Immune responses to infection with H5N1 influenza virus

Influenza A H5N1 viruses remain a substantial threat to global public health. In particular, the expanding genetic diversity of H5N1 viruses and the associated risk for human adaptation underscore the importance of better understanding host immune responses that may protect against disease or infection. Although much emphasis has been placed on investigating early virus–host interactions and the induction of innate immune responses, little is known of the consequent adaptive immune response to H5N1 virus infection. In this review, we describe the H5N1 virus-specific and cross-reactive antibody and T cell responses in humans and animal models. Data from limited studies suggest that although initially robust, there is substantial waning of the serum antibody responses in survivors of H5N1 virus infection. Characterization of monoclonal antibodies generated from memory B cells of survivors of H5N1 virus infection has provided an understanding of the fine specificity of the human antibody response to H5N1 virus infection and identified strategies for immunotherapy. Human T cell responses induced by infection with seasonal influenza viruses are directed to relatively conserved internal proteins and cross-react with the H5N1 subtype. A role for T cell-based heterosubtypic immunity against H5N1 viruses is suggested in animal studies. Further studies on adaptive immune responses to H5N1 virus infection in both humans and animals are needed to inform the design of optimal immunological treatment and prevention modalities.     

Influenza A/H5N1 virus infection in humans in Cambodia.

BACKGROUND: Between January 2005 and April 2006, six patients of influenza A/H5N1 virus infection were reported in Cambodia, all with fatal outcome. OBJECTIVES: We describe the virological findings of these six H5N1 patients in association with clinical and epidemiologic findings. STUDY DESIGN: Broncho-alveolar lavage, nasopharyngeal, throat and rectal swabs and sera were cultured for virus isolation and viral load quantified in clinical specimens by real-time RT-PCR. We compared sequences obtained from different body sites within the same patient to detect viral quasi-species. RESULTS: H5N1 virus strains isolated in Cambodia belong to genotype Z, clade 1 viruses. H5N1 viruses were isolated from serum and rectal swab specimens in two patients. The haemagglutinin gene sequences of the virus in different body sites did not differ. Amino acid substitutions known to be associated with a change in virus binding were not observed. CONCLUSION: The high frequency of virus isolation from serum and faecal swabs highlights that H5N1 is likely to be a disseminated infection in humans and this has implications for antiviral treatment, biosafety in clinical laboratories and on risks for nosocomial and human-to-human transmission. There were no tissue-specific adaptive mutations in the HA gene from viruses isolated from different organs.     

Replication and pathogenesis associated with H5N1, H5N2, and H5N3 low-pathogenic avian influenza virus infection in chickens and ducks

A comparative study examining replication and disease pathogenesis associated with low-pathogenic H5N1, H5N2, or H5N3 avian influenza virus (AIV) infection of chickens and ducks was performed. The replication and pathogenesis of highly pathogenic AIV (HPAIV) has received substantial attention; however, the behavior of low-pathogenic AIVs, which serve as precursors to HPAIVs, has received less attention. Thus, chickens or ducks were inoculated with an isolate from a wild bird [A/Mute Swan/MI/451072/06 (H5N1)] or isolates from chickens [A/Ck/PA/13609/93 (H5N2), A/Ck/TX/167280-4/02 (H5N3)], and virus replication, induction of a serological response, and disease pathogenesis were investigated, and the hemagglutinin and neuraminidase (NA) gene sequences of the isolates were determined. Virus isolated from tracheal and cloacal swabs showed that H5N1 replicated better in ducks, whereas H5N2 and H5N3 replicated better in chickens. Comparison of the NA gene sequences showed that chicken-adapted H5N2 and H5N3 isolates both have a deletion of 20 amino acids in the NA stalk region, which was absent in the H5N1 isolate. Histopathological examination of numerous organs showed that H5N2 and H5N3 isolates caused lesions in chickens in a variety of organs, but to a greater extent in the respiratory and intestinal tracts, whereas H5N1 lesions in ducks were observed mainly in the respiratory tract. This study suggests that the H5N1, H5N2, and H5N3 infections occurred at distinct sites in chicken and ducks, and that comparative studies in different model species are needed to better understand the factors influencing the evolution of these viruses.     

