Objective Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic (HIN1) 200...Objective Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic (HIN1) 2009 and seasonal influenza (H3N2) in patients attending fever clinics. Methods From 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios (LRs) were calculated to identify the best predictors. Results The clinical features and routine blood test results of influenza (H1N1) 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness (ILl) criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic (HIN1) 2009 and seasonal influenza. The revised criteria are: fever ~ 38 ~C accompanied by at least one of the following--cough, arthralgia or relative iymphopenia. Conclusion Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.展开更多
In this study, we investigated the in vitro antiviral activity of the mycelia of higher mushrooms against influenza virus type A(serotype H1N1) and herpes simplex virus type 2(HSV-2), strain BH. All 10 investigated mu...In this study, we investigated the in vitro antiviral activity of the mycelia of higher mushrooms against influenza virus type A(serotype H1N1) and herpes simplex virus type 2(HSV-2), strain BH. All 10 investigated mushroom species inhibited the reproduction of influenza virus strain A/FM/1/47(H1N1) in MDCK cells reducing the infectious titer by 2.0–6.0 lg ID50. Four species, Pleurotus ostreatus, Fomes fomentarius, Auriporia aurea, and Trametes versicolor, were also determined to be effective against HSV-2 strain BH in RK-13 cells, with similar levels of inhibition as for influenza. For some of the investigated mushroom species—Pleurotus eryngii, Lyophyllum shimeji, and Flammulina velutipes—this is the first report of an anti-influenza effect. This study also reports the first data on the medicinal properties of A. aurea, including anti-influenza and antiherpetic activities. T. versicolor 353 mycelium was found to have a high therapeutic index(324.67), and may be a promising material for the pharmaceutical industry as an anti-influenza and antiherpetic agent with low toxicity. Mycelia with antiviral activity were obtained in our investigation by bioconversion of agricultural wastes(amaranth flour after CO2 extraction), which would reduce the cost of the final product and solve some ecological problems.展开更多
BACKGROUND:The 2009 H1N1 influenza A virus was first identified in April 2009 and rapidly evolved into a pandemic. Recipients of solid-organ transplants have a higher risk for severe infection because of immunosuppres...BACKGROUND:The 2009 H1N1 influenza A virus was first identified in April 2009 and rapidly evolved into a pandemic. Recipients of solid-organ transplants have a higher risk for severe infection because of immunosuppression.There are limited reports of 2009 H1N1 influenza in liver transplant recipients,especially in China. METHODS:We present a case of a 48-year-old male liver transplant recipient with 2009 H1N1 influenza A virus.He received therapy for acute rejection after transplantation and was confirmed with H1N1 virus infection. RESULTS:The patient was started on oseltamivir(75 mg, orally twice daily)and had a benign hospital course,with defervescence and resolution of symptoms within 72 hours. The follow-up chest radiograph after discharge was normal. CONCLUSIONS:The 2009 H1N1 influenza in this hospitalized transplant recipient was relatively mild,and prolonged viral shedding was not noted.Oseltamivir can be a valid measure in immunocompromised individuals.展开更多
The pig industry in Colombia has grown 30% in the last decade achieving high levels of technology and efficiency;in spite of that, respiratory diseases remain a constraint. Since 1970, serological evidence and histolo...The pig industry in Colombia has grown 30% in the last decade achieving high levels of technology and efficiency;in spite of that, respiratory diseases remain a constraint. Since 1970, serological evidence and histological findings suggested the role of swine influenza virus (SIV) as part of the porcine respiratory disease complex;nevertheless, elusive and molecular typing isolates are missing. This study was aimed at isolating SIV from intensive pig farms and to achieve molecular characterization to determine strains circulating in the field. In order to accomplish this goal, 242 samples were taken from nasal swabs, 25 from bronchial washes and 8 from lung tissue. Samples were collected during a period of three years, between 2008 and 2010 and were originated from 78 farms of the three main pig production regions of the country. The samples were transported in BHI broth with 2% antibiotic and antimycotic solution and stored at –70?C until processed. The swabs were inoculated in 9 - 11 days old embryo chicken eggs and in MDCK (Madin Darby Canine Kidney) cell cultures with the addition of trypsin. The isolates were identified by the HA (hemoagglutination) test and by RT-PCR targeting the HA (hemagglutinin), NA (Neuraminidase) and M (Matrix) genes. Full length sequence of the HA and NA glycoproteins from four selected virus isolates was conducted (Macrogen?. USA). As a result, fifteen SIV isolates from nine farms distributed in the three regions were obtained. Twelve of the isolates are related to the swine origin H1N1 virus that caused the 2009 influenza pandemic. The remaining three viruses were related to classical swine influenza viruses.展开更多
