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儿童人类细小病毒B19感染

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染人类细小病毒B19是一种常见的病毒,在儿童中尤其常见。

它通常引起手足口病、疹疸热和第五病等传染病,但在某些情况下也可能引起一些更严重的并发症。

本文将讨论儿童人类细小病毒B19感染及其相关症状、诊断和治疗。

病毒简介人类细小病毒B19是一种单链DNA病毒,属于Erythrovirus属。

它是一种非常传染性的病毒,通过飞沫传播或直接接触感染。

感染后,病毒在体内繁殖并破坏富含红细胞前体的细胞,导致红细胞减少和贫血的症状。

症状人类细小病毒B19感染的症状通常在感染后1-2周内出现。

一般而言,感染后的头7-10天是传染期,在这段时间里患者最容易向他人传播病毒。

一些患者可能在感染后没有任何症状,而另一些患者可能表现出以下症状:1. 发热:感染后的第一周,患者可能出现中度发热,体温可能高达39℃。

2. 皮疹:大约50%的患者在发热清除后会出现不规则的红色斑丘疹,通常从面颊开始,然后向体干和四肢蔓延。

这种皮疹可能持续1-3天,然后逐渐消退。

3. 流行性感冒样症状:包括流感样症状,如头痛、肌肉酸痛、关节痛和全身不适等。

4. 关节肿痛:5-10%的患者可能出现短暂的关节肿痛,通常在皮疹出现后开始,但与病毒的清除相关。

5. 贫血:在某些情况下,特别是在成人或有免疫缺陷的患者中,人类细小病毒B19感染可能导致严重的贫血。

这是由于病毒破坏红细胞前体导致红细胞生产不足引起的。

诊断如果怀疑患儿感染了人类细小病毒B19,可以通过以下方法进行诊断:1. 临床症状:根据患儿出现的症状进行初步诊断,如发热、皮疹、贫血等。

2. 实验室检查:可以通过血液检查来检测病毒DNA或抗体,以确认感染。

治疗大多数患儿感染了人类细小病毒B19后会自行康复,不需要特殊治疗。

但在某些情况下,可能需要进行治疗,如:1. 对于贫血严重的患者,可能需要输血来纠正贫血。

2. 对于免疫缺陷的患者,可能需要使用免疫球蛋白来帮助清除病毒。

3. 对于关节肿痛的患者,可以使用非类固醇抗炎药来缓解疼痛。

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染儿童人类细小病毒B19感染,通常称为B19病毒感染,是一种常见的儿童传染病。

这种病毒可引起传染性红斑病(又称第五病),并可能导致患者出现一系列的症状。

B19病毒属于巴尔科维病毒科,是一种只感染人类的病毒。

传播途径主要是通过呼吸道飞沫传播,也可以通过血液、体液等途径传播。

一个人一旦感染了B19病毒,会在感染后的6到7天内出现症状。

这个潜伏期过后,患者会出现持续数天的症状。

最常见的症状是皮疹,表现为颜面潮红,咽部也会出现红点。

除了皮疹外,还可能伴有发热、头痛、肌肉疼痛和关节疼痛。

大部分患者的症状会在一到两周内自行消失,但在部分患者中,关节疼痛可能会持续数周至数月。

B19病毒感染对正常儿童的健康影响较小,通常不会引起严重的并发症。

但对于一些特殊人群,如免疫系统功能低下的患者、孕妇及患有血液病的儿童而言,B19病毒感染可能会引起严重的并发症。

对于免疫系统功能低下的患者,B19病毒感染可能导致严重的贫血,甚至危及生命。

对于孕妇,B19病毒感染在怀孕早期可能导致胎儿畸形或流产。

而对于患有血液病的儿童,B19病毒感染可能导致骨髓抑制,进一步加重原本就已存在的血液病状况。

由于B19病毒感染主要通过呼吸道传播,预防措施主要是注意个人卫生和避免与感染者过于密切接触。

如果家庭中有患B19病毒感染的儿童,应保持良好的居室通风,勤洗手,避免与其他儿童或孕妇过于密切接触。

对于已经感染了B19病毒的患者,基本的治疗方法主要是对症治疗。

对于发热患者,可以使用退烧药物来缓解症状。

如果出现关节疼痛,可以使用非甾体抗炎药来缓解疼痛。

对于那些已经出现了严重的并发症的患者,如贫血或骨髓抑制,可能需要进行进一步的治疗。

儿童人类细小病毒B19感染是一种常见的传染病,通常表现为颜面潮红、发热、头痛、肌肉疼痛和关节疼痛。

大部分患者的症状会自行缓解,但在一些特殊人群中可能会引起严重的并发症。

预防措施主要是保持个人卫生和避免与感染者过于密切接触。

人细小病毒B19-VP1u保守区外C端氨基酸对sPLA2活性的影响

人细小病毒B19-VP1u保守区外C端氨基酸对sPLA2活性的影响
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人类细小病毒B19感染危害及预防PPT课件

