021, People's Republic of China
| | - Yanfeng Xu
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, Institute of Laboratory Animal Science, CAMS&PUMC, Beijing, 100021, People's Republic of China
| | - Yongdong Liu
- National Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, 100190, People's Republic of China. .,University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
| | - Chuan Qin
- NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Reemerging Infectious Diseases, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, Institute of Laboratory Animal Science, CAMS&PUMC, Beijing, 100021, People's Republic of China.
| |
Collapse
|
11
|
Dang H, Li J, Liu C, Xu F. Chromogranin A provides additional prognostic information in children with severe hand, foot, and mouth disease: A prospective observational study. Int J Infect Dis 2020; 93:367-374. [PMID: 32109626 DOI: 10.1016/j.ijid.2020.02.035] [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: 11/19/2019] [Revised: 02/15/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Severe hand, foot, and mouth disease (HFMD) is associated with high mortality in children, and persistent sympathetic activation is a common presentation. The aim of this study was to prospectively investigate serum chromogranin A (CHGA) levels and their prognostic role in this condition. METHODS Serum CHGA, creatine kinase myocardial band (CK-MB), serum D-dimer, norepinephrine, blood glucose, lactate, and C-reactive protein levels, white blood cell (WBC) counts, usage of vasopressors, pediatric risk of mortality Ⅲ (PRISM-Ⅲ) scores, and viral etiology were measured upon pediatric intensive care unit (PICU) admission. The correlation between clinical outcomes and the indicators listed above were analyzed, and the ability of CHGA as a biomarker to predict mortality was evaluated. RESULTS Serum CHGA levels were higher in the non-survivors group than in the survivors group (median (interquartile range): 434.8 (374.3-502.4) vs 183.3 (131.9-246.9) μg/l; p < 0.001) and were correlated with norepinephrine (r = 0.37. p < 0.001), blood glucose (r = 0.32, p = 0.001), lactate (r = 0.25, p = 0.009), WBC (r = 0.20, p = 0.039), and PRISM-Ⅲ scores (r = 0.748, p < 0.0001). Patients suffering neurogenic pulmonary edema, those infected with enterovirus A71, and those requiring more vasopressors had higher serum CHGA levels (median (interquartile range): 385 (239.9-488.8) vs 161 (115.6-222.9), 340.6 (190.6-436.0) vs 150.5 (112.1-210.0), 395.6 (209.1-487.0) vs 167.7 (110.5-240.5) μg/l, respectively; p < 0.0001). The CHGA level upon PICU admission in severe HFMD could be an independent risk factor for mortality (adjusted odds ratio 2.459, 95% confidence interval 1.054-5.906, p = 0.038) with high specificity (87.5%) and sensitivity (82.6%) (cut-off value at 339.6 μg/l). CONCLUSIONS The CHGA level in severe HFMD was found to be associated with cardiopulmonary failure. If measured upon PICU admission, CHGA may provide additional prognostic information in this disease.
Collapse
Affiliation(s)
- Hongxing Dang
- Department of PICU, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; Chongqing Key Laboratory of Child Infection and Immunity, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China
| | - Jing Li
- Department of PICU, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; Chongqing Key Laboratory of Child Infection and Immunity, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China
| | - Chengjun Liu
- Department of PICU, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; Chongqing Key Laboratory of Child Infection and Immunity, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China
| | - Feng Xu
- Department of PICU, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China; Chongqing Key Laboratory of Child Infection and Immunity, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
| |
Collapse
|
12
|
Anti-inflammatory and antiviral effects of minocycline in enterovirus 71 infections. Biomed Pharmacother 2019; 118:109271. [DOI: 10.1016/j.biopha.2019.109271] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022] Open
|
13
|
Synthesis and Broad Antiviral Activity of Novel 2-aryl-isoindolin-1-ones towards Diverse Enterovirus A71 Clinical Isolates. Molecules 2019; 24:molecules24050985. [PMID: 30862068 PMCID: PMC6429200 DOI: 10.3390/molecules24050985] [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: 02/19/2019] [Revised: 03/01/2019] [Accepted: 03/06/2019] [Indexed: 01/18/2023] Open
Abstract
Enterovirus 71 (EV-A71) is the main causative pathogen of childhood hand, foot and mouth disease. Effective medicine is currently unavailable for the treatment of this viral disease. Using the fragment-hopping strategy, a series of 2-aryl-isoindolin-1-one compounds were designed, synthesized and investigated for their in vitro antiviral activity towards multiple EV-A71 clinical isolates (H, BrCr, Shenzhen98, Jiangsu52) in Vero cell culture in this study. The structure⁻activity relationship (SAR) studies identified 2-phenyl-isoindolin-1-ones as a new potent chemotype with potent antiviral activity against EV-A71. Ten out of the 24 tested compounds showed significant antiviral activity (EC50 < 10 µM) towards four EV-A71 strains. Compounds A3 and A4 exhibited broad and potent antiviral activity with the 50% effective concentration (EC50) values in the range of 1.23⁻1.76 μM. Moreover, the selectivity indices of A3 and A4 were significantly higher than those of the reference compound, pirodavir. The western blotting experiment indicated that the viral VP1 was significantly decreased at both the protein and RNA level in a dose-dependent manner following treatment with compound A3. Moreover, compound A3 inhibited the viral replication by acting on the virus entry stage. In summary, this study led to the discovery of 2-aryl-isoindolin-1-ones as a promising scaffold with potent anti-EV-A71 activities, which deserves further in-depth studies.
Collapse
|
14
|
Zhang J, Huang H, Xu L, Lou C, Pan M. Screening and Identification of Linear B Cell Epitopes Within the Nonstructural Proteins of Enterovirus 71. Viral Immunol 2019; 32:84-88. [DOI: 10.1089/vim.2018.0125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jianhua Zhang
- Department of Laboratory Medicine, School of Medicine, Shaoxing University, Shaoxing, P.R. China
| | - Huiqi Huang
- Department of Laboratory Medicine, School of Medicine, Shaoxing University, Shaoxing, P.R. China
| | - Lian Xu
- Department of Laboratory Medicine, School of Medicine, Shaoxing University, Shaoxing, P.R. China
| | - Chaonan Lou
- Department of Laboratory Medicine, School of Medicine, Shaoxing University, Shaoxing, P.R. China
| | - Mi Pan
- Department of Laboratory Medicine, School of Medicine, Shaoxing University, Shaoxing, P.R. China
| |
Collapse
|
15
|
Harrison CJ, Weldon WC, Pahud BA, Jackson MA, Oberste MS, Selvarangan R. Neutralizing Antibody against Enterovirus D68 in Children and Adults before 2014 Outbreak, Kansas City, Missouri, USA 1. Emerg Infect Dis 2019; 25:585-588. [PMID: 30789123 PMCID: PMC6390745 DOI: 10.3201/eid2503.180960] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We evaluated enterovirus D68 seroprevalence in Kansas City, Missouri, USA, from samples obtained during 2012-2013. Neutralizing antibodies against Fermon and the dominant 2014 Missouri isolate were universally detected. Titers increased with age. Widespread circulation of enterovirus D68 occurred before the 2014 outbreak. Research is needed to determine a surrogate of protection.
Collapse
|
16
|
Clinical Value of Dorsal Medulla Oblongata Involvement Detected With Conventional Magnetic Resonance Imaging for Prediction of Outcome in Children With Enterovirus 71-Related Brainstem Encephalitis. Pediatr Infect Dis J 2019; 38:99-103. [PMID: 29624567 DOI: 10.1097/inf.0000000000002041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Brainstem encephalitis is the most common neurologic complication after enterovirus 71 infection. The involvement of brainstem, especially the dorsal medulla oblongata, can cause severe sequelae or death in children with enterovirus 71 infection. We aimed to determine the prevalence of dorsal medulla oblongata involvement in children with enterovirus 71-related brainstem encephalitis (EBE) by using conventional magnetic resonance imaging (MRI) and to evaluate the value of dorsal medulla oblongata involvement in outcome prediction. METHODS Forty-six children with EBE were enrolled in the study. All subjects underwent a 1.5 Tesla MRI examination of the brain. The disease distribution and clinical data were collected. Dichotomized outcomes (good vs. poor) at longer than 6 months were available for 28 patients. Logistic regression was used to determine whether the MRI-confirmed dorsal medulla oblongata involvement resulted in improved clinical outcome prediction when compared with other location involvement. RESULTS Of the 46 patients, 35 had MRI evidence of dorsal medulla oblongata involvement, 32 had pons involvement, 10 had midbrain involvement and 7 had dentate nuclei involvement. Patients with dorsal medulla oblongata involvement or multiple area involvement were significantly more often in the poor outcome group than in the good outcome group. Logistic regression analysis showed that dorsal medulla oblongata involvement was the most significant single variable in outcome prediction (predictive accuracy, 90.5%), followed by multiple area involvement, age and initial Glasgow Coma Scale score. CONCLUSIONS Dorsal medulla oblongata involvement on conventional MRI correlated significantly with poor outcomes in EBE children, improved outcome prediction when compared with other clinical and disease location variables, and was most predictive when combined with multiple area involvement, Glasgow Coma Scale score and age.
Collapse
|
17
|
Ma Y, Cong W, Huang H, Sun L, Mai AH, Boonen K, Maryam W, De Borggraeve W, Luo G, Liu Q, Schoofs L, Van Kuppeveld F, Neyts J, Mirabelli C, Luyten W. Identification of fukinolic acid from Cimicifuga heracleifolia and its derivatives as novel antiviral compounds against enterovirus A71 infection. Int J Antimicrob Agents 2019; 53:128-136. [PMID: 30063999 DOI: 10.1016/j.ijantimicag.2018.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 06/17/2018] [Accepted: 07/14/2018] [Indexed: 01/07/2023]
Abstract
Human enterovirus 71 (EV-A71) infections cause a wide array of diseases ranging from diarrhoea and rashes to hand-foot-and-mouth disease and, in rare cases, severe neurological disorders. No specific antiviral drug therapy is currently available. Extracts from 75 Chinese medicinal plants selected for antiviral activity based on the Chinese pharmacopeia and advice from traditional Chinese medicine clinicians were tested for activity against EV-A71. The aqueous extract of the rhizome of Cimicifuga heracleifolia (Sheng Ma) and Arnebia euchroma (Zi Cao) showed potent antiviral activity. The active fractions were isolated by bioassay-guided purification, and identified by a combination of high-resolution mass spectrometry and nuclear magnetic resonance. Fukinolic acid and cimicifugic acid A and J, were identified as active anti-EV-A71 compounds for C. heracleifolia, whereas for A. euchroma, two caffeic acid derivatives were tentatively deduced. Commercially available fukinolic acid analogues such as L-chicoric acid and D-chicoric also showed in vitro micromolar activity against EV-A71 lab-strain and clinical isolates.