As the world is closely watching the current 2009 H1N1 pandemic unfold, there is a great interest and need in understanding its origin, genetic structures, virulence, and pathogenicity. The two surface proteins, hemag...As the world is closely watching the current 2009 H1N1 pandemic unfold, there is a great interest and need in understanding its origin, genetic structures, virulence, and pathogenicity. The two surface proteins, hemagglutinin (HA) and neuraminidase (NA), of the influenza virus have been the focus of most flu research due to their crucial biological functions. In our previous study on 2009 H1N1, three aspects of NA were investigated: the mutations and co-mutations, the stalk motifs, and the phylogenetic analysis. In this study, we turned our attention to HA and the interaction between HA and NA. The 118 mutations of 2009 H1N1 HA were found and mapped to the 3D homology model of H1, and the mutations on the five epitope regions on H1 were identified. This information is essential for developing new drugs and vaccine. The distinct response patterns of HA to the changes of NA stalk motifs were discovered, illustrating the functional dependence between HA and NA. With help from our previous results, two co-mutation networks were uncovered, one in HA and one in NA, where each mutation in one network co-mutates with the mutations in the other network across the two proteins HA and NA. These two networks residing in HA and NA separately may provide a functional linkage between the mutations that can impact the drug binding sites in NA and those that can affect the host immune response or vaccine efficacy in HA. Our findings demonstrated the value of conducting timely analysis on the 2009 H1N1 virus and of the integrated approach to studying both surface proteins HA and NA together to reveal their interdependence, which could not be accomplished by studying them individually.展开更多
Objective To perform gene expression profiles comparison so that to identify and understand the potential differences in pathogenesis between the pandemic and seasonal A (H1N1) influenza viruses. Methods A549 cells ...Objective To perform gene expression profiles comparison so that to identify and understand the potential differences in pathogenesis between the pandemic and seasonal A (H1N1) influenza viruses. Methods A549 cells were infected with A/California/07/09 (H1N1) and A/GuangdongBaoan/51/08 (H1N1) respectively at the same MOI of 2 and collected at 2, 4, 8, and 24 h post infection (p.i.). Gene expression profiles of A549 cells were obtained using the 22 K Human Genome Oligo Array, and differentially expressed genes were analyzed at selected time points. Results Microarrays results indicated that both of the viruses suppressed host immune response related pathways including cytokine production while pandemic H1N1 virus displayed weaker suppression of host immune response than seasonal H1N1 virus. Observation on similar anti-apoptotic events such as activation of apoptosis inhibitor and down-regulation of key genes of apoptosis pathways in both infections showed that activities of promoting apoptosis were different in later stage of infection. Conclusion The immuno-suppression and anti-apoptosis events of pandemic H1N1 virus were similar to those seen by seasonal H1N1 virus. The pandemic H1N1 virus had an ability to inhibit biological pathways associated with cytokine responses, NK activation and macrophage recognition .展开更多
Background Venovenous extracorporeal membrane oxygenation(VV-ECMO)has been demonstrated to be effective in treating patients with virus-induced acute respiratory distress syndrome(ARDS).However,whether the management ...Background Venovenous extracorporeal membrane oxygenation(VV-ECMO)has been demonstrated to be effective in treating patients with virus-induced acute respiratory distress syndrome(ARDS).However,whether the management of ECMO is different in treating H1N1 influenza and coronavirus disease 2019(COVID-19)-associated ARDS patients remains unknown.Methods This is a retrospective cohort study.We included 12 VV-ECMO-supported COVID-19 patients admitted to The First Affiliated Hospital of Guangzhou Medical University,Guangzhou Eighth People's Hospital,and Wuhan Union Hospital West Campus between January 23 and March 31,2020.We retrospectively included VV-ECMO-supported patients with COVID-19 and H1N1 influenza-associated ARDS.Clinical characteristics,respiratory mechanics including plateau pressure,driving pressure,mechanical power,ventilatory ratio(VR)and lung compliance,and outcomes were compared.Results Data from 25 patients with COVID-19(n=12)and H1N1(n=13)associated ARDS who had received ECMO support were analyzed.COVID-19 patients were older than H1N1 influenza patients(P=0.004).The partial pressure of arterial carbon dioxide(PaCO_(2))and VR before ECMO initiation were significantly higher in COVID-19 patients than in H1N1 influenza patients(P<0.001 and P=0.004,respectively).COVID-19 patients showed increased plateau and driving pressure compared with H1N1 subjects(P=0.013 and P=0.018,respectively).Patients with COVID-19 remained longer on ECMO support than did H1N1 influenza patients(P=0.015).COVID-19 patients who required ECMO support also had fewer intensive care unit and ventilator-free days than H1N1.Conclusions Compared with H1N1 influenza patients,COVID-19 patients were older and presented with increased PaCO_(2) and VR values before ECMO initiation.The differences between ARDS patients with COVID-19 and influenza on VV-ECMO detailed herein could be helpful for obtaining a better understanding of COVID-19 and for better clinical management.展开更多