人类细小病毒B19感染危害及预防PPT课件
目前尚无针对细小病毒B19的特异性疫苗,预防 以提高个人卫生为主。
关注相关疫苗研发动态。
如何预防人类细小病毒B19感染? 健康管理
保持良好的免疫状态,适当锻炼,均衡饮食,充 足睡眠。
特别是孕妇和免疫力低下者,应定期进行健康检 查。
感染后的处理与应对
感染后的处理与应对 早期诊断
一旦出现相关症状,应及时就医,进行病毒 检测。
人类细小病毒B19感染的危害
人类细小病毒B19感染的危害 临床表现
感染可引起轻微的感冒症状、麻疹样皮疹等 ,也可能导致关节痛、疲劳等。
部分患者可能出现严重贫血,影响生活质量 。
人类细小病毒B19感染的危害 高风险人群
孕妇感染可能导致胎儿流产、胎儿贫血等并 发症。
免疫系统受抑制的患者也容易出现严重感染 。
提高公众对该病毒的认知,有助于减少传播与感 染。
总结与展望
研究进展
科学家们正在研究针对细小病毒B19的疫苗和治 疗方法。
关注科研动态,积极参与健康教育活动。ຫໍສະໝຸດ 总结与展望倡导健康生活
鼓励个人和社会共同努力,提高防控意识,维护 健康。
定期更新健康知识,保持警惕。
谢谢观看
人类细小病毒B19感染危害及预防
演讲人:
目录
1. 什么是人类细小病毒B19? 2. 人类细小病毒B19感染的危害 3. 如何预防人类细小病毒B19感染? 4. 感染后的处理与应对 5. 总结与展望
什么是人类细小病毒B19?
什么是人类细小病毒B19? 定义
人类细小病毒B19是一种小型DNA病毒,属于细小 病毒科。
该病毒主要通过呼吸道传播,感染后可导致多种 临床表现。
什么是人类细小病毒B19? 传播途径
主要通过空气飞沫、直接接触感染者的体液或血 液传播。

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染人类细小病毒B19是一种常见的病毒,主要侵害人类。

它是一种只能感染人类的病毒,对儿童的感染率较高。

人类细小病毒B19感染通常引起第五病,也称作弓形红斑疹,是一种常见的儿童疾病,通常在春季和夏季发病。

人类细小病毒B19是通过飞沫传播或接触传播而传播的,一个感染了B19病毒的人会在咳嗽、打喷嚏或接触时,将病毒传播给其他人,因此公共场合尤其是幼儿园和学校是传播病毒的高危地点。

而一旦感染,病毒会在体内潜伏数周,然后引发一系列特有的症状。

下面就是人类细小病毒B19感染的一些常见症状:1. 红斑疹感染人类细小病毒B19后,患儿通常会在面部和四肢出现红色或粉红色的红斑疹,这些红斑疹通常伴随有轻微的瘙痒,如果被擦伤或摩擦会变得更明显。

这些红斑疹通常会在数天内蔓延到其他部位,整个身体都可能会被覆盖上红斑疹。

2. 发热感染人类细小病毒B19后,患儿通常会出现发热的症状,体温通常会在38°C至39°C 之间,持续几天。

3. 头痛和流感症状感染人类细小病毒B19后,患儿可能会有轻微的头痛和流感症状,如咳嗽、鼻塞、喉咙痛和乏力等。

4. 关节痛人类细小病毒B19感染后,患儿可能会出现关节痛的症状,通常在感染后的一周内出现。

关节痛通常轻度,但有时会影响到活动能力。

需要注意的是,虽然人类细小病毒B19感染有一系列的特有症状,但并不是所有感染了B19病毒的人都一定会出现症状,一些人可能感染了病毒却没有明显的症状。

不过,对于儿童来说,一旦感染了B19病毒,通常会出现上述一些或者所有的症状。

对于大部分感染人类细小病毒B19的患儿来说,病情通常是轻度的,不需要特殊的治疗措施。

在发热期间,可以给患儿服用退烧药,保持充足的水分和休息是很重要的。

对于出现关节痛的患儿,可以适当进行按摩和热敷,缓解疼痛。

在发病期间,还需要注意让患儿隔离休息,避免接触其他人,减少病毒的传播。

但对于一些特殊情况的患儿,例如免疫系统功能较差的患儿、贫血患者或者患有血液疾病的患儿,需要特别关注,因为人类细小病毒B19感染可能会导致更严重的后果,如重度贫血或者严重的骨髓抑制等。