Collapse
Affiliation(s)
- Yipeng Ma
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Belgium; Laboratory of Animal Physiology and Neurobiology, Department of Biology, KU Leuven, Belgium
| | - Wenjuan Cong
- Wolfson Wohl Cancer Research Centre, University of Glasgow, Scotland, UK
| | - Hao Huang
- College of Pharmacy, Gannan Medical University, Ganzhou, China
| | - Liang Sun
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Belgium
| | - Anh Hung Mai
- R&D Department, PolymerExpert,1 Allée du Doyen Georges Brus, Pessac, France
| | - Kurt Boonen
- Laboratory of Animal Physiology and Neurobiology, Department of Biology, KU Leuven, Belgium
| | - Wahedi Maryam
- Departement of infection and immunology, University of Utrecht, the Netherlands
| | - Wim De Borggraeve
- Molecular Design and Synthesis unit, Chemistry department, KU Leuven, Belgium
| | - Guoan Luo
- Department of Chemistry, Tsinghua University, Beijing, China
| | - Qingfei Liu
- School of Medicine, Tsinghua University, Beijing, China
| | - Liliane Schoofs
- Laboratory of Animal Physiology and Neurobiology, Department of Biology, KU Leuven, Belgium
| | - Frank Van Kuppeveld
- Departement of infection and immunology, University of Utrecht, the Netherlands
| | - Johan Neyts
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Belgium
| | - Carmen Mirabelli
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Belgium
| | - Walter Luyten
- Laboratory of Animal Physiology and Neurobiology, Department of Biology, KU Leuven, Belgium.
| |
Collapse
|
18
|
Enterovirus A71 Infection Activates Human Immune Responses and Induces Pathological Changes in Humanized Mice. J Virol 2019; 93:JVI.01066-18. [PMID: 30429352 DOI: 10.1128/jvi.01066-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/05/2018] [Indexed: 12/16/2022] Open
Abstract
Since the discovery of enterovirus A71 (EV-A71) half a century ago, it has been recognized as the cause of large-scale outbreaks of hand-foot-and-mouth disease worldwide, particularly in the Asia-Pacific region, causing great concern for public health and economic burdens. Detailed mechanisms on the modulation of immune responses after EV-A71 infection have not been fully known, and the lack of appropriate models hinders the development of promising vaccines and drugs. In the present study, NOD-scid IL2Rγ-/- (NSG) mice with a human immune system (humanized mice) at the age of 4 weeks were found to be susceptible to a human isolate of EV-A71 infection. After infection, humanized mice displayed limb weakness, which is similar to the clinical features found in some of the EV-A71-infected patients. Histopathological examination indicated the presence of vacuolation, gliosis, or meningomyelitis in brain stem and spinal cord, which were accompanied by high viral loads detected in these organs. The numbers of activated human CD4+ and CD8+ T cells were upregulated after EV-A71 infection, and EV-A71-specific human T cell responses were found. Furthermore, the secretion of several proinflammatory cytokines, such as human gamma interferon (IFN-γ), interleukin-8 (IL-8), and IL-17A, was elevated in the EV-A71-infected humanized mice. Taken together, our results suggested that the humanized mouse model permits insights into the human immune responses and the pathogenesis of EV-A71 infection, which may provide a platform for the evaluation of anti-EV-A71 drug candidates in the future.IMPORTANCE Despite causing self-limited hand-food-and-mouth disease in younger children, EV-A71 is consistently associated with severe forms of neurological complications and pulmonary edema. Nevertheless, only limited vaccines and drugs have been developed over the years, which is possibly due to a lack of models that can more accurately recapitulate human specificity, since human is the only natural host for wild-type EV-A71 infection. Our humanized mouse model not only mimics histological symptoms in patients but also allows us to investigate the function of the human immune system during infection. It was found that human T cell responses were activated, accompanied by an increase in the production of proinflammatory cytokines in EV-A71-infected humanized mice, which might contribute to the exacerbation of disease pathogenesis. Collectively, this model allows us to delineate the modulation of human immune responses during EV-A71 infection and may provide a platform to evaluate anti-EV-A71 drug candidates in the future.
Collapse
|
19
|
Hand-foot-mouth disease and use of steroids, intravenous immunoglobulin, and traditional Chinese herbs in a tertiary hospital in Shantou, China. Altern Ther Health Med 2018; 18:190. [PMID: 29925360 PMCID: PMC6011388 DOI: 10.1186/s12906-018-2259-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND In contrast to the guidelines of World Health Organization (WHO) and United States-Centers for Disease Control and prevention (US-CDC), the Chinese national guidelines recommend the use of steroids, intravenous immunoglobulin (IVIG), or traditional Chinese herbs (TCHs) in hand-foot-mouth disease (HFMD) management. Their use and therapeutic efficacies are, however, unclear. We aimed to describe their use in and the clinical outcomes of hospitalized HFMD cases. METHODS A retrospective review of hospital medical records for HFMD cases during 2008-2016 was conducted in a medical school-affiliated tertiary hospital in Shantou, Guangdong, China. RESULTS Hospitalized children with the discharge diagnosis of HFMD (n = 3778), comprising mild (58.4%), severe (41.5%), and very severe (0.1%) cases, were enrolled in the study. Steroids, IVIG, and antiviral TCH Lan-Qin were respectively prescribed in 60.5, 37.1, and 71.0% of cases. Most cases (99.8%) recovered and six died. Recovery rate was lower with the use of IVIG and higher with Lan-Qin (alone or in combination with steroid) in the mild cases (Ps < 0.05). Longer hospital stay was observed with steroid/IVIG with or without Lan-Qin in the severe cases (Ps < 0.05). CONCLUSIONS This nine-year retrospective review shows 1) an increase in the incidence of HFMD as well as the use of steroids, IVIG, and TCH over time, 2) no significant advantage of using steroids and IVIG, either alone or in combination, in the management of mild HFMD cases, and 3) a higher recovery rate in mild HFMD cases with the use of antiviral TCH (Lan-Qin). Our findings need verification in a larger prospect study with cases from hospitals in other regions of China. Lan-Qin efficacy should be evaluated in randomized trials. Meanwhile, caution should be exercised in the extensive use of steroids and IVIG in HFMD management.
Collapse
|
20
|
Min N, Sakthi Vale PD, Wong AA, Tan NWH, Chong CY, Chen CJ, Wang RYL, Chu JJH. Circulating Salivary miRNA hsa-miR-221 as Clinically Validated Diagnostic Marker for Hand, Foot, and Mouth Disease in Pediatric Patients. EBioMedicine 2018; 31:299-306. [PMID: 29754884 PMCID: PMC6014581 DOI: 10.1016/j.ebiom.2018.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/24/2018] [Accepted: 05/03/2018] [Indexed: 12/01/2022] Open
Abstract
Enhancements in the diagnostic capabilities using host biomarkers are currently much needed where sensitivity and specificity issues plague the diagnosis of Hand, Foot and Mouth Disease (HFMD) in pediatrics clinical samples. We investigated miRNome profiles of HFMD saliva samples against healthy children and developed miRNA-based diagnosis models. Our 6-miRNA scoring model predicted HFMD with an overall accuracy of 85.11% in the training set and 92.86% in the blinded test set of Singapore cohort. Blinded evaluation of the model in Taiwan HFMD cases resulted in 77.08% accuracy with the 6-miRNA model and 68.75% with the 4-miRNA model. The strongest predictor of HFMD in all of the panels, hsa-miR-221 was found to be consistently and significantly downregulated in all of our HFMD cohorts. This is the first study to prove that HFMD infection could be diagnosed by circulating miRNAs in patient's saliva. Moreover, this study also serves as a stepping stone towards the future development of other infectious disease diagnosis workflows using novel biomarkers. Targeted salivary miRNome profiling was conducted between Hand Foot and Mouth disease patients and healthy individuals. HFMD diagnosis models were established with training data from Singapore HFMD cohort using the support vector machine. The models were also validated blindly using the testing data from Singapore HFMD cohort and the entire Taiwan HFMD cohort.
Using saliva as the medium for diagnosis of human diseases has been a long dream for doctors and patients. In this research article, we developed a rapid test for detecting hand foot and mouth disease using molecules known as miRNA in saliva. We created a mathematical model to detect a specific pattern of miRNA response of the HFMD infection to identify HFMD infected patients. Our model can accurately distinguish HFMD patients from the healthy person by 92.86% in the blinded testing set of Singapore HFMD cohort.
Collapse
Affiliation(s)
- Nyo Min
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Health System, 5 Science Drive 2, National University of Singapore, 117597, Singapore.
| | - Previtha Dawn Sakthi Vale
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Health System, 5 Science Drive 2, National University of Singapore, 117597, Singapore.
| | - Anng Anng Wong
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore.