Purpose: We investigated the efficacy of potent or combined antibiotics in patients suffering bacterial infections secondary to H1N1 by retrospectively analyzing their bacterial pathogen spectrum and clinical characte...Purpose: We investigated the efficacy of potent or combined antibiotics in patients suffering bacterial infections secondary to H1N1 by retrospectively analyzing their bacterial pathogen spectrum and clinical characteristics. Methods: Multi-center retrospective analysis was performed using clinical data of H1N1 patients from 27 hospitals in Hebei Province, China, from November 1 to December 31, 2009. Results: Of 480 H1N1-infected patients enrolled from an inpatient clinic, 91 were positive for bacterial culture. Bacteria were detected in sputum culture at 7.00 ± 8.87 days post-admission. Compared with the negative group, the patients in the positive sputum culture group had a higher mean age and prevalence of basic diseases, higher APECHEII (Acute Physiology and Chronic Health Evaluation II) score within 24 hours of admission, longer hospital stays, and higher mortality. In total, 189 bacterial strains were isolated, with the majority of samples testing positive for Acinetobacter baumanii (47), Streptococcus viridians (26), or Pseudomonas aeruginosa (19). S. viridians was the major cause of infection within 3 days of admission, while A. baumanii infection was more prevalent from 4 days post-admission;there was a significant difference in the constituent ratio between the two pathogens (p 0.001). Compared with patients administered common antibiotics, the potent antibiotics group showed no significant difference in hospitalization time, time until bacterial detection, mortality, or detection ratio of resistant strains (p > 0.05). Conclusions: Complicated bacterial infection in H1N1 patients increases hospitalization time and mortality. Gram-negative bacilli and multi-resistant strains are the main sources of infection. Early administration of potent or combined antibiotics, even during the period of rapid onset, may not be suitable in H1N1-infected patients, particularly previously healthy young patients.展开更多
Objective To analyze the clinical features,therapeutic management and risk factors for mortality of patients with severe novel A(H1N1)influenza in Shanghai,China.Methods All patients were diagnosed by influenza A(H1N1...Objective To analyze the clinical features,therapeutic management and risk factors for mortality of patients with severe novel A(H1N1)influenza in Shanghai,China.Methods All patients were diagnosed by influenza A(H1N1)virus mRNA detection.Chest CT scan,routine blood,hepatic function,humoral and cellular immunity,sputum smears,and sputum cultures were performed.Logistic analysis was applied to identify risk factors for mortality.Results Total of 68 patients were enrolled in this study,the primary clinical symptoms including cough(66,97.1%),expectoration(41,60.3%),and polypnea(41,60.3%).Altogether,37(54.4%)and 11(16.2%)patients were infected with bacterial and fungal,respectively.CT scan demonstrated that 67(98.6%)patients had pneumonia.Oxygen therapy,oseltamivir,antibiotic and antifungal drugs were performed in 68(100%),66(97.1%),39(57.4%),and 11(16.2%)patients,respectively.Finally,4 of 68 patients died.Logistic analysis demonstrated that there was a significant correlation between the percentage of neutrophils and mortality before therapy and direct bilirubin content and mortality after therapy,respectively.Conclusions Patients with severe H1N1 influenza were susceptible to bacterial and/or fungal infection.The risk factors for mortality may be associated with pre-therapeutic neutrophil percentage and post-therapeutic direct bilirubin content.展开更多
A recent phylogenetic inference indicated that the 2009 pandemic H1N1 strains circulating from March 2009 to September 2009 could be divided into two closely related but distinct clusters. Cluster one contained most s...A recent phylogenetic inference indicated that the 2009 pandemic H1N1 strains circulating from March 2009 to September 2009 could be divided into two closely related but distinct clusters. Cluster one contained most strains from Mexico, Texas, and California, and cluster two had most strains from New York, both of which were reported to co-circulate in all continents. The same study further revealed nine nucleotide changes in six gene segments of the new virus specific for the two clusters. In the current study, the informational spectrum method (ISM), a bioinformatics technique, was employed to study the receptor binding patterns of the two clusters. It discovered that while both groups shared the same primary human binding affinity, their secondary binding preferences were different. Cluster one favored swine binding as its secondary binding pattern, whereas cluster two mostly exhibited the binding specificity of A/South Carolina/1/18 (H1N1) (one of the 1918 flu pandemic strains) as its secondary binding pattern. Besides all the nine nucleotide changes found in the previous study, Random Forests were applied to uncover several new nucleotide polymorphisms in 10 genes of the strains between the two clusters, and several amino acid changes in the HA protein that might be accountable for the discrepancy of the secondary receptor binding patterns of the two clusters. Finally, entropy analysis was conducted to present a global view of gene sequence variations between the two clusters, which illustrated that cluster one had much higher genetic divergence than cluster two. Furthermore, it suggested a significant overall correspondence between the nucleotide positions of high importance in differentiating the two clusters and nucleotide positions of high entropy in cluster one.展开更多
