A coxsackievirus B5‐associated aseptic meningitis outbreak in Shandong Province,China in 2009

In 2009, a major outbreak of aseptic meningitis was noted in Linyi city, Shandong province, China. From June to September 2009, a total of 2,104 cases were involved in this outbreak, and 98.6% of patients were <16 years of age. To determine the pathogen of the outbreak, 42 cerebrospinal fluid specimens collected from aseptic meningitis cases were tested for cell culture, and 17 (40.5%) enteroviruses were isolated and identified as Coxsackievirus B5 (CVB5). Homologous comparison indicated that these isolates had 0–7.7% nucleotide divergence with each other. Phylogenetic reconstruction showed global CVB5 could be separated into four genogroups, and all Linyi CVB5 isolates belonged to the genogroup C which had been circulating for recent 27 years in Asia and Europe. Interestingly, two distinct lineages were observed for the 17 isolates in the phylogenetic tree, indicating that at least two different transmission chains of CVB5 were responsible for this outbreak. This study showed that CVB5‐associated aseptic meningitis is an emerging concern in China. J. Med. Virol. 85:483–489, 2013. © 2012 Wiley Periodicals, Inc.     

基于CXCL12/CXCR4生物轴探讨清心饮抑制CVB3感染后CMVECs发生EndMT的作用

[目的] 探讨趋化因子12(chemokine 12,CXCL12)/趋化因子受体4(chemokine receptor 4,CXCR4)生物轴在清心饮含药血清抑制柯萨奇B3病毒(Coxsackie virus B3,CVB3)感染后心脏微血管内皮细胞(cardiac microvascular endothelial cells,CMVECs)发生内皮间充质转分化(endothelial-mesenchymal transition,EndMT)过程中的作用。[方法] 取生长状态良好的CMVECs设计为正常对照组、模型组、CXCR4拮抗剂组、清心饮组和清心饮+CXCR4拮抗剂组。除正常对照组用含10%胎牛血清(fetal bovine serum,FBS)的杜尔伯克改良伊格尔培养基(Dulbecco‘s modification of Eaglews medium,DMEM)培养外,其余各组CMVECs先用CVB3培养基感染2 h,后弃去CVB3培养基,改为普通培养。通过细胞计数试剂(cell counting kit-8,CCK8)检测各组细胞活力,免疫荧光(immunofluorescence,IF)、免疫印迹和实时荧光定量聚合酶链式反应(Real-time quantitative polymerase chain reaction,Real-time qPCR)等实验方法检测内皮细胞标志物血小板-内皮细胞黏附分子(platelet endothelial cell adhesion molecule-1,PECAM-1/CD31)、间充质细胞标志物α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)、CXCL12和CXCR4的蛋白及基因表达。[结果] 与正常对照组比较,模型组CD31表达下降(P＜0.01),α-SMA、CXCL12和CXCR4表达增强(P＜0.01)。与模型组比较,CXCR4拮抗剂组、清心饮组CD31表达增强(P＜0.01),α-SMA和CXCR4表达下降(P＜0.01),CXCR4拮抗剂组CXCL12表达差异无统计学意义(P＞0.05),清心饮组CXCL12表达下降(P＜0.05)。与清心饮组比较,清心饮+CXCR4拮抗剂组CD31的表达增强(P＜0.05),α-SMA、CXCL12和CXCR4表达下降(P＜0.01,P＜0.05)。[结论] CXCL12/CXCR4生物轴参与了CVB3感染后CMVECs发生EndMT的过程,拮抗CXCL12/CXCR4生物轴能够明显增强清心饮对该过程的抑制。     

Inhibition of IL-2 inducible T-cell kinase alleviates T-cell activation and murine myocardial inflammation associated with CVB3 infection

Background

Coxsackievirus B3 (CVB3) infection causes myocarditis, pancreatitis, and aseptic meningitis. Targeting antigen-specific T cell reactions might be a promising way to alleviate the inflammatory response induced by CVB3 infection. IL-2-inducible T-cell kinase (ITK), a member of Tec kinase family expressed mainly in T cells, plays an important role in the activation of T cells. The role of ITK in viral myocarditis induced by CVB3 has not been documented.