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore.
| | - Chia Yin Chong
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore.
| | - Chih-Jung Chen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial and Children's Hospital, Linkuo 33305, Taiwan
| | - Robert Y L Wang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial and Children's Hospital, Linkuo 33305, Taiwan; Department of Biomedical Sciences, College of Medicine, Chang Gung University, TaoYuan 33302, Taiwan.
| | - Justin Jang Hann Chu
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Health System, 5 Science Drive 2, National University of Singapore, 117597, Singapore; Collaborative and Translational Unit for HFMD, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore.
| |
Collapse
|
21
|
Min N, Leong PT, Lee RCH, Khuan JSE, Chu JJH. A flavonoid compound library screen revealed potent antiviral activity of plant-derived flavonoids on human enterovirus A71 replication. Antiviral Res 2017; 150:60-68. [PMID: 29233744 DOI: 10.1016/j.antiviral.2017.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 12/29/2022]
Abstract
Hand Foot Mouth Disease (HFMD), resulting from human enterovirus A71 (HEVA71) infection can cause severe neurological complications leading to fatality in young children. Currently, there is no approved antiviral for therapeutic treatment against HEVA71 infection. In this study, a 500-compound flavonoid library was screened to identify potential inhibitors of HEVA71 using high-throughput immunofluorescence-based phenotypic screening method. Two lead flavonoid compounds, ST077124 and ST024734 at the non-cytotoxic concentration of 50 μM were found to be effective antivirals that inhibited replication of HEVA71, reducing infectious viral titers by 3.5 log10 PFU/ml and 2.5 log10 PFU/ml respectively. Our study revealed that ST077124 is a specific antiviral compound that inhibits human enteroviruses while ST024734 exhibited antiviral activity against human enteroviruses as well as dengue virus type-2. We also identified that both compounds affected the viral RNA transcription and translation machinery of HEVA71 but did not interfere with the viral internal ribosomal entry site (IRES) activity. Hence, our findings strongly suggest that ST077124 and ST024734 are effective antiviral compounds of minimal cytotoxicity and could serve as promising therapeutic agents against HEVA71 infection.
Collapse
Affiliation(s)
- Nyo Min
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore
| | - Pok Thim Leong
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore
| | - Regina Ching Hua Lee
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore
| | - Jeffery Seng Eng Khuan
- School of Chemical & Life Sciences, 180 Ang Mo Kio Ave 8, Nanyang Polytechnic, Singapore 569830, Singapore
| | - Justin Jang Hann Chu
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore; Collaborative and Translational Unit for HFMD, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore.
| |
Collapse
|
22
|
Dong Q, Men R, Dan X, Chen Y, Li H, Chen G, Zee B, Wang MHT, He ML. Hsc70 regulates the IRES activity and serves as an antiviral target of enterovirus A71 infection. Antiviral Res 2017; 150:39-46. [PMID: 29180285 DOI: 10.1016/j.antiviral.2017.11.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/23/2017] [Accepted: 11/23/2017] [Indexed: 12/11/2022]
Abstract
Enterovirus A71 (EV-A71) is a small positive-stranded RNA virus that causes human hand, foot and mouth disease (HFMD) and fatal neurological disorders in some cases without effective treatment. Here we show that heat shock cognate protein 70 (Hsc70), a molecular chaperone, displays pivotal role in viral infections. Knockdown of Hsc70 significantly suppresses viral replication evidenced by reducing not only the level of both viral replication intermediates (negative stranded RNA) and viral genomic RNA (positive stranded RNA), but also the level of viral protein expression; whereas ectopic expression of Hsc70 markedly promotes viral replication. Interestingly, depletion of Hsc70 decreases the IRES activity of EV-A71, and the ectopic expression of Hsc70 enhances the IRES activity accordingly. Further study shows that Hsc70 binds viral genomic RNA but does not directly interact with IRES. Moreover, we reveal that Hsc70 interacts with 2A protease and promotes eIF4G cleavage. More importantly, Hsc70 inhibitor Ver-155008 significantly protects cytopathic effects from EV-A71 infection and inhibits both IRES activity and viral reproduction in a dose-dependent manner. The cell viability assay shows that the IC50 and CC50 are 2.01 μM and 47.67 μM, respectively. These results demonstrate not only an important mechanism of Hsc70 in facilitating EV-A71 replication, but also a target for antiviral drug development.
Collapse
Affiliation(s)
- Qi Dong
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Ruoting Men
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China; Jockey Club of School of Public Health, Chinese University of Hong Kong, Hong Kong, China
| | - Xuelian Dan
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Ying Chen
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Huangcan Li
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Gong Chen
- Departments of Surgery, Faculty of Medicine, Chinese University of Hong Kong, China
| | - Benny Zee
- Jockey Club of School of Public Health, Chinese University of Hong Kong, Hong Kong, China
| | - Maggie H T Wang
- Jockey Club of School of Public Health, Chinese University of Hong Kong, Hong Kong, China.
| | - Ming-Liang He
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China; Biotechnology and Health Center, CityU Shenzhen Research Institute, Shenzhen, China.
| |
Collapse
|
23
|
Qu M, Di S, Zhang S, Xia Z, Quan G. Vitamin D receptor protects glioblastoma A172 cells against Coxsackievirus A16 infection induced cell death in the pathogenesis of hand, foot, and mouth disease. Biochem Biophys Res Commun 2017; 493:952-956. [DOI: 10.1016/j.bbrc.2017.09.112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 09/20/2017] [Indexed: 01/13/2023]
|
24
|
Antiviral effects of Retro-2 cycl and Retro-2.1 against Enterovirus 71 in vitro and in vivo. Antiviral Res 2017; 144:311-321. [PMID: 28688753 DOI: 10.1016/j.antiviral.2017.07.001] [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: 04/18/2017] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 11/23/2022]
Abstract
Enterovirus 71 (EV71) is one of the causative pathogens of hand, foot and mouth disease (HFMD), especially the form associated with fatal neurological disorders. Sustained outbreaks of EV71 infections remain a serious health threat worldwide. However, no antiviral agent against EV71 for clinical therapy has been approved. Retro-2cycl and Retro-2.1 are inhibitors of several pathogens specifically targeting the intracellular vesicle transport, which also participates in the EV71 lifecycle processes including progeny virus release. Here, we reported that Retro-2cycl and Retro-2.1, respectively, could inhibit EV71 infection with 50% effective concentrations of 12.56 μM and 0.05 μM in a cytopathic effect inhibition assay and showed relatively low cytotoxicity with 50% cytotoxicity concentrations of more than 500 μM and 267.80 μM. Preliminary mechanism studies revealed that Retro-2cycl and Retro-2.1 did not inhibit EV71 protein synthesis or RNA replication but could block progeny EV71 release specifically. Furthermore, administration of Retro-2cycl at the dose of 10 mg/kg significantly protected 90% of newborn mice from lethal EV71 challenge. Consequently, our results for the first time identified Retro-2cycl and Retro-2.1 as effective inhibitors of EV71 as well as lead compounds, which would contribute to anti-EV71 drug development. We also identified progeny virus release and the intracellular vesicle transport as antiviral targets for EV71.
Collapse
|
25
|
Su W, Li X, Chen M, Dai W, Sun S, Wang S, Sheng X, Sun S, Gao C, Hou A, Zhou Y, Sun B, Gao F, Xiao J, Zhang Z, Jiang C. Synonymous codon usage analysis of hand, foot and mouth disease viruses: A comparative study on coxsackievirus A6, A10, A16, and enterovirus 71 from 2008 to 2015. INFECTION GENETICS AND EVOLUTION 2017; 53:212-217. [PMID: 28602802 DOI: 10.1016/j.meegid.2017.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/02/2017] [Accepted: 06/04/2017] [Indexed: 11/15/2022]
Abstract
Enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) have been considered major pathogens of hand, foot and mouth disease (HFMD) throughout the world for decades. In recent years, coxsackievirus A6 (CVA6) and coxsackievirus A10 (CVA10) have raised attention as two other serious pathogens of HFMD. The present study focused on the synonymous codon usage of four viruses isolated from 2008 to 2015, with particular attention on P1 (encoding capsid proteins) and P2-P3 regions (both encoding non-structural proteins) in the genomic RNA. Relative synonymous codon usage, effective number of codons, neutrality and correspondence were analyzed. The results indicated that these viruses prefer A/T at the third position in codons rather than G/C. The most frequent codons of 4 essential and 2 semi-essential amino acids, as well as a key amino acid of metabolic junctions (Glu) used in the four viruses are also the most frequently used in humans. Effective number of codons (ENC) values indicated weak codon usage bias in all the viruses. Relatively, the force of mutation pressure in the P1 region was found to be stronger than that in the P2-P3 region, and this force in the P1 region of CVA6 and EV71 was stronger than that of CVA10 and A16. The neutrality analysis results implied that mutation pressure plays a minor role in shaping codon bias of these viruses. Correspondence analysis indicated that the codon usage of EV71 strains varied much more than that of other viruses. In conclusion, the present study provides novel and comparative insight into the evolution of HFMD pathogens at the codon level.
Collapse
Affiliation(s)
- Weiheng Su
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China; Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Xue Li
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Meili Chen
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Wenwen Dai
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Shiyang Sun
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Shuai Wang
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Xin Sheng
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Shixiang Sun
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chen Gao
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ali Hou
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China; Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Yan Zhou
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China; Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Bo Sun
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China; Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Feng Gao
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China; Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Jingfa Xiao
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhewen Zhang
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China.
| | - Chunlai Jiang
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China; Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China.
| |
Collapse
|
26
|
Feng N, Zhou Z, Li Y, Zhao L, Xue Z, Lu R, Jia K. Enterovirus 71-induced has-miR-21 contributes to evasion of host immune system by targeting MyD88 and IRAK1. Virus Res 2017; 237:27-36. [PMID: 28506791 DOI: 10.1016/j.virusres.2017.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/06/2017] [Accepted: 05/09/2017] [Indexed: 01/23/2023]
Abstract
Enterovirus71(EV71), the etiological agent of hand-foot-and-mouth disease, has increasingly become a public health challenge around the world. Type I interferons (IFNs) are an important family of cytokines that regulate innate and adaptive immune responses to pathogens.These pathways are tightly regulated by the host to prevent an inappropriate cellular response, but viruses can modulate these pathways to proliferate and spread. In this study, we demonstrated that EV71 evades the immune surveillance system to proliferate by activating microRNA-21. We demonstrated that EV71 infection upregulates miR-21, which in turn suppresses EV71-triggered type I IFN production, thus promoting EV71 replication. Furthermore, we demonstrated that miR-21 targets the myeloid differentiation factor 88(MyD88) and interleukin-1 receptor-associated kinase 1(IRAK1), which are involved in EV71-induced type I IFN production.