2009甲型H1N1疫苗株与普通季节性H1N1疫苗株在呼吸道细胞中感染效率的比较

 摘要：目的 探讨2009甲型H1N1疫苗株与季节性H1N1疫苗株在人呼吸道细胞中感染效率的差异。方法 用间接免疫荧光法检测H1N1病毒感染A549、CNE-2Z、H1650、Hep-2和MRC-5细胞的效率;用间接免疫荧光法检测抑制因子对H1N1病毒侵入细胞的影响。结果 （1）2009甲型H1N1疫苗株感染人呼吸道细胞的效率：H1650>A549>CNE-2Z>MRC-5>Hep-2;季节性H1N1疫苗株感染人呼吸道细胞的效率A549>CNE-2Z>H1650>MRC-5>Hep-2;（2）2009甲型H1N1疫苗株和季节性H1N1疫苗株均依赖于内吞作用进入细胞。结论 在A549细胞中,季节性H1N1疫苗株的感染效率明显高于甲型H1N1疫苗株;在H1650细胞中,甲型H1N1疫苗株的感染效率明显高于季节性H1N1疫苗株。     

人感染高致病性禽流感病毒H5N1的病理学观察

目的 观察人感染高致病性禽流感病毒H5N1后各主要脏器的病理改变.方法 按传染病尸体解剖要求对2例死亡病例系统解剖,并获得心、肝、脾、肺和肾等主要脏器,对1例重症患者行肺大泡切除术,组织常规HE和免疫组织化学染色,光学显微镜下观察.结果 2例肺组织主要呈弥漫性肺泡损伤改变.早期呈渗出性改变,肺泡上皮坏死脱落,肺泡腔内见大量均匀粉染渗出液伴广泛透明膜形成.中晚期主要呈增生性和纤维化性改变,肺泡上皮和支气管上皮增生,肺泡腔内渗出物和肺间质纤维化.1例在慢性支气管扩张症基础上伴弥漫性肺泡损伤和肺间质纤维化.免疫器官改变:全身淋巴组织萎缩伴活跃的噬血现象.其他脏器病变:1例心脏有间质性心肌炎;1例肾脏有急性肾小管坏死;1例有脑水肿伴脑实质内神经细胞嗜酸性变,轴突肿胀,粗细不均.脑室旁见灶状坏死.1例孕妇胎盘内多灶状滋养叶细胞坏死伴营养不良性钙化,有急性坏死性蜕膜炎.胚胎肺脏有肺水肿和肺炎改变.结论 人感染高致病性禽流感病毒H5N1后首先出现呼吸系统症状,广泛弥漫性肺泡损伤致低氧血症是病理学基础,患者最终因多器官功能衰竭致呼吸、循环衰竭死亡.     

Emergence of amantadine-resistant avian influenza H5N1 virus in India

This study reports the genetic characterization of highly pathogenic avian influenza (HPAI) virus (subtype H5N1) isolated from poultry in West Bengal, India. We analyzed all the eight genome segments of two viruses isolated from chickens in January 2010 to understand their genetic relationship with other Indian H5N1 isolates and possible connection between different outbreaks. The hemagglutinin (HA) gene of the viruses showed multiple basic amino acids at the cleavage site, a marker for high virulence in chickens. Of greatest concern was that the viruses displayed amino acid substitution from serine-to-asparagine at position 31 of M2 ion channel protein suggesting emergence of amantadine-resistant mutants not previously reported in HPAI H5N1 outbreaks in India. Amino acid lysine at position 627 of the PB2 protein highlights the risk the viruses possess to mammals. In the phylogenetic trees, the viruses clustered within the lineage of avian isolates from India (2008-2009) and avian and human isolates from Bangladesh (2007-2009) in all the genes. Both these viruses were most closely related to the viruses from 2008 in West Bengal within the subclade 2.2.3 of H5N1 viruses.     