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染

儿童人类细小病毒B19感染
儿童人类细小病毒B19感染,是一种常见的儿童传染病,引起儿童贫血和皮肤炎症。

本文将介绍关于儿童人类细小病毒B19感染的症状、传播途径、诊断和治疗方法,以及预防措施。

症状
儿童人类细小病毒B19感染的常见症状包括发热、头痛、咽喉痛、乏力和食欲不振。

一些感染者可能出现皮疹,主要表现为红色的斑块或斑丘疹,通常出现在面部、手臂、腿部和胸部。

儿童人类细小病毒B19感染还可能引起关节炎和贫血,尤其是对于有血液系统疾病或免疫系统缺陷的儿童来说。

传播途径
儿童人类细小病毒B19感染主要通过飞沫传播,当感染者咳嗽或打喷嚏时,病毒将通过空气中的飞沫传播给其他人。

病毒还可以通过直接接触感染者的口水或血液而传播。

感染者在感染后一周内具有最高的传染性,因此需要采取预防措施来避免传播给其他人。

诊断和治疗
儿童人类细小病毒B19感染的诊断可以通过检测患者的血清抗体来确认。

对于出现典型症状的儿童,医生还可以进行血液检查来确认贫血和炎症症状的发生。

一旦确诊,治疗主要是对症状进行缓解。

对于发热和疼痛,可以使用退烧药和止痛药来减轻症状。

对于贫血患者,可能需要输血或口服铁剂来帮助恢复血液的健康。

预防措施
预防儿童人类细小病毒B19感染的最有效方法是采取良好的卫生习惯。

鼓励儿童勤洗手、避免与感染者分享餐具和饮水,并教育他们咳嗽或打喷嚏时用纸巾遮挡口鼻。

儿童接种疫苗也是预防感染的重要手段。

疫苗可以有效预防儿童人类细小病毒B19感染,降低患病率和传播风险。

人类细小病毒B19感染护理

人类细小病毒B19感染护理

什么是人类细小病毒B19? 传播途径
该病毒通过空气中的飞沫传播,也可以通过血液 传播。
特别是在拥挤的环境中,如学校或托儿所,传播 风险增加。
Байду номын сангаас
什么是人类细小病毒B19? 症状
感染后,常见症状包括发热、皮疹、关节疼痛等 。
部分患者可能没有明显症状,但仍具传染性。
谁容易感染?
谁容易感染?
高风险人群
可能需要额外的治疗和监测。
护理措施
护理措施 居家护理
保持良好的卫生习惯,勤洗手,避免与他人 密切接触。
患者在家休息可以帮助身体恢复。
护理措施 缓解症状
可服用退烧药和止痛药来缓解不适。
遵医嘱用药,避免自行用药。
护理措施 定期复查
感染后定期复查,确保病情稳定。
特别是对高风险人群,定期监测至关重要。
何时寻求医疗帮助? 严重症状
如出现高热、严重关节疼痛或皮疹等症状,应及 时就医。
医生会根据症状进行必要的检查和诊断。
何时寻求医疗帮助? 妊娠期监测
孕妇如怀疑感染需尽快就医进行监测。
医生可能会建议超声波检查以评估胎儿健康。
何时寻求医疗帮助? 免疫系统问题
免疫系统受损者应在感染后尽快咨询专业医生。
怎样预防感染?
怎样预防感染?
接种疫苗
目前尚无针对B19病毒的疫苗,预防主要依靠卫 生习惯。
研究正在进行中,未来可能会有疫苗问世。
怎样预防感染?
保持环境清洁
定期消毒公共场所,尤其是儿童活动区域。
减少病毒传播的风险。
怎样预防感染?
增强免疫力
通过均衡饮食、适量运动和充足睡眠来增强免疫 力。
良好的生活习惯有助于抵御病毒感染。