Collapse
Affiliation(s)
- Na Feng
- Department of Pediatrics, Affiliated Hospital of Yanan University, China
| | - Zhizhao Zhou
- Neonatology Department, Yangling Demonstration Zone Hospital, China
| | - Yuanxia Li
- Department of Pediatrics, Affiliated Hospital of Yanan University, China
| | - Lifang Zhao
- Department of Pediatrics, Affiliated Hospital of Yanan University, China
| | - Zhengfeng Xue
- Department of Pediatrics, Affiliated Hospital of Yanan University, China
| | - Rong Lu
- Department of Pediatrics, Affiliated Hospital of Yanan University, China
| | - Kunpeng Jia
- Department of Pediatrics, Affiliated Hospital of Yanan University, China.
| |
Collapse
|
27
|
Antiviral activities of Schizonepeta tenuifolia Briq. against enterovirus 71 in vitro and in vivo. Sci Rep 2017; 7:935. [PMID: 28428548 PMCID: PMC5430552 DOI: 10.1038/s41598-017-01110-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/23/2017] [Indexed: 12/31/2022] Open
Abstract
No effective drug is currently available for treatment of enterovirus 71 (EV71) infection. Schizonepeta tenuifolia Briq. (ST) has been used as a herbal constituent of traditional Chinese medicine. We studied whether the aqueous extract of Schizonepeta tenuifolia Briq (STE) has antiviral activity. STE inhibited replication of EV71, as evident by its ability to diminish plaque formation and cytopathic effect induced by EV71, and to inhibit the synthesis of viral RNA and protein. Moreover, daily single-dose STE treatment significantly improved the survival of EV71-infected mice, and ameliorated the symptoms. Mechanistically, STE exerts multiple effects on enteroviral infection. Treatment with STE reduced viral attachment and entry; the cleavage of eukaryotic translation initiation factor 4 G (eIF4G) by EV71 protease, 2Apro; virus-induced reactive oxygen species (ROS) formation; and relocation of heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1) from the nucleus to the cytoplasm. It was accompanied by a decline in EV71-associated hyperphosphorylation of p38 kinase and EPS15. It is plausible that STE may inhibit ROS-induced p38 kinase activation, and subsequent hnRNP A1 relocation and EPS15-mediated membrane trafficking in infected cells. These findings suggest that STE possesses anti-EV71 activities, and may serve as health food or candidate antiviral drug for protection against EV71.
Collapse
|
28
|
Guan H, Tian J, Qin B, Wojdyla JA, Wang B, Zhao Z, Wang M, Cui S. Crystal structure of 2C helicase from enterovirus 71. SCIENCE ADVANCES 2017; 3:e1602573. [PMID: 28508043 PMCID: PMC5409451 DOI: 10.1126/sciadv.1602573] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/24/2017] [Indexed: 06/07/2023]
Abstract
Enterovirus 71 (EV71) is the major pathogen responsible for outbreaks of hand, foot, and mouth disease. EV71 nonstructural protein 2C participates in many critical events throughout the virus life cycle; however, its precise role is not fully understood. Lack of a high-resolution structure made it difficult to elucidate 2C activity and prevented inhibitor development. We report the 2.5 Å-resolution crystal structure of the soluble part of EV71 2C, containing an adenosine triphosphatase (ATPase) domain, a cysteine-rich zinc finger with an unusual fold, and a carboxyl-terminal helical domain. Unlike other AAA+ ATPases, EV71 2C undergoes a carboxyl terminus-mediated self-oligomerization, which is dependent on a specific interaction between the carboxyl-terminal helix of one monomer and a deep pocket formed between the ATPase and the zinc finger domains of the neighboring monomer. The carboxyl terminus-mediated self-oligomerization is fundamental to 2C ATPase activity and EV71 replication. Our findings suggest a strategy for inhibition of enterovirus replication by disruption of the self-oligomerization interface of 2C.
Collapse
Affiliation(s)
- Hongxin Guan
- Ministry of Health Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing 100730, China
| | - Juan Tian
- Ministry of Health Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing 100730, China
| | - Bo Qin
- Ministry of Health Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing 100730, China
| | | | - Bei Wang
- Ministry of Health Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing 100730, China
| | - Zhendong Zhao
- Ministry of Health Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing 100730, China
| | - Meitian Wang
- Swiss Light Source at Paul Scherrer Institute, CH-5232 Villigen, Switzerland
| | - Sheng Cui
- Ministry of Health Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing 100730, China
| |
Collapse
|
29
|
Jin J, Li R, Jiang C, Zhang R, Ge X, Liang F, Sheng X, Dai W, Chen M, Wu J, Xiao J, Su W. Transcriptome analysis reveals dynamic changes in coxsackievirus A16 infected HEK 293T cells. BMC Genomics 2017; 18:933. [PMID: 28198671 PMCID: PMC5310284 DOI: 10.1186/s12864-016-3253-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Coxsackievirus A16 (CVA16) and enterovirus 71 (EV71) are two of the major causes of hand, foot and mouth disease (HFMD) world-wide. Although many studies have focused on infection and pathogenic mechanisms, the transcriptome profile of the host cell upon CVA16 infection is still largely unknown. RESULTS In this study, we compared the mRNA and miRNA expression profiles of human embryonic kidney 293T cells infected and non-infected with CVA16. We highlighted that the transcription of SCARB2, a cellular receptor for both CVA16 and EV71, was up-regulated by nearly 10-fold in infected cells compared to non-infected cells. The up-regulation of SCARB2 transcription induced by CVA16 may increase the possibility of subsequent infection of CVA16/EV71, resulting in the co-infection with two viruses in a single cell. This explanation would partly account for the co-circulation and genetic recombination of a great number of EV71 and CVA16 viruses. Based on correlation analysis of miRNAs and genes, we speculated that the high expression of SCARB2 is modulated by down-regulation of miRNA has-miR-3605-5p. At the same time, we found that differentially expressed miRNA target genes were mainly reflected in the extracellular membrane (ECM)-receptor interaction and circadian rhythm pathways, which may be related to clinical symptoms of patients infected with CVA16, such as aphthous ulcers, cough, myocarditis, somnolence and potentially meningoencephalitis. The miRNAs hsa-miR-149-3p and hsa-miR-5001-5p may result in up-regulation of genes in these morbigenous pathways related to CVA16 and further cause clinical symptoms. CONCLUSIONS The present study elucidated the changes in 293T cells upon CVA16 infection at transcriptome level, containing highly up-regulated SCARB2 and genes in ECM-receptor interaction and circadian rhythm pathways, and key miRNAs in gene expression regulation. These results provided novel insight into the pathogenesis of HFMD induced by CVA16 infection.
Collapse
Affiliation(s)
- Jun Jin
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, 130012, China
| | - Rujiao Li
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Chunlai Jiang
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, 130012, China
- Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun, 130012, China
| | - Ruosi Zhang
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaomeng Ge
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Fang Liang
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Xin Sheng
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Wenwen Dai
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, 130012, China
| | - Meili Chen
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jiayan Wu
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jingfa Xiao
- BIG Data Center, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China.
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Weiheng Su
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, 130012, China.
- Key Laboratory for Molecular Enzymology and Engineering, the Ministry of Education, School of Life Sciences, Jilin University, Changchun, 130012, China.
| |
Collapse
|
30
|
Purification and assembling a fused capsid protein as an enterovirus 71 vaccine candidate from inclusion bodies to pentamer-based nanoparticles. Biochem Eng J 2017. [DOI: 10.1016/j.bej.2016.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
31
|
Lee ZM, Huang YH, Ho SC, Kuo HC. Correlation of symptomatic enterovirus infection and later risk of allergic diseases via a population-based cohort study. Medicine (Baltimore) 2017; 96:e5827. [PMID: 28121929 PMCID: PMC5287953 DOI: 10.1097/md.0000000000005827] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Infants who are exposed to the rhinovirus or respiratory syncytial virus are at a higher risk of subsequently developing wheezing or asthma. This study aims to determine whether preschoolers with a history of symptomatic enterovirus infection are at an increased risk of developing allergic diseases or not.We used data from the Taiwan National Health Insurance Research Database from 1999 to 2006 for this nationwide population-based cohort study. The subsequent risks for allergic diseases, which included asthma (International Classification of Diseases [ICD]-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477.X), and atopic dermatitis (AD; ICD-9-CM code 691.X), were compared between herpangina (ICD-9: 074.0) and hand, foot, and mouth disease (HFMD; ICD-9: 074.3) throughout the follow-up period using the Cox proportional hazards model.In this database, 12,016 neonates were born between January 1999 and December 1999. Among them, we further evaluated 8337 subjects; 3267 children infected with either herpangina or HFMD served as the study cohort, and the other 5070 children made up the comparison cohort. Children in the herpangina group had a higher risk of developing AR and AD, with adjusted hazard ratios of 1.15 (1.02-1.30, 95% CI) and 1.38 (1.17-1.63. 95% CI), respectively, while children suffered from HFMD had decreased risks of asthma, with an adjusted hazard ratio of 0.76 (0.63-0.93, 95% CI).Children who previously suffered from herpangina experienced an increased risk of subsequently developing AD and AR. Meanwhile, children who had suffered from HFMD experienced a decrease in the subsequent occurrence of asthma compared to the general population.