Recently, a genetic variant of 2009 H1N1 has become the predominant virus circulating in the southern hemisphere, particularly Australia and New Zealand, and in Singapore during the winter of 2010. It was associated w...Recently, a genetic variant of 2009 H1N1 has become the predominant virus circulating in the southern hemisphere, particularly Australia and New Zealand, and in Singapore during the winter of 2010. It was associated with several vaccine breakthroughs and fatal cases. We analyzed three reported mutations D94N, N125D, and V250A in the HA protein of this genetic variant. It appeared that the reason for D94N and V250A to occur in pairs was to maintain the HA binding to human type receptor, so the virus could replicate in humans efficiently. Guided by this interpretation, we discovered a new mutation V30A that could compensate for N125D as V250A did for D94N. We demonstrated that the presence of amino acids 30A and 125N in HA enhanced the binding to human type receptor, while 30V and 125D favored the receptors of avian type and of A/South Carolina/1/18 (H1N1). Furthermore, a combination of 94D, 125D, and 250V made the primary binding preference similar to that of A/South Carolina/1/18 (H1N1) and a combination of 94N, 125D, and 250A resulted in the primary binding affinity for avian type receptor, which clearly differed from that of A/California/07/2009 (H1N1), a strain used in the vaccine for 2009 H1N1. We also re-examined the origin of 2009 H1N1 to refine our knowledge of this important issue. Although the NP, PA, PB1, and PB2 of 2009 H1N1 were closest to North American swine H3N2 in sequence identity, their interaction patterns were closest to swine H1N1 in North America.展开更多
Objective To evaluate the effect of the aluminum hydroxide (Al-OH) adjuvant on the 2009 pandemic influenza A/H1N1 (pH1N1) vaccine. Methods In a multicenter, double-blind, randomized, placebo-controlled trial, part...Objective To evaluate the effect of the aluminum hydroxide (Al-OH) adjuvant on the 2009 pandemic influenza A/H1N1 (pH1N1) vaccine. Methods In a multicenter, double-blind, randomized, placebo-controlled trial, participants received two doses of split-virion formulation containing 15 ug hemagglutinin antigen, with or without aluminum hydroxide (N-OH). We classified the participants into six age categories (〉61 years, 41-60 years, 19-40 years, 13-18 years, 8-12 years, and 3-7 years) and obtained four blood samples from each participant on days 0, 21, 35, and 42 following the first dose of immunization. We assessed vaccine immunogenicity by measuring the geometric mean titer (GMT) of hemagglutination inhibiting antibody. We used a two-level model to evaluate the fixed effect of aluminum Al-OH and other factors, accounting for repeated measures. Results The predictions of repeated measurement on GMTs of formulations with or without Al-OH, were 80.35 and 112.72, respectively. Al-OH significantly reduced immunogenicity after controlling for time post immunization, age-group and gender. Conclusion The Al-OH adjuvant does not increase but actually reduces the immunogenicity of the split-virion pH1N1 vaccine.展开更多
Background: Influenza A (H1N1) is the most recent pandemic disease that has affected the human population. Objective: To evaluate knowledge and preventive measures related with this disease one year after the epidemic...Background: Influenza A (H1N1) is the most recent pandemic disease that has affected the human population. Objective: To evaluate knowledge and preventive measures related with this disease one year after the epidemic of Mexico- that took place in 2009. Material and methods: An epidemiologic survey regarding influenza A (H1N1) was conducted in June 2010 among 2541 students from the second grade of all public high schools in a borough in Mexico City. The questionnaire included items on the knowledge of the disease and practice of preventive measures. Results: Most students obtained the information from television, half of them from parents and only one fifth from teachers;72% of the participants had a favorable knowledge about the disease and the measures to avoid being infected. However, only 37% practiced such preventive measures. Conclusion: Knowledge has a positive influence on practices towards health. Parents and teachers have an important role in health education, thus efforts should be directed to involve them more intensely in health education.展开更多
This research focused on the modification of the functional groups of oseltamivir as neuraminidase inhibitor against influenza A virus subtype H1N1.Interactions of three of the best ligands were evaluated in the hydra...This research focused on the modification of the functional groups of oseltamivir as neuraminidase inhibitor against influenza A virus subtype H1N1.Interactions of three of the best ligands were evaluated in the hydrated state using molecular dynamics simulation at two different temperatures.The docking result showed that AD3BF2 D ligand(N-[(1S,6R)-5-amino-5-{[(2R,3S,4S)-3,4-dihydroxy-4-(hydroxymethyl) tetrahydrofuran-2-yl]oxy}-4-formylcyclohex-3-en-1-yl]acetamide-3-(1-ethylpropoxy)-1-cyclohexene-1-carboxylate) had better binding energy values than standard oseltamivir.AD3BF2 D had several interactions,including hydrogen bonds,with the residues in the catalytic site of neuraminidase as identified by molecular dynamics simulation.The results showed that AD3BF2 D ligand can be used as a good candidate for neuraminidase inhibitor to cope with influenza A virus subtype H1N1.展开更多
基金supported by Chinese National Programs for High Technology Research and Development (863 Program,2008AA02Z416)
文摘Objective Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic (HIN1) 2009 and seasonal influenza (H3N2) in patients attending fever clinics. Methods From 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios (LRs) were calculated to identify the best predictors. Results The clinical features and routine blood test results of influenza (H1N1) 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness (ILl) criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic (HIN1) 2009 and seasonal influenza. The revised criteria are: fever ~ 38 ~C accompanied by at least one of the following--cough, arthralgia or relative iymphopenia. Conclusion Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.