Methodology

In this study, we inhibited the ITK expression in Jurkat cells, primary human peripheral blood mononuclear cells (PBMC), and mouse splenocytes by ITK-specific siRNA. The inhibition efficiently suppressed cell proliferation (P < 0.05) and T-cell related cytokine secretion (P < 0.05). In order to inhibit ITK in vivo, the pGCSIL plasmid containing short hairpin RNAs targeting ITK was constructed and transduced into mice infected with CVB3. ITK-inhibited mice showed reduced cell proliferation (3, 5, and 7 days post-challenge, P < 0.05) as well as CD4+ and CD8+ T cells (5 days post-challenge, P < 0.05). The altered production of inflammatory cytokines alleviated pathologic heart damage and improved mice survival rate (P < 0.05).

Conclusion

ITK played an important role in the T cell development and represented a new target for the modulation of T-cell-mediated inflammatory response by CVB3 infection.     

特异性的VP1-siRNA对CVB3复制抑制作用的研究

目的 研究特异性的CVB3-VP1 siRNA对CVB3体外复制的抑制作用的量效关系与时效关系。方法 CVB3感染HeLa细胞，利用脂质体介导将CVB3-VP1siRNA转染HeLa细胞，用RT-PCR法检测CVB3-VP1 RNA水平，免疫荧光检测CVB3-VP1蛋白的表达水平。结果 60pmol／LCVB3-VP1 siRNA是抑制CVB3 RNA及VP1表达的最佳剂量；在转染后的48h，siRNA对CVB3-VP1的抑制作用达到最佳状态。结论 特异性的CVB3-VP1 siRNA对CVB3-VP1蛋白表达水平及CVB3-RNA复制水平呈明显的剂量依赖关系和时效关系，转染后48h呈现出完全抑制作用。     

CVB3心肌炎CTL亚类TCR Vβ基因取用格局分析

目的探讨柯萨奇病毒（CVB3）心肌炎细胞毒T细胞（CTL）亚类（ACTL、VCTL、MCTL）TCR CDR3 Vβ基因取用格局。方法无菌摘取72h内新生Balb／c鼠心脏,培养单层心肌细胞并将其分为三组,分别用CVB3、放线菌素D处理和不经过任何处理;实验组制备CVB3心肌炎鼠模型,处死后将其肠系膜淋巴结制成单细胞悬液,分别加入上述三组单层心肌细胞,采用免疫吸附法获取ACTL、VCTL、MCTL,对照组鼠为正常小鼠处死后取肠系膜淋巴结制成单细胞悬液;采用MTT法对实验组ACTL、VCTL、MCTL和对照组T细胞进行细胞毒鉴定;常规进行RT-PCR,判断实验组细胞及对照组细胞的TCR Vβ基因取用格局。结果对照组T细胞表达Vβ基因全部20个家族,而实验组三类CTL的Vβ基因取用格局呈现明显的限制性,ACTL优势表达Vβ36、Vβ8．1、Vβ8．2、Vβ8．3,MCTL优势表达Vβ5．1、Vβ8．1、Vβ8．2、Vβ8．3,而VCTL优势表达Vβ7、Vβ8．1、Vβ8．2、Vβ8．3。结论CVB3心肌炎中导致心肌细胞损伤的CTL受到特异性抗原刺激后其TCR Vβ基因取用格局呈现明显的限制性。     

Once-monthly radiotherapy for the palliation of pelvic gynecological malignancy

Twenty-seven patients with advanced pelvic gynecological malignancies were treated using a once-monthly fractionation scheme of 10 Gy to a total dose of 30 Gy to the whole pelvis. This course was well tolerated and provided effective palliation with a minimum of hospitalization. The results obtained suggest this course merits consideration for the palliation of other pelvic malignancies.     