Collapse
Affiliation(s)
- Zon-Min Lee
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Ying-Hsien Huang
- Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan
| | - Shu-Chen Ho
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan
| |
Collapse
|
32
|
Abstract
In recent decades, probiotics have shown beneficial effects on animal and human health. Probiotics can protect the host against several health threats, including infectious diseases. Before 1995, researchers believed that the effect of probiotics was only on gut microbiota which can restore the gut flora and thus prevent pathogenic bacteria from triggering gastroenteritis. Recent studies have shown that the immunomodulatory activity is the most important mechanism of action of probiotics. From this information, researchers started to evaluate the effect of some immunobiotics, not only on pathogenic bacteria but also on viruses, including enteric and respiratory viruses. Several studies have confirmed the potential antiviral activity of some probiotics due to the immunomodulatory effect. These studies were conducted on humans (clinical trials) and in animal models. In this chapter, probiotics with antiviral effect against respiratory and enteric viruses will be presented and discussed, as well as their mechanisms of action.
Collapse
|
33
|
Development of a fluorescence resonance energy transfer-based intracellular assay to identify novel enterovirus 71 antivirals. Arch Virol 2016; 162:713-720. [PMID: 27873071 DOI: 10.1007/s00705-016-3143-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/30/2016] [Indexed: 10/20/2022]
Abstract
Enterovirus 71 (EV71) is considered one of the most virulent pathogens in the family Picornaviridae. However, there have been no effective treatments for the severe complications caused by EV71. Development of new drugs against targets that are essential for viral replication often requires screening large collections of compounds, for which a high-throughput screening platform is needed. In this study, a drug-screening platform was developed based on a genetically engineered cell line that displays fluorescence resonance energy transfer (FRET) and shows a real-time and quantifiable impairment of FRET upon EV71 infection. A library of small molecules consisting of 1280 compounds with defined bioactivities was used for screening drugs with anti-EV71 activity; accurate, rapid, and robust results were obtained from this screening procedure. Ten drugs were identified in the primary screening, and their antiviral activities were indicated by dose-dependent elevation of FRET. Among these, AC-93253, mitoxantrone and N-bromoacetamide had not been reported as enterovirus inhibitors, and it was confirmed that they were able to suppress viral yields in a dose-dependent manner. Taken together, these studies demonstrate the feasibility of this FRET-based platform for efficient screening and identification of novel compounds with activity against EV71 infection.
Collapse
|
34
|
Zeng H, Wen F, Huang W, Gan Y, Zeng W, Chen R, He Y, Wang Y, Liu Z, Liang C, Wong KKL. New Findings, Classification and Long-Term Follow-Up Study Based on MRI Characterization of Brainstem Encephalitis Induced by Enterovirus 71. PLoS One 2016; 11:e0162877. [PMID: 27798639 PMCID: PMC5087960 DOI: 10.1371/journal.pone.0162877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 08/30/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To report the diversity of MRI features of brainstem encephalitis (BE) induced by Enterovirus 71. This is supported by implementation and testing of our new classification scheme in order to improve the diagnostic level on this specific disease. METHODS Neuroimaging of 91 pediatric patients who got EV71 related BE were hospitalized between March, 2010 to October, 2012, were analyzed retrospectively. All patients underwent pre- and post-contrast MRI scan. Thereafter, 31 patients were randomly called back for follow-up MRI study during December 2013 to August 2014. The MRI signal patterns of BE primary lesion were analyzed and classified according to MR signal alteration at various disease stages. Findings in fatal and non-fatal cases were compared, and according to the MRI scan time point during the course of this disease, the patients' conditions were classified as 1) acute stage, 2) convalescence stage, 3) post mortem stage, and 4) long term follow-up study. RESULTS 103 patients were identified. 11 patients did not undergo MRI, as they died within 48 hours. One patient died on 14th day without MR imaging. 2 patients had postmortem MRI. Medical records and imaging were reviewed in the 91 patients, aged 4 months to 12 years, and two cadavers who have had MRI scan. At acute stage: the most frequent pattern (40 patients) was foci of prolonged T1 and T2 signal, with (15) or without (25) contrast enhancement. We observed a novel pattern in 4 patients having foci of low signal intensity on T2WI, with contrast enhancement. Another pattern in 10 patients having foci of contrast enhancement without abnormalities in T1WI or T2WI weighted images. Based on 2 cases, the entire medulla and pons had prolonged T1 and T2 signal, and 2 of our postmortem cases demonstrated the same pattern. At convalescence stage, the pattern observed in 4 patients was foci of prolonged T1 and T2 signal without contrast enhancement. Follow-up MR study of 31 cases showed normal in 26 cases, and demonstrated foci of prolonged T1 and T2 signal with hyper-intensity on FLAIR in 3 cases, or of prolonged T1 and T2 signal with hypo-intensity on FLAIR in 2 cases. Most importantly, MR findings of each case were thoroughly investigated and classified according to phases and MRI signal alteration. CONCLUSIONS This study has provided enhanced and useful information for the MRI features of BE induced by EV71, apart from common practice established by previous reports. In addition, a classification scheme that summarizes all types of features based on the MRI signal at the four different stages of the disease would be helpful to improve the diagnostic level.
Collapse
Affiliation(s)
- Hongwu Zeng
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
- Department of Radiology, Guangdong General Hospital, Guangdong, China
- School of Medicine, Southern Medical University, Guangdong, China
| | - Feiqiu Wen
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
| | - Wenxian Huang
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
| | - Yungen Gan
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
| | - Weibin Zeng
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
| | - Ranran Chen
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
| | - Yanxia He
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children’s Hospital, Guangdong, China
| | - Yonker Wang
- Department of Radiology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Zaiyi Liu
- Department of Radiology, Guangdong General Hospital, Guangdong, China
| | - Changhong Liang
- Department of Radiology, Guangdong General Hospital, Guangdong, China
- School of Medicine, Southern Medical University, Guangdong, China
- * E-mail:
| | - Kelvin K. L. Wong
- School of Medicine, Western Sydney University, New South Wales, Australia
| |
Collapse
|
35
|
Lee KY. Enterovirus 71 infection and neurological complications. KOREAN JOURNAL OF PEDIATRICS 2016; 59:395-401. [PMID: 27826325 PMCID: PMC5099286 DOI: 10.3345/kjp.2016.59.10.395] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 10/14/2015] [Accepted: 10/14/2015] [Indexed: 11/27/2022]
Abstract
Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children, and usually resolves spontaneously. However, EV71 occasionally involves the central nervous system (CNS), and induces diverse neurological complications such as brainstem encephalitis, aseptic meningitis, and acute flaccid paralysis. Among those complications, brainstem encephalitis is the most critical neurological manifestation because it can cause neurogenic pulmonary hemorrhage/edema leading to death. The characteristic clinical symptoms such as myoclonus and ataxia, cerebrospinal fluid (CSF) pleocytosis, and brainstem lesions on magnetic resonance imaging, in conjunction with the skin rash of HFMD and the isolation of EV71 from a stool, throat-swab, or CSF sample are typical findings indicating CNS involvement of EV71 infection. Treatment with intravenous immunoglobulin and milrinone are recommended in cases with severe neurological complications from EV71 infection, such as brainstem encephalitis. Despite the recent discovery of receptors for EV71 in human cells, such as the scavenger receptor B2 and P-selection glycoprotein ligand 1, it is not known why EV71 infection predominantly involves the brainstem. Recently, 3 companies in China have completed phase III clinical trials of EV71 vaccines. However, the promotion and approval of these vaccines in various countries are problems yet to be resolved.
Collapse
Affiliation(s)
- Kyung Yeon Lee
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| |
Collapse
|
36
|
Horwood PF, Andronico A, Tarantola A, Salje H, Duong V, Mey C, Ly S, Dussart P, Cauchemez S, Buchy P. Seroepidemiology of Human Enterovirus 71 Infection among Children, Cambodia. Emerg Infect Dis 2016; 22:92-5. [PMID: 26690000 PMCID: PMC4696711 DOI: 10.3201/eid2201.151323] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Enterovirus 71 is reported to have emerged in Cambodia in 2012; at least 54 children with severe encephalitis died during that outbreak. We used serum samples collected during 2000–2011 to show that the virus had been widespread in the country for at least a decade before the 2012 outbreak.
Collapse
|
37
|
Xie BY, Xu C, Xiong Q, Zhu M, Duan H, Wang YY, Zhang H, Ni XF, Wang LH, Li XW, Shen T, Peng YH. Gene sequencing and variable site analyzing of coding region of two enterovirus A71 isolates with different clinical phenotypes. INFECTION GENETICS AND EVOLUTION 2016; 45:83-89. [PMID: 27566335 DOI: 10.1016/j.meegid.2016.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/08/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022]
Abstract
Currently, it is still controversial that if the pathogenicity of EV-A71 causing severe or mild hand, foot, and mouth disease (HFMD) is associated with viral nucleotide or amino acid sequence(s). In this study, 19 clinical strains were detected in samples from diagnosed patients of EV-A71-caused HFMD with mild or severe symptoms. Then, VP1-2A fragment sequences of 19 EV-A71 isolates were determined, the phylogenetic analysis, based on VP1 sequences of 19 EV-A71 stains in this study and which of 62 EV-A71 strains with different clinical phenotypes reported before, were carried out. Our results showed that no difference in the genotype and evolution distribution was observed among the EV-A71 strains mentioned above. Furthermore, two EV-A71 isolates, which with much close evolutionary relationship but different clinical manifestations, were purified by plaque assay, the complete genome sequencing was done, and deduced amino acid sequence analysis of 11 proteins coded by EV-A71 was carried out. Eight variable amino acid sites were found and further verified with those of 62 strains reported before. Our study provides further evidence that the potential pathogenicity of EV-A71 causing severe or mild HFMD seems not to be associated with viral genotype and even the amino acid substitution.