H5N1型禽流感病毒动物模型的研究现状

H5N1亚型禽流感病毒在全球多个国家肆虐,已严重威胁人类健康。禽流感病毒动物模型的建立可以为研究病毒的突变、传染性和发病机制提供良好的技术平台。本综述概括了H5N1对几种哺乳动物:食蟹猴、雪貂、小鼠、大鼠、沙鼠、家猫等的致病性,为以后理想动物模型的建立和研究提供一定的帮助。     

Pathogenesis of swine influenza virus subtype H1N2 infection in pigs

The purpose of this study was to elucidate pathogenesis and viral distribution in pigs infected with swine influenza virus subtype H1N2, over a period of 10 days, by morphometric analysis and in-situ hybridization. Fifteen colostrum-deprived pigs aged 3 weeks were inoculated intranasally with virus. Pneumonia was severe at 1 day post-inoculation (dpi), moderate at 3 and 5 dpi, and mild at 7 and 10 dpi. The pulmonary lesion score was correlated with the score of cells positive by in-situ hybridization for swine influenza virus (r(s)= 0.9114, P< 0.05). The distribution of swine influenza virus varied according to the duration of infection. At 1 and 3 dpi, hybridization signals were detected mainly in the bronchial and bronchiolar epithelial cells, but they were detected mainly in the pneumocytes and macrophages (alveolar and interstitial) at 7 and 10 dpi. The results confirmed that swine influenza virus subtype H1N2, isolated in Korea, is a virulent pathogen causing severe pneumonia.     

Involvement of type I immune responses in swine-origin H1N1 influenza virus infection

Swine-origin H1N1 influenza virus (S-OIV) appeared in 2009 with a higher incidence rate among children. Although fever was the most common symptom, some complicated cases occurred. We evaluated the percentages of effector T cells, B cells, and regulatory T cells in peripheral blood from 5 children infected by S-OIV (1 with acute necrotizing encephalitis, 2 with pneumonia, and 2 without complications), 5 children with seasonal influenza, and 5 healthy children. We found higher percentages of T-bet(+) CD4(+)CD8(+) T cells, monocytes, and B cells, granzyme B(+) and perforin(+) CD4(+), and CD8(+) T cells in affected children with both seasonal and H1N1 influenza than in controls, whereas both groups demonstrated similar percentages of CD4(+)CD25(+)Foxp3(+) regulatory T cells. In infected children with complications we observed high percentages of perforin(+) and interferon-γ(+) CD4(+) and CD8(+) T cells associated with low percentages of T regulatory cells. Our data suggest a dysregulation of antipathogen type I immune responses in complicated S-OIV infections.     

A critical role of IL-17 in modulating the B-cell response during H5N1 influenza virus infection

Interleukin-17 (IL-17), a member of the IL-17 cytokine family, plays a crucial role in mediating the immune response against extracellular bacteria and fungi in the lung. Although there is increasing evidence that IL-17 is involved in protective immunity against H1 and H3 influenza virus infections, little is known about the role of IL-17 in the highly pathogenic H5N1 influenza virus infection. In this study, we show that H5N1-infected IL-17 knockout (KO) mice exhibit markedly increased weight loss, more pronounced lung immunopathology and significantly reduced survival rates as compared with infected wild-type controls. Moreover, the frequency of B cells in the lung were substantially decreased in IL-17 KO mice after virus infection, which correlated with reduced CXCR5 expression in B cells and decreased CXCL13 production in the lung tissue of IL-17 KO mice. Consistent with this observation, B cells from IL-17 KO mice exhibited a significant reduction in chemokine-mediated migration in culture. Taken together, these findings demonstrate a critical role for IL-17 in mediating the recruitment of B cells to the site of pulmonary influenza virus infection in mice.     