硝酸甘油和硝酸异山梨酯抗柯萨奇病毒的体外实验研究

目的研究硝酸甘油(GTN)和硝酸异山梨酯(ISDN)对柯萨奇B组3型病毒(CVB3)的体外抑制作用。方法用Hela细胞扩增并收获柯萨奇B组3型病毒(CVB3)后,测定CVB3的半数组织培养感染剂量(TCID50)和空斑形成单位(PFU),应用MTT法测定实验所用药物的细胞毒性,用细胞病变效应(CPE)抑制实验和空斑减少实验,观察和分析研究GTN、ISDN对CVB3的抑制作用。结果GTN、ISDN可以明显抑制病毒的细胞病变效应以及空斑形成(P<0.05)。结论GTN、ISDN等临床常用于抗心绞痛的硝酸酯类药物具有明确的抗CVB3感染Hela细胞的作用。     

空心莲子草抗柯萨奇病毒B3的实验研究

本采用微量细胞培养法观察细胞病变效应测定经不同剂量空心莲子作用后的病毒滴度,用逆转录－聚合物酶链反应（ＲＴ－ＰＣＲ）检测药物作用后细胞裂解液中的病毒核酸（ＣＶＢ３－ＲＮＡ）,结果药物直接作用组和药物抗病毒吸附组均不能阻止病毒感染宿主细胞,药物抗病毒生物合成组则随培养液中药物浓度加大,细胞裂解液中病毒滴度下降,但ＣＶＢ３－ＲＮＡ却一直可检出。结论：（１）空心莲子草不能直接杀灭ＣＢ３;（２）空心莲子     

柯萨奇病毒心肌病动物模型研究

目的 研究反复增量柯萨奇病毒B3m(CVB3m)感染对小鼠心肌的影响,建立病毒性心肌病动物模型.方法 80只3~4周龄雄性Balb/c小鼠,随机分为心肌病组、单次感染组和正常对照组,于首次感染病毒后第120 d处死小鼠,应用阻抗微分法测定心输出量,病理及组织化学技术分析心肌病理损伤和胶原系统改变,计算胶原容积分数.结果...     

Cardiomyocyte-targeted overexpression of the coxsackie–adenovirus receptor causes a cardiomyopathy in association with β-catenin signaling

The coxsackie–adenovirus receptor (CAR) is an adhesion molecule found at the intercalated disc of cardiomyocytes in association with other adherens and tight junction proteins. CAR expression is increased at cardiomyocyte junctions in patients with heart failure. It is not known what contribution elevated CAR expression makes to cardiac pathology. We generated a binary transgenic mouse enabling cardiac-restricted doxycycline-regulated expression of Flag-tagged murine CAR (mCAR⁺/αMtTA⁺ mice). Myocardial CAR levels were increased 6-fold in mCAR⁺/αMtTA⁺ mice, localizing to intercalated discs and sarcolemma. Well at birth, mCAR⁺/αMtTA⁺ mice developed a severe cardiomyopathy and died by 4 weeks. Cardiomyocyte hypertrophy was evident at 1 week, with increased heart:body weight ratios by 3 weeks. Disorganization and degeneration of cardiomyocytes were evident with disrupted adherens junctions. Doxycycline administration turned off transgene expression and rescued mice from the development of the cardiomyopathic phenotype. In CAR-overexpressing mCAR⁺/αMtTA⁺ mice, adherens junction proteins were abnormally expressed. N-cadherin protein levels were 83% lower in mCAR⁺/αMtTA⁺ hearts vs controls at 1 week, with levels subsequently increased above controls at 3 weeks. β-catenin expression was 90% and 135% above controls at 1 and 3 weeks, respectively. Nuclear translocation of β-catenin in cardiomyocytes of mCAR⁺/αMtTA⁺ mice was associated with increased c-myc RNA, a target of active β-catenin known to be associated with cardiac hypertrophy. Our study is the first to demonstrate that increased CAR expression can induce a cardiomyopathy and supports a model whereby the pathogenesis is determined by CAR stimulated β-catenin signaling, and/or disruption of the adherens junction.