Collapse
Affiliation(s)
- Bing-Yu Xie
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Chao Xu
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Qing Xiong
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Meng Zhu
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Hao Duan
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Yu-Ya Wang
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Hao Zhang
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Xue-Fei Ni
- Infectious Disease Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China
| | - Ling-Hang Wang
- Infectious Disease Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China
| | - Xing-Wang Li
- Infectious Disease Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China
| | - Tao Shen
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Yi-Hong Peng
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China.
| |
Collapse
|
38
|
Cabrerizo M, Díaz-Cerio M, Muñoz-Almagro C, Rabella N, Tarragó D, Romero MP, Pena MJ, Calvo C, Rey-Cao S, Moreno-Docón A, Martínez-Rienda I, Otero A, Trallero G. Molecular epidemiology of enterovirus and parechovirus infections according to patient age over a 4-year period in Spain. J Med Virol 2016; 89:435-442. [PMID: 27505281 DOI: 10.1002/jmv.24658] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 12/28/2022]
Abstract
The epidemiology and clinical association of enterovirus (EV) and parechovirus (HPeV) infections, as well as the type-distribution-according-to-age, were determined during a 4-year study period in Spain. During 2010-2013, a total of 21,832 clinical samples were screened for EV and the detection frequency was 6.5% (1,430). Of the total EV-negative samples, only 1,873 samples from 2011 to 2013 were available for HPeV testing. HPeV was detected in 42 (2%) of them. Positive samples were genotyped using PCR and sequencing. EV infections occurred in all age groups of patients: neonates (17%), children 28 days to 2 years (29%), children 2-14 years (40%), and adults (14%). Thirty-four different EV types were identified. HPeV infections were detected exclusively in infants <8 m (70% neonates, P < 0.05). All but one HPeV were HPeV-3. Differences in type frequency detection were found according to age and clinical manifestation. Coxsackievirus (CV)-B4 (61%), CV-B5 (83%), and HPeV-3 (64%) were more frequent in neonates than in older patients (P < 0.05). Echovirus (E)-3 (60%), E-18 (47%), E-25 (62%), CV-A6 (61%), CV-A16 (72%), and EV-71 (75%) were mainly detected in children 28 days to 2 years (P < 0.05), whereas, E-6 (79%), E-20 (88%), and E-30 (85%) were predominant in children >2 years and adults (P < 0.05). Clinically, meningitis was associated with EV (P < 0.01) whereas, encephalitis was more frequent in HPeV-infected patients. CV-B types were associated with myocarditis (90%; P < 0.05) and EV species A with hand-foot-mouth-disease/atypical exanthema (88%; P < 0.05). J. Med. Virol. 89:435-442, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- María Cabrerizo
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - María Díaz-Cerio
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - David Tarragó
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - María José Pena
- Hospital Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | - Almudena Otero
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Gloria Trallero
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
39
|
Ang LYE, Too HKI, Tan EL, Chow TKV, Shek LPC, Tham EH, Alonso S. Antiviral activity of Lactobacillus reuteri Protectis against Coxsackievirus A and Enterovirus 71 infection in human skeletal muscle and colon cell lines. Virol J 2016; 13:111. [PMID: 27341804 PMCID: PMC4920999 DOI: 10.1186/s12985-016-0567-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/20/2016] [Indexed: 12/31/2022] Open
Abstract
Background Recurrence of hand, foot and mouth disease (HFMD) pandemics continues to threaten public health. Despite increasing awareness and efforts, effective vaccine and drug treatment have yet to be available. Probiotics have gained recognition in the field of healthcare worldwide, and have been extensively prescribed to babies and young children to relieve gastrointestinal (GI) disturbances and diseases, associated or not with microbial infections. Since the faecal-oral axis represents the major route of HFMD transmission, transient persistence of probiotic bacteria in the GI tract may confer some protection against HFMD and limit transmission among children. Methods In this work, the antiviral activity of two commercially available probiotics, namely Lactobacillus reuteri Protectis (L. reuteri Protectis) and Lactobacillus casei Shirota (L. casei Shirota), was assayed against Coxsackieviruses and Enterovirus 71 (EV71), the main agents responsible for HFMD. In vitro infection set-ups using human skeletal muscle and colon cell lines were designed to assess the antiviral effect of the probiotic bacteria during entry and post-entry steps of the infection cycle. Results Our findings indicate that L. reuteri Protectis displays a significant dose-dependent antiviral activity against Coxsackievirus type A (CA) strain 6 (CA6), CA16 and EV71, but not against Coxsackievirus type B strain 2. Our data support that the antiviral effect is likely achieved through direct physical interaction between bacteria and virus particles, which impairs virus entry into its mammalian host cell. In contrast, no significant antiviral effect was observed with L. casei Shirota. Conclusions Should the antiviral activity of L. reuteri Protectis observed in vitro be translated in vivo, such probiotics-based therapeutic approach may have the potential to address the urgent need for a safe and effective means to protect against HFMD and limit its transmission among children.
Collapse
Affiliation(s)
- Lei Yin Emily Ang
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Centre for Life Sciences, 28 Medical Drive, #03-05, Singapore, 117456, Singapore.,Immunology programme, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Horng Khit Issac Too
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Centre for Life Sciences, 28 Medical Drive, #03-05, Singapore, 117456, Singapore.,Immunology programme, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Eng Lee Tan
- Department of Paediatrics, National University Hospital, Singapore, Singapore.,Centre for Biomedical & Life Sciences, Singapore Polytechnic, Singapore, Singapore
| | - Tak-Kwong Vincent Chow
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Centre for Life Sciences, 28 Medical Drive, #03-05, Singapore, 117456, Singapore
| | | | | | - Sylvie Alonso
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Centre for Life Sciences, 28 Medical Drive, #03-05, Singapore, 117456, Singapore. .,Immunology programme, Life Sciences Institute, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
40
|
Interleukin-27 as a Novel Biomarker for Early Cardiopulmonary Failure in Enterovirus 71-Infected Children with Central Nervous System Involvement. Mediators Inflamm 2016; 2016:4025167. [PMID: 27403033 PMCID: PMC4925946 DOI: 10.1155/2016/4025167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/19/2016] [Indexed: 11/18/2022] Open
Abstract
Enterovirus 71 (EV71) is a major pathogen for severe hand, foot, and mouth disease (HFMD), which leads to severe neurological complications and has high morbidity and mortality. Reliable biomarker for the prediction of deterioration in EV71-infected children with central nervous system (CNS) involvement may reduce the cardiopulmonary failure and mortality. Here, we found that serum IL-27 levels were significantly higher in stage III EV71-infected HFMD patients with early cardiopulmonary failure and strong correlation with CRP levels. IL27p28 polymorphisms (rs153109, rs17855750, and rs181206) did not influence IL-27 production, and these three SNPs were not associated with EV71 infection risk and clinical stage. IL-27 can be used as an prediction indicator for early cardiopulmonary failure in EV71-infected children with CNS involvement.
Collapse
|
41
|
Zhou Y, Li JX, Jin PF, Wang YX, Zhu FC. Enterovirus 71: a whole virion inactivated enterovirus 71 vaccine. Expert Rev Vaccines 2016; 15:803-13. [PMID: 27206811 DOI: 10.1080/14760584.2016.1191357] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Enterovirus A71 (EV71) is the predominant causative agent of hand, foot, and mouth disease (HFMD), which is often associated with severe cases and even deaths. EV71-associated epidemics have emerged as a serious threat to public health, particularly in the Asia-Pacific region. AREAS COVERED We searched PubMed using the terms 'enterovirus 71', 'hand, foot, and mouth disease', and 'vaccine', with no date or language restrictions for all publications before April 27, 2016. Among various vaccine candidates, the alum-adjuvant inactivated EV71 vaccines are most promising. Three alum-adjuvant inactivated EV71 vaccines developed by mainland China showed high efficacy, good immunogenicity persistence and acceptable safety profiles in clinical trials. Recently, two of these EV71 vaccines have been approved for marketing in China and the other one is undergoing the review process of licensure. In this manuscript, we summarized previous study results as well as discussed the regulatory affairs and post-market surveillances issues. Expert commentary: The marketing of EV71 vaccines is a milestone in the controlling of HFMD. International clinical trials are needed to further assess the efficacy and cross-immunogenicity. Establishing a sensitive pathogen monitoring system would be essential to monitor the variation of genotypes and control HFMD epidemics.
Collapse
Affiliation(s)
- Yang Zhou
- a School of Public Health , Southeast University , Nanjing , PR China
| | - Jing-Xin Li
- b Department of Vaccine Clinical Evaluation , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , PR China.,c College of Pharmacy , Third Military Medical University & National Engineering Research Center for Immunological Products , Chongqing , PR China
| | - Peng-Fei Jin
- d School of Public Health , Nanjing Medical University , Nanjing , PR China
| | - Yu-Xiao Wang
- a School of Public Health , Southeast University , Nanjing , PR China
| | - Feng-Cai Zhu
- b Department of Vaccine Clinical Evaluation , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , PR China
| |
Collapse
|
42
|
Li J, Sun Y, Du Y, Yan Y, Huo D, Liu Y, Peng X, Yang Y, Liu F, Lin C, Liang Z, Jia L, Chen L, Wang Q, He Y. Characterization of Coxsackievirus A6- and Enterovirus 71-Associated Hand Foot and Mouth Disease in Beijing, China, from 2013 to 2015. Front Microbiol 2016; 7:391. [PMID: 27065963 PMCID: PMC4812011 DOI: 10.3389/fmicb.2016.00391] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/11/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Etiology surveillance of Hand Foot and Mouth disease (HFMD) in Beijing showed that Coxsackievirus A6 (CVA6) became the major pathogen of HFMD in 2013 and 2015. In order to understand the epidemiological characteristics and clinical manifestations of CVA6-associated HFMD, a comparison study among CVA6-, EV71- (Enterovirus 71), and CVA16- (Coxsackievirus A16) associated HFMD was performed. METHODS Epidemiological characteristics and clinical manifestations among CVA6-, EV71- and CVA16-associated mild or severe cases were compared from 2013 to 2015. VP1 gene of CVA6 and EV71 from mild cases, severe cases were sequenced, aligned, and compared with strains from 2009 to 2015 in Beijing and strains available in GenBank. Phylogenetic tree was constructed by neighbor-joining method. RESULTS CVA6 became the predominant causative agent of HFMD and accounted for 35.4 and 36.9% of total positive cases in 2013 and 2015, respectively. From 2013 to 2015, a total of 305 severe cases and 7 fatal cases were reported. CVA6 and EV71 were responsible for 57.5% of the severe cases. Five out six samples from fatal cases were identified as EV71. High fever, onychomadesis, and decrustation were the typical symptoms of CVA6-associated mild HFMD. CVA6-associated severe cases were characterized by high fever with shorter duration and twitch compared with EV71-associated severe cases which were characterized by poor mental condition, abnormal pupil, and vomiting. Poor mental condition, lung wet rales, abnormal pupil, and tachycardia were the most common clinical features of fatal cases. The percentage of lymphocyte in CVA6-associated cases was significantly lower than that of EV71. High percentage of lymphocyte and low percentage of neutrophils were the typical characteristics of fatal cases. VP1 sequences between CVA6- or EV71-associated mild and severe cases were highly homologous. CONCLUSION CVA6 became one of the major pathogens of HFMD in 2013 and 2015 in Beijing. Epidemiological characteristics, clinical manifestations of CVA6-, EV71- and CVA16-associated cases in this study enriched the definition of HFMD caused by different pathogens and shed light to accurate diagnosis, appropriate treatment and effective prevention of HFMD.