Pathology of clade 2.3.2.1 avian influenza virus (H5N1) infection in quails and ducks in Bangladesh

We performed pathological and molecular virological investigation of three outbreaks of highly pathogenic avian influenza (HPAI) in a quail farm and two duck farms of Mymensingh and Netrokona districts of Bangladesh in 2011. HPAI viruses of subtype H5N1 were detected from all three outbreaks and phylogenetic analysis of HA gene sequence placed the viruses into clade 2.3.2.1. The outbreak in the quail farm was characterized by acute death with 100% mortality within two days. Marked haemorrhages and congestion with necrotic and inflammatory lesions in the respiratory tract, liver, pancreas and kidneys were the major gross and histopathological lesions. In the case of ducks, nervous signs were the remarkable clinical manifestations and the mortality was around 10%. No significant gross lesions were observed at necropsy. Non-purulent encephalitis with gliosis and neuronal degeneration was observed on histopathological examination. By immunohistochemistry, viral antigen could be detected in different organs of both quails and ducks. This study records varying clinical and pathological manifestations of HPAI in ducks and quails following natural infection with the same strain of the virus.

RESEARCH HIGHLIGHTS

• HPAIV of clade 2.3.2.1 was detected from clinical outbreaks in quails and ducks

• Sudden death with severe haemorrhages in various organs was found in quails

• Pronounced nervous signs with non-purulent encephalitis were observed in ducks

• Viral antigen could be localized in different organs by immunohistochemistry

     

FoxO1在小鼠感染流感病毒H1N1中的作用及机制

目的探讨叉头盒转录因子O1（forkhead box O1,FoxO1）在小鼠抵抗流感病毒H1N1感染中发挥的作用及机制。方法用琼脂糖凝胶电泳鉴定小鼠的基因型后,将小鼠分为2组:条件性敲除NKp46⁺细胞中FoxO1基因的Foxo1^△NK组小鼠,以及对照组WT小鼠;2组小鼠使用滴鼻法同1天感染流感病毒H1N1,每天记录小鼠体质量及2组小鼠的死亡情况;在2组小鼠体质量及状态差异明显的第10天取样,HE染色法观察肺组织病理;Luminex液相芯片技术检测肺组织匀浆上清中36种细胞因子的表达情况;流式细胞术检测肺组织免疫细胞的比例变化。结果与WT组相比,感染流感病毒后Foxo1^△NK组小鼠死亡率增加,体质量下降更加严重;肺组织病理显示炎症反应减弱;肺组织匀浆上清中的细胞因子表达水平下降,ENA-78、IFN-α、IL-4、IL-5显著降低;肺组织免疫细胞中CD3⁺NKp46⁺NKT细胞比例显著下降。结论 FoxO1基因的缺失加重了小鼠流感感染进程,可能是通过抑制依赖FoxO1基因调控...     

禽流感H5N1型病毒对NIH小鼠的致病敏感性研究

目的观察禽流感H5N1型病毒对NIH小鼠的致病性。方法将NIH小鼠随机分为接毒组（20只）和对照组（10只）,在负压感染实验室,接毒组于乙醚麻醉后给予AIVH5N1型病毒滴鼻,对照组予正常阴性尿囊液滴鼻,观察14d,记录小鼠的体温、体重、临床症状、死亡情况、病理变化、肺指数及抗体变化。结果NIH小鼠感染禽流感H5N1型病毒后第1天就出现精神不振,病程主要集中在第3—7天,临床症状主要表现为弓背、蜷缩、竖毛、颤抖、反应迟钝、活动减少、爱扎堆,体重（下降）出现减轻,体温降低,死亡率为40％;接毒组死亡小鼠肺指数为（2．21±0．40）,较对照组的（0．44±0．23）明显增高,差异有统计学意义（P〈0．01）;肺组织病理严重改变,第8天才能检出抗体（OD值等于0．231）。结论禽流感H5N1型病毒对NIH小鼠有一定的致病性。