文摘In this study, we investigated the in vitro antiviral activity of the mycelia of higher mushrooms against influenza virus type A(serotype H1N1) and herpes simplex virus type 2(HSV-2), strain BH. All 10 investigated mushroom species inhibited the reproduction of influenza virus strain A/FM/1/47(H1N1) in MDCK cells reducing the infectious titer by 2.0–6.0 lg ID50. Four species, Pleurotus ostreatus, Fomes fomentarius, Auriporia aurea, and Trametes versicolor, were also determined to be effective against HSV-2 strain BH in RK-13 cells, with similar levels of inhibition as for influenza. For some of the investigated mushroom species—Pleurotus eryngii, Lyophyllum shimeji, and Flammulina velutipes—this is the first report of an anti-influenza effect. This study also reports the first data on the medicinal properties of A. aurea, including anti-influenza and antiherpetic activities. T. versicolor 353 mycelium was found to have a high therapeutic index(324.67), and may be a promising material for the pharmaceutical industry as an anti-influenza and antiherpetic agent with low toxicity. Mycelia with antiviral activity were obtained in our investigation by bioconversion of agricultural wastes(amaranth flour after CO2 extraction), which would reduce the cost of the final product and solve some ecological problems.
基金supported by a grant from the National Key Technology R&D Program of China(2008ZX10002-26)
文摘BACKGROUND:The 2009 H1N1 influenza A virus was first identified in April 2009 and rapidly evolved into a pandemic. Recipients of solid-organ transplants have a higher risk for severe infection because of immunosuppression.There are limited reports of 2009 H1N1 influenza in liver transplant recipients,especially in China. METHODS:We present a case of a 48-year-old male liver transplant recipient with 2009 H1N1 influenza A virus.He received therapy for acute rejection after transplantation and was confirmed with H1N1 virus infection. RESULTS:The patient was started on oseltamivir(75 mg, orally twice daily)and had a benign hospital course,with defervescence and resolution of symptoms within 72 hours. The follow-up chest radiograph after discharge was normal. CONCLUSIONS:The 2009 H1N1 influenza in this hospitalized transplant recipient was relatively mild,and prolonged viral shedding was not noted.Oseltamivir can be a valid measure in immunocompromised individuals.
文摘The pig industry in Colombia has grown 30% in the last decade achieving high levels of technology and efficiency;in spite of that, respiratory diseases remain a constraint. Since 1970, serological evidence and histological findings suggested the role of swine influenza virus (SIV) as part of the porcine respiratory disease complex;nevertheless, elusive and molecular typing isolates are missing. This study was aimed at isolating SIV from intensive pig farms and to achieve molecular characterization to determine strains circulating in the field. In order to accomplish this goal, 242 samples were taken from nasal swabs, 25 from bronchial washes and 8 from lung tissue. Samples were collected during a period of three years, between 2008 and 2010 and were originated from 78 farms of the three main pig production regions of the country. The samples were transported in BHI broth with 2% antibiotic and antimycotic solution and stored at –70?C until processed. The swabs were inoculated in 9 - 11 days old embryo chicken eggs and in MDCK (Madin Darby Canine Kidney) cell cultures with the addition of trypsin. The isolates were identified by the HA (hemoagglutination) test and by RT-PCR targeting the HA (hemagglutinin), NA (Neuraminidase) and M (Matrix) genes. Full length sequence of the HA and NA glycoproteins from four selected virus isolates was conducted (Macrogen?. USA). As a result, fifteen SIV isolates from nine farms distributed in the three regions were obtained. Twelve of the isolates are related to the swine origin H1N1 virus that caused the 2009 influenza pandemic. The remaining three viruses were related to classical swine influenza viruses.