Collapse
Affiliation(s)
- Jie Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical UniversityBeijing, China; Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease ControlBeijing, China
| | - Ying Sun
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Yiwei Du
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Yuxiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University Beijing, China
| | - Da Huo
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Yuan Liu
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Xiaoxia Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University Beijing, China
| | - Yang Yang
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Fen Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University Beijing, China
| | - Changying Lin
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Zhichao Liang
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Lei Jia
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Lijuan Chen
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Yan He
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University Beijing, China
| |
Collapse
|
43
|
Wang SM. Milrinone in Enterovirus 71 Brain Stem Encephalitis. Front Pharmacol 2016; 7:82. [PMID: 27065870 PMCID: PMC4809901 DOI: 10.3389/fphar.2016.00082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 03/14/2016] [Indexed: 12/31/2022] Open
Abstract
Enterovirus 71 (EV71) was implicated in a widespread outbreak of hand-foot-and-mouth disease (HFMD) across the Asia Pacific area since 1997 and has also been reported sporadically in patients with brain stem encephalitis. Neurogenic shock with pulmonary edema (PE) is a fatal complication of EV71 infection. Among inotropic agents, milrinone is selected as a therapeutic agent for EV71- induced PE due to its immunopathogenesis. Milrinone is a type III phosphodiesterase inhibitor that has both inotropic and vasodilator effects. Its clinical efficacy has been shown by modulating inflammation, reducing sympathetic over-activity, and improving survival in patients with EV71-associated PE. Milrinone exhibits immunoregulatory and anti-inflammatory effects in the management of systemic inflammatory responses in severe EV71 infection.
Collapse
Affiliation(s)
- Shih-Min Wang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung UniversityTainan, Taiwan
| |
Collapse
|
44
|
Zeng H, Huang W, Wen F, Wang Y, Gan Y, Zeng W, Chen R, He Y, Liu Z, Liang C, Wong KKL. MRI signal intensity differentiation of brainstem encephalitis induced by Enterovirus 71: a classification approach for acute and convalescence stages. Biomed Eng Online 2016; 15:25. [PMID: 26917424 PMCID: PMC4766649 DOI: 10.1186/s12938-016-0136-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study is to assess standardized histograms of signal intensities of T1 signal and T2 signal on sagittal view without enhancement during (1) acute stage, and (2) convalescence stage of pediatric patients with Enterovirus 71 related brainstem encephalitis (BE), and with respect to (3) healthy normal. Methods Our subjects were hospitalized between March 2010 and October 2012, and underwent pre- and post-contrast MRI studies. The research question to be answered is whether the comparison of the MRI image intensity histograms and relevant statistical quantification can add new knowledge to the diagnosis of BE patients. So, both 25 cases in acute stage with prolonged T1 and T2 signal, without enhancement, and 13 cases in convalescence stage were introduced. In additional, a healthy group with 25 cases was recruited for comparison. Results MRI signal intensity histogram changes of the lesions were compared at the acute and convalescence stages of the disease. Our preliminary results suggest that standardized histograms of signal intensities and their statistical properties are able to provide diagnostic information for the clinical assessment of the disease. Different stages pertaining to the histogram plots comparison showed that overall T1 signal intensity values increase as we traverse from the acute stage to the convalescence stage. And then for the healthy subjects, the T2 signal intensity values changed their magnitudes in a reverse direction. However, exceptions of this can happen in four cases where the primary lesions occurred in the brainstem that developed encephalomalacia resulting in a lower signal in T1WI and higher signal in T2WI. Statistical analysis revealed there was significant difference of T1 signal intensity among the three groups; and also, the T2 signal intensity was lower than other two groups. Conclusions Standardized histogram of T1 and T2 intensity provide valuable and useful information for disease diagnosis and evaluation, which can potentially help medical doctors to save the lives of children. Electronic supplementary material The online version of this article (doi:10.1186/s12938-016-0136-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hongwu Zeng
- School of Medicine, Southern Medical University, Zhongshan Er Road No. 106, 510080, Guangzhou City, Guangdong Province, People's Republic of China. .,Department of Radiology, Guangdong General Hospital, Guangdong, People's Republic of China. .,Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Wenxian Huang
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Feiqiu Wen
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Yonker Wang
- Department of Radiology, College of Medicine, University of Kentucky, Lexington, KY, USA.
| | - Yungen Gan
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Weibin Zeng
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Ranran Chen
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Yanxia He
- Radiology, Neurology and Pediatric Intensive Care Unit Department, Shenzhen Children's Hospital, Guangdong, People's Republic of China.
| | - Zaiyi Liu
- Department of Radiology, Guangdong General Hospital, Guangdong, People's Republic of China.
| | - Changhong Liang
- School of Medicine, Southern Medical University, Zhongshan Er Road No. 106, 510080, Guangzhou City, Guangdong Province, People's Republic of China. .,Department of Radiology, Guangdong General Hospital, Guangdong, People's Republic of China.
| | - Kelvin K L Wong
- School of Medicine, Western Sydney University, Locked Bag 1797 Penrith, Campbelltown, NSW, 2751, Australia.
| |
Collapse
|
45
|
Jin P, Li J, Zhang X, Meng F, Zhou Y, Yao X, Gan Z, Zhu F. Validation and evaluation of serological correlates of protection for inactivated enterovirus 71 vaccine in children aged 6-35 months. Hum Vaccin Immunother 2016; 12:916-21. [PMID: 26751765 DOI: 10.1080/21645515.2015.1118595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND A primary goal of this study was to establish the serological mechanistic correlate of protection (mCoP) for an inactivated Enterovirus 71 (EV71) vaccine. METHODS We used the Prentice criterion framework and scaled logit model to explore the relationship between the neutralizing antibody (NTAb) and EV71-associated disease, and to build a protection curve for estimating the efficacy of EV71 vaccine. Data of NTAb at day 56 post-vaccination and the occurrence of EV71-associated disease during a 12-month follow-up period were collected from a phase 3 efficacy trial of EV71 vaccine in this study. RESULTS NTAb at day 56 post-vaccination in participants met the Prentice criterion framework. According to the protection curve, the antibody levels of 14.7, 27.8, 55.7, 129.0 and 459.4 (U/mL) were associated with 50%, 60%, 70%, 80% and 90% clinical protection rate, respectively. Vaccine efficacy predicted by the model was 81.5%, which was very similar to the actual vaccine efficacy of 80.4% (95% CI, 58.2, 90.8) observed in the phase 3 trial. CONCLUSIONS NTAb titers post-vaccination can be validated as mCoP for evaluating the efficacy of an inactivated enterovirus 71 vaccine, with a titers of 14.7 (U/ml) as a surrogate associated with the protection of 50% against EV71-associated disease.
Collapse
Affiliation(s)
- Pengfei Jin
- a Department of Epidemiology and Biostatistics , School of Public Health, Nanjing Medical University , Nanjing , China
| | - Jingxin Li
- b Jiangsu Province Center for Disease Control and Prevention , Nanjing , China.,c College of Pharmacy, Third Military Medical University & National Engineering Research Center for Immunological Products , Chongqing , China
| | - Xuefeng Zhang
- b Jiangsu Province Center for Disease Control and Prevention , Nanjing , China
| | - Fangyue Meng
- b Jiangsu Province Center for Disease Control and Prevention , Nanjing , China
| | - Yang Zhou
- d School of Public Health, Southeast University , Nanjing , China
| | - Xuejun Yao
- a Department of Epidemiology and Biostatistics , School of Public Health, Nanjing Medical University , Nanjing , China
| | - Zhengkai Gan
- d School of Public Health, Southeast University , Nanjing , China
| | - Fengcai Zhu
- a Department of Epidemiology and Biostatistics , School of Public Health, Nanjing Medical University , Nanjing , China.,b Jiangsu Province Center for Disease Control and Prevention , Nanjing , China
| |
Collapse
|
46
|
Song J, Hu Y, Hu Y, Wang J, Zhang X, Wang L, Guo L, Wang Y, Ning R, Liao Y, Zhang Y, Zheng H, Shi H, He Z, Li Q, Liu L. Global gene expression analysis of peripheral blood mononuclear cells in rhesus monkey infants with CA16 infection-induced HFMD. Virus Res 2016; 214:1-10. [PMID: 26775814 DOI: 10.1016/j.virusres.2016.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/05/2016] [Accepted: 01/05/2016] [Indexed: 11/26/2022]
Abstract
Coxsackievirus A16 (CA16) is a dominant pathogen that results in hand, foot, and mouth disease and causes outbreaks worldwide, particularly in the Asia-Pacific region. However, the underlying molecular mechanisms remain unclear. Our previous study has demonstrated that the basic CA16 pathogenic process was successfully mimicked in rhesus monkey infant. The present study focused on the global gene expression changes in peripheral blood mononuclear cells of rhesus monkey infants with hand, foot, and mouth disease induced by CA16 infection at different time points. Genome-wide expression analysis was performed with Agilent whole-genome microarrays and established bioinformatics tools. Nine hundred and forty-eight significant differentially expressed genes that were associated with 5 gene ontology categories, including cell communication, cell cycle, immune system process, regulation of transcription and metabolic process were identified. Subsequently, the mapping of genes related to the immune system process by PANTHER pathway analysis revealed the predominance of inflammation mediated by chemokine and cytokine signaling pathways and the interleukin signaling pathway. Ultimately, co-expressed genes and their networks were analyzed. The results revealed the gene expression profile of the immune system in response to CA16 in rhesus monkey infants and suggested that such an immune response was generated as a result of the positive mobilization of the immune system. This initial microarray study will provide insights into the molecular mechanism of CA16 infection and will facilitate the identification of biomarkers for the evaluation of vaccines against this virus.
Collapse
Affiliation(s)
- Jie Song
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Yajie Hu
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Yunguang Hu
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Jingjing Wang
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Xiaolong Zhang
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Lichun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Lei Guo
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Yancui Wang
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Ruotong Ning
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Yun Liao
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Ying Zhang
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Huiwen Zheng
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Haijing Shi
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Zhanlong He
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China
| | - Qihan Li
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China.
| | - Longding Liu
- Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, 650118, China.
| |
Collapse
|
47
|
Norepinephrine and Epinephrine Enhanced the Infectivity of Enterovirus 71. PLoS One 2015; 10:e0135154. [PMID: 26252639 PMCID: PMC4529162 DOI: 10.1371/journal.pone.0135154] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 07/19/2015] [Indexed: 11/19/2022] Open
Abstract
Background Enterovirus 71 (EV71) infections may be associated with neurological complications, including brainstem encephalitis (BE). Severe EV71 BE may be complicated with autonomic nervous system (ANS) dysregulation and/or pulmonary edema (PE). ANS dysregulation is related to the overactivation of the sympathetic nervous system, which results from catecholamine release. Objective The aims of this study were to explore the effects of catecholamines on severe EV71 infection and to investigate the changes in the percentages of EV71-infected cells, virus titer, and cytokine production on the involvement of catecholamines. Study Design Plasma levels of norepinephrine (NE) and epinephrine (EP) in EV71-infected patients were measured using an enzyme-linked immunoassay. The expression of adrenergic receptors (ADRs) on RD, A549, SK-N-SH, THP-1, Jurkat and human peripheral blood mononuclear cells (hPBMCs) were detected using flow cytometry. The percentages of EV71-infected cells, virus titer, and cytokine production were investigated after treatment with NE and EP. Results The plasma levels of NE and EP were significantly higher in EV71-infected patients with ANS dysregulation and PE than in controls. Both α1A- and β2-ADRs were expressed on A549, RD, SK-N-SH, HL-60, THP-1, Jurkat cells and hPBMCs. NE treatment elevated the percentages of EV71-infected cells to 62.9% and 22.7% in THP-1 and Jurkat cells, respectively. Via treatment with EP, the percentages of EV71-infected cells were increased to 64.6% and 26.9% in THP-1 and Jurkat cells. The percentage of EV71-infected cells increased upon NE or EP treatment while the α- and β-blockers reduced the percentages of EV71-infected cells with NE or EP treatment. At least two-fold increase in virus titer was observed in EV71-infected A549, SK-N-SH and hPBMCs after treatment with NE or EP. IL-6 production was enhanced in EV71-infected hPBMCs at a concentration of 102 pg/mL NE. Conclusion The plasma levels of NE and EP elevated in EV71-infected patients with ANS dysregulation and PE. Both NE and EP enhanced the percentages of infected cells and virus titers in EV71 infection in vitro. NE and EP may play a role in the pathogenesis of EV71 BE complicated with ANS dysregulation and PE.
Collapse
|
48
|
Chung YC, Hsieh FC, Lin YJ, Wu TY, Lin CW, Lin CT, Tang NY, Jinn TR. Magnesium lithospermate B and rosmarinic acid, two compounds present in Salvia miltiorrhiza, have potent antiviral activity against enterovirus 71 infections. Eur J Pharmacol 2015; 755:127-33. [PMID: 25773498 DOI: 10.1016/j.ejphar.2015.02.046] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 02/23/2015] [Accepted: 02/26/2015] [Indexed: 12/15/2022]
Abstract
The aim of this study was to identify the active ingredients responsible for the anti-EV71 activity produced by Salvia miltiorrhiza extracts. A pGS-EV71 IRES-based bicistronic reporter assay platform was used for rapid analysis of compounds that could specifically inhibit EV71 viral IRES-mediated translation. The analysis identified 2 caffeic acid derivatives, magnesium lithospermate B (MLB) and rosmarinic acid (RA), which suppressed EV71 IRES-mediated translation at concentrations of 30μg/ml. We also found that MLB and RA inhibited EV71 infection when they were added to RD cells during the viral absorption stage. MLB had a low IC50 value of 0.09mM and a high TI value of 10.52. In contrast, RA had an IC50 value of 0.50mM with a TI value of 2.97. MLB and RA (100µg/ml) also reduced EV71 viral particle production and significantly decreased VP1 protein production. We propose that these two derivatives inhibit EV71 viral entry into cells and viral IRES activity, thereby reducing viral particle production and viral RNA expression and blocking viral VP1 protein translation. This study provides useful information for the development of anti-EV71 assays and reagents by demonstrating a convenient EV71 IRES-based bicistronic assay platform to screen for anti-EV71 IRES activity, and also reports 2 compounds, MLB and RA, which are responsible for the anti-EV71 activity of S. miltiorrhiza.
Collapse
Affiliation(s)
- Yi-Ching Chung
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, ROC
| | - Feng-Chia Hsieh
- Biopesticide Department, Agricultural Chemicals and Toxic Substances Research Institute, Taichung 41300, Taiwan, ROC
| | - Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, ROC
| | - Tzong-Yuan Wu
- Department of Science Technology, Chung Yuan Christian University, Chung Li 32023, Taiwan, ROC
| | - Cheng-Wen Lin
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung 40402, Taiwan, ROC
| | - Ching-Ting Lin
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, ROC
| | - Nou-Ying Tang
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, ROC
| | - Tzyy-Rong Jinn
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, ROC.
| |
Collapse
|
49
|
Zhu M, Duan H, Gao M, Zhang H, Peng Y. Both ERK1 and ERK2 are required for enterovirus 71 (EV71) efficient replication. Viruses 2015; 7:1344-56. [PMID: 25803100 PMCID: PMC4379574 DOI: 10.3390/v7031344] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/12/2015] [Accepted: 03/17/2015] [Indexed: 12/16/2022] Open
Abstract
It has been demonstrated that MEK1, one of the two MEK isoforms in Raf-MEK-ERK1/2 pathway, is essential for successful EV71 propagation. However, the distinct function of ERK1 and ERK2 isoforms, the downstream kinases of MEKs, remains unclear in EV71 replication. In this study, specific ERK siRNAs and selective inhibitor U0126 were applied. Silencing specific ERK did not significantly impact on the EV71-caused biphasic activation of the other ERK isoform, suggesting the EV71-induced activations of ERK1 and ERK2 were non-discriminative and independent to one another. Knockdown of either ERK1 or ERK2 markedly impaired progeny EV71 propagation (both by more than 90%), progeny viral RNA amplification (either by about 30% to 40%) and protein synthesis (both by around 70%), indicating both ERK1 and ERK2 were critical and not interchangeable to EV71 propagation. Moreover, suppression of EV71 replication by inhibiting both early and late phases of ERK1/2 activation showed no significant difference from that of only blocking the late phase, supporting the late phase activation was more importantly responsible for EV71 life cycle. Taken together, this study for the first time identified both ERK1 and ERK2 were required for EV71 efficient replication and further verified the important role of MEK1-ERK1/2 in EV71 replication.
Collapse
Affiliation(s)
- Meng Zhu
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Hao Duan
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Meng Gao
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Hao Zhang
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yihong Peng
- Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| |
Collapse
|
50
|
Wang SM, Chen IC, Liao YT, Liu CC. The clinical correlation of regulatory T cells and cyclic adenosine monophosphate in enterovirus 71 infection. PLoS One 2014; 9:e102025. [PMID: 25010330 PMCID: PMC4092122 DOI: 10.1371/journal.pone.0102025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/13/2014] [Indexed: 11/23/2022] Open
Abstract
Background Brainstem encephalitis (BE) and pulmonary edema (PE) are notable complications of enterovirus 71 (EV71) infection. Objective This study investigated the immunoregulatory characterizations of EV71 neurological complications by disease severity and milrinone treatment. Study Design Patients <18 years with virologically confirmed EV71 infections were enrolled and divided into 2 groups: the hand, foot, and mouth disease (HFMD) or BE group, and the autonomic nervous system (ANS) dysregulation or PE group. Cytokine and cyclic adenosine monophosphate (cAMP) levels, and the regulatory T cell (Tregs) profiles of the patients were determined. Results Patients with ANS dysregulation or PE exhibited significantly low frequency of CD4+CD25+Foxp3+ and CD4+Foxp3+ T cells compared with patients with HFMD or BE. The expression frequency of CD4−CD8− was also significantly decreased in patients with ANS dysregulation or PE. Among patients with ANS dysregulation or PE, the expression frequency of CD4+Foxp3+ increased markedly after milrinone treatment, and was associated with reduction of plasma levels IL-6, IL-8 and IL-10. Plasma concentrations of cAMP were significantly decreased in patients with ANS dysregulation or PE compared with patients with HFMD or BE; however, cAMP levels increased after milrinone treatment. Conclusions These findings suggested decreased different regulatory T populations and cAMP expression correlate with increased EV71 disease severity. Improved outcome after milrinone treatment may associate with increased regulatory T populations, cAMP expression and modulation of cytokines levels.
Collapse
Affiliation(s)
- Shih-Min Wang
- Department of Emergency Medicine College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
- * E-mail: (SMW); (CCL)
| | - I-Chun Chen
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ting Liao
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Chuan Liu
- Department of Pediatrics, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
- * E-mail: (SMW); (CCL)
| |
Collapse
|