文摘As the world is closely watching the current 2009 H1N1 pandemic unfold, there is a great interest and need in understanding its origin, genetic structures, virulence, and pathogenicity. The two surface proteins, hemagglutinin (HA) and neuraminidase (NA), of the influenza virus have been the focus of most flu research due to their crucial biological functions. In our previous study on 2009 H1N1, three aspects of NA were investigated: the mutations and co-mutations, the stalk motifs, and the phylogenetic analysis. In this study, we turned our attention to HA and the interaction between HA and NA. The 118 mutations of 2009 H1N1 HA were found and mapped to the 3D homology model of H1, and the mutations on the five epitope regions on H1 were identified. This information is essential for developing new drugs and vaccine. The distinct response patterns of HA to the changes of NA stalk motifs were discovered, illustrating the functional dependence between HA and NA. With help from our previous results, two co-mutation networks were uncovered, one in HA and one in NA, where each mutation in one network co-mutates with the mutations in the other network across the two proteins HA and NA. These two networks residing in HA and NA separately may provide a functional linkage between the mutations that can impact the drug binding sites in NA and those that can affect the host immune response or vaccine efficacy in HA. Our findings demonstrated the value of conducting timely analysis on the 2009 H1N1 virus and of the integrated approach to studying both surface proteins HA and NA together to reveal their interdependence, which could not be accomplished by studying them individually.
基金supported by the National Basic Research Program of China (973 program: 2010CB534001)
文摘Objective To perform gene expression profiles comparison so that to identify and understand the potential differences in pathogenesis between the pandemic and seasonal A (H1N1) influenza viruses. Methods A549 cells were infected with A/California/07/09 (H1N1) and A/GuangdongBaoan/51/08 (H1N1) respectively at the same MOI of 2 and collected at 2, 4, 8, and 24 h post infection (p.i.). Gene expression profiles of A549 cells were obtained using the 22 K Human Genome Oligo Array, and differentially expressed genes were analyzed at selected time points. Results Microarrays results indicated that both of the viruses suppressed host immune response related pathways including cytokine production while pandemic H1N1 virus displayed weaker suppression of host immune response than seasonal H1N1 virus. Observation on similar anti-apoptotic events such as activation of apoptosis inhibitor and down-regulation of key genes of apoptosis pathways in both infections showed that activities of promoting apoptosis were different in later stage of infection. Conclusion The immuno-suppression and anti-apoptosis events of pandemic H1N1 virus were similar to those seen by seasonal H1N1 virus. The pandemic H1N1 virus had an ability to inhibit biological pathways associated with cytokine responses, NK activation and macrophage recognition .
基金support from the Special Project of the Guangdong Science and Technology Department (grant number:2020B1111340013)Mergency Key Program of Guangzhou Laboratory (grant number:EKPG21-29)+1 种基金Guangzhou City School (Institute)Joint Funding Project (grant number:202201020414)the National Natural Science Foundation of China (grant number:81970071).
文摘Background Venovenous extracorporeal membrane oxygenation(VV-ECMO)has been demonstrated to be effective in treating patients with virus-induced acute respiratory distress syndrome(ARDS).However,whether the management of ECMO is different in treating H1N1 influenza and coronavirus disease 2019(COVID-19)-associated ARDS patients remains unknown.Methods This is a retrospective cohort study.We included 12 VV-ECMO-supported COVID-19 patients admitted to The First Affiliated Hospital of Guangzhou Medical University,Guangzhou Eighth People's Hospital,and Wuhan Union Hospital West Campus between January 23 and March 31,2020.We retrospectively included VV-ECMO-supported patients with COVID-19 and H1N1 influenza-associated ARDS.Clinical characteristics,respiratory mechanics including plateau pressure,driving pressure,mechanical power,ventilatory ratio(VR)and lung compliance,and outcomes were compared.Results Data from 25 patients with COVID-19(n=12)and H1N1(n=13)associated ARDS who had received ECMO support were analyzed.COVID-19 patients were older than H1N1 influenza patients(P=0.004).The partial pressure of arterial carbon dioxide(PaCO_(2))and VR before ECMO initiation were significantly higher in COVID-19 patients than in H1N1 influenza patients(P<0.001 and P=0.004,respectively).COVID-19 patients showed increased plateau and driving pressure compared with H1N1 subjects(P=0.013 and P=0.018,respectively).Patients with COVID-19 remained longer on ECMO support than did H1N1 influenza patients(P=0.015).COVID-19 patients who required ECMO support also had fewer intensive care unit and ventilator-free days than H1N1.Conclusions Compared with H1N1 influenza patients,COVID-19 patients were older and presented with increased PaCO_(2) and VR values before ECMO initiation.The differences between ARDS patients with COVID-19 and influenza on VV-ECMO detailed herein could be helpful for obtaining a better understanding of COVID-19 and for better clinical management.
文摘Purpose: We investigated the efficacy of potent or combined antibiotics in patients suffering bacterial infections secondary to H1N1 by retrospectively analyzing their bacterial pathogen spectrum and clinical characteristics. Methods: Multi-center retrospective analysis was performed using clinical data of H1N1 patients from 27 hospitals in Hebei Province, China, from November 1 to December 31, 2009. Results: Of 480 H1N1-infected patients enrolled from an inpatient clinic, 91 were positive for bacterial culture. Bacteria were detected in sputum culture at 7.00 ± 8.87 days post-admission. Compared with the negative group, the patients in the positive sputum culture group had a higher mean age and prevalence of basic diseases, higher APECHEII (Acute Physiology and Chronic Health Evaluation II) score within 24 hours of admission, longer hospital stays, and higher mortality. In total, 189 bacterial strains were isolated, with the majority of samples testing positive for Acinetobacter baumanii (47), Streptococcus viridians (26), or Pseudomonas aeruginosa (19). S. viridians was the major cause of infection within 3 days of admission, while A. baumanii infection was more prevalent from 4 days post-admission;there was a significant difference in the constituent ratio between the two pathogens (p 0.001). Compared with patients administered common antibiotics, the potent antibiotics group showed no significant difference in hospitalization time, time until bacterial detection, mortality, or detection ratio of resistant strains (p > 0.05). Conclusions: Complicated bacterial infection in H1N1 patients increases hospitalization time and mortality. Gram-negative bacilli and multi-resistant strains are the main sources of infection. Early administration of potent or combined antibiotics, even during the period of rapid onset, may not be suitable in H1N1-infected patients, particularly previously healthy young patients.
基金supported by a grant-in-aid from the state administration of Traditional Chinese Medicine of China for the infectious disease prophylaxis and treatment through grant number 200907001-2
文摘Objective To analyze the clinical features,therapeutic management and risk factors for mortality of patients with severe novel A(H1N1)influenza in Shanghai,China.Methods All patients were diagnosed by influenza A(H1N1)virus mRNA detection.Chest CT scan,routine blood,hepatic function,humoral and cellular immunity,sputum smears,and sputum cultures were performed.Logistic analysis was applied to identify risk factors for mortality.Results Total of 68 patients were enrolled in this study,the primary clinical symptoms including cough(66,97.1%),expectoration(41,60.3%),and polypnea(41,60.3%).Altogether,37(54.4%)and 11(16.2%)patients were infected with bacterial and fungal,respectively.CT scan demonstrated that 67(98.6%)patients had pneumonia.Oxygen therapy,oseltamivir,antibiotic and antifungal drugs were performed in 68(100%),66(97.1%),39(57.4%),and 11(16.2%)patients,respectively.Finally,4 of 68 patients died.Logistic analysis demonstrated that there was a significant correlation between the percentage of neutrophils and mortality before therapy and direct bilirubin content and mortality after therapy,respectively.Conclusions Patients with severe H1N1 influenza were susceptible to bacterial and/or fungal infection.The risk factors for mortality may be associated with pre-therapeutic neutrophil percentage and post-therapeutic direct bilirubin content.
文摘A recent phylogenetic inference indicated that the 2009 pandemic H1N1 strains circulating from March 2009 to September 2009 could be divided into two closely related but distinct clusters. Cluster one contained most strains from Mexico, Texas, and California, and cluster two had most strains from New York, both of which were reported to co-circulate in all continents. The same study further revealed nine nucleotide changes in six gene segments of the new virus specific for the two clusters. In the current study, the informational spectrum method (ISM), a bioinformatics technique, was employed to study the receptor binding patterns of the two clusters. It discovered that while both groups shared the same primary human binding affinity, their secondary binding preferences were different. Cluster one favored swine binding as its secondary binding pattern, whereas cluster two mostly exhibited the binding specificity of A/South Carolina/1/18 (H1N1) (one of the 1918 flu pandemic strains) as its secondary binding pattern. Besides all the nine nucleotide changes found in the previous study, Random Forests were applied to uncover several new nucleotide polymorphisms in 10 genes of the strains between the two clusters, and several amino acid changes in the HA protein that might be accountable for the discrepancy of the secondary receptor binding patterns of the two clusters. Finally, entropy analysis was conducted to present a global view of gene sequence variations between the two clusters, which illustrated that cluster one had much higher genetic divergence than cluster two. Furthermore, it suggested a significant overall correspondence between the nucleotide positions of high importance in differentiating the two clusters and nucleotide positions of high entropy in cluster one.
文摘Recently, a genetic variant of 2009 H1N1 has become the predominant virus circulating in the southern hemisphere, particularly Australia and New Zealand, and in Singapore during the winter of 2010. It was associated with several vaccine breakthroughs and fatal cases. We analyzed three reported mutations D94N, N125D, and V250A in the HA protein of this genetic variant. It appeared that the reason for D94N and V250A to occur in pairs was to maintain the HA binding to human type receptor, so the virus could replicate in humans efficiently. Guided by this interpretation, we discovered a new mutation V30A that could compensate for N125D as V250A did for D94N. We demonstrated that the presence of amino acids 30A and 125N in HA enhanced the binding to human type receptor, while 30V and 125D favored the receptors of avian type and of A/South Carolina/1/18 (H1N1). Furthermore, a combination of 94D, 125D, and 250V made the primary binding preference similar to that of A/South Carolina/1/18 (H1N1) and a combination of 94N, 125D, and 250A resulted in the primary binding affinity for avian type receptor, which clearly differed from that of A/California/07/2009 (H1N1), a strain used in the vaccine for 2009 H1N1. We also re-examined the origin of 2009 H1N1 to refine our knowledge of this important issue. Although the NP, PA, PB1, and PB2 of 2009 H1N1 were closest to North American swine H3N2 in sequence identity, their interaction patterns were closest to swine H1N1 in North America.
基金supported by the Infectious Disease Prevention and Control Major Research plan from the Ministry of Science and Technology of China-the Platform of Construction of Clinical Trial of Vaccine. (Project number 2009ZX0004-806)
文摘Objective To evaluate the effect of the aluminum hydroxide (Al-OH) adjuvant on the 2009 pandemic influenza A/H1N1 (pH1N1) vaccine. Methods In a multicenter, double-blind, randomized, placebo-controlled trial, participants received two doses of split-virion formulation containing 15 ug hemagglutinin antigen, with or without aluminum hydroxide (N-OH). We classified the participants into six age categories (〉61 years, 41-60 years, 19-40 years, 13-18 years, 8-12 years, and 3-7 years) and obtained four blood samples from each participant on days 0, 21, 35, and 42 following the first dose of immunization. We assessed vaccine immunogenicity by measuring the geometric mean titer (GMT) of hemagglutination inhibiting antibody. We used a two-level model to evaluate the fixed effect of aluminum Al-OH and other factors, accounting for repeated measures. Results The predictions of repeated measurement on GMTs of formulations with or without Al-OH, were 80.35 and 112.72, respectively. Al-OH significantly reduced immunogenicity after controlling for time post immunization, age-group and gender. Conclusion The Al-OH adjuvant does not increase but actually reduces the immunogenicity of the split-virion pH1N1 vaccine.
文摘Background: Influenza A (H1N1) is the most recent pandemic disease that has affected the human population. Objective: To evaluate knowledge and preventive measures related with this disease one year after the epidemic of Mexico- that took place in 2009. Material and methods: An epidemiologic survey regarding influenza A (H1N1) was conducted in June 2010 among 2541 students from the second grade of all public high schools in a borough in Mexico City. The questionnaire included items on the knowledge of the disease and practice of preventive measures. Results: Most students obtained the information from television, half of them from parents and only one fifth from teachers;72% of the participants had a favorable knowledge about the disease and the measures to avoid being infected. However, only 37% practiced such preventive measures. Conclusion: Knowledge has a positive influence on practices towards health. Parents and teachers have an important role in health education, thus efforts should be directed to involve them more intensely in health education.
文摘This research focused on the modification of the functional groups of oseltamivir as neuraminidase inhibitor against influenza A virus subtype H1N1.Interactions of three of the best ligands were evaluated in the hydrated state using molecular dynamics simulation at two different temperatures.The docking result showed that AD3BF2 D ligand(N-[(1S,6R)-5-amino-5-{[(2R,3S,4S)-3,4-dihydroxy-4-(hydroxymethyl) tetrahydrofuran-2-yl]oxy}-4-formylcyclohex-3-en-1-yl]acetamide-3-(1-ethylpropoxy)-1-cyclohexene-1-carboxylate) had better binding energy values than standard oseltamivir.AD3BF2 D had several interactions,including hydrogen bonds,with the residues in the catalytic site of neuraminidase as identified by molecular dynamics simulation.The results showed that AD3BF2 D ligand can be used as a good candidate for neuraminidase inhibitor to cope with influenza A virus subtype H1N1.