预防人类细小病毒B19感染

预防人类细小病毒B19感染
预防感染能减少医疗负担,保护公共健康, 促进社会的正常运转。
这对于社区和社会的整体健康至关重要。
如何预防感染?
如何预防感染?
保持良好的卫生习惯
勤洗手,特别是在接触公共场所后,使用肥皂和 清水洗手至少20秒。
使用洗手液也是有效的替代方案。
如何预防感染?
避免密切接触
尽量避免与有症状的感染者密切接触,保持社交 距离。
该病毒在儿童中常见,成人感染后可能导致更严 重的症状。
什么是人类细小病毒B19? 传播途径
该病毒通过感染者的唾液、鼻涕或血液传播,也 可以通过母婴传播。
了解传播途径有助于采取适当的预防措施。
什么是人类细小病毒B19? 感染症状
感染后可能出现发热、皮疹、关节疼痛等症状, 部分人可能无明显症状。
了解症状有助于早期识别和治疗。
何时寻求医疗帮助? 高风险人群
孕妇、免疫系统受损者等高风险人群应特别 注意,如有感染迹象应及时就医。
这些人群更易受到病毒的影响。
何时寻求医疗帮助? 定期检查
高风险人群应定期进行健康检查,以便及时 发现潜在问题。
定期体检可以帮助早期识别病毒感染。
总结与展望
总结与展望
综合预防
通过个人和社会层面的共同努力,可以有效预防 人类细小病毒B19的感染。
特别是在流行期间,采取额外的预防措施。
如何预防感染?
健康教育
通过宣传和教育,提高公众对人类细小病毒B19 的认识和预防意识。
社区活动和学校课程可以有效传播这些知识。
何时寻求医疗帮助?
何时寻求医疗帮助? 症状加重
如出现高热、持续疼痛或其他严重症状,应 尽早就医。
及时的医预防感染? 潜在风险
尽管大多数感染是轻微的,但对免疫系统较 弱的人群可能造成严重影响。
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VP1u phospholipase activity is critical for infectivity of full-lengthparvovirus B19genomic clonesClaudia Filippone a,1,Ning Zhi a,⁎,1,Susan Wong a ,Jun Lu a ,Sachiko Kajigaya a ,Giorgio Gallinella b ,Laura Kakkola c ,Maria Söderlund-Venermo c ,Neal S.Young a,2,Kevin E.Brown d,2aHematology Branch,National Heart,Lung,and Blood Institute,National Institute of Health,USAbDepartment of Clinical and Experimental Medicine,University of Bologna,Italy cDepartment of Virology,Haartman Institute,University of Helsinki,FinlanddCentre for Infections,Health Protection Agency,London,UKReceived 9November 2007;returned to author for revision 14December 2007;accepted 4January 2008Available online 5February 2008AbstractThree full-length genomic clones (pB19-M20,pB19-FL and pB19-HG1)of parvovirus B19were produced in different laboratories.pB19-M20was shown to produce infectious virus.To determine the differences in infectivity,all three plasmids were tested by transfection and infection assays.All three clones were similar in viral DNA replication,RNA transcription,and viral capsid protein production.However,only pB19-M20and pB19-HG1produced infectious parison of viral sequences showed no significant differences in ITR or NS regions.In the capsid region,there was a nucleotide sequence difference conferring an amino acid substitution (E176K)in the phospholipase A 2-like motif of the VP1-unique (VP1u)region.The recombinant VP1u with the E176K mutation had no catalytic activity as compared with the wild-type.When this mutation was introduced into pB19-M20,infectivity was significantly attenuated,confirming the critical role of this motif.Investigation of the original serum from which pB19-FL was cloned confirmed that the phospholipase mutation was present in the native B19virus.©2008Elsevier Inc.All rights reserved.Keywords:Parvovirus B19;PLA 2-like motif;Infectious cloneIntroductionParvovirus B19(B19V),a member of the genus Erythrovirus of the family Parvoviridae ,is a pathogenic virus distributed worldwide in the human population (Young and Brown,2004).B19V is highly erythrotropic:infection of human erythroid progenitor cells leads to cytotoxicity and interruption of eryth-rocyte production (Mortimer et al.,1983).The physiological con-ditions of the host and the extent of the immune antiviral response then contribute to the evolution and clinical manifestation of the infection (Young and Brown,2004).Infection causes fifth diseasein children (Anderson et al.,1985,1983),polyarthropathy syndrome in adults (Matsumura,2001;Moore,2000),transient aplastic crisis in patients with underlying chronic hemolytic anemia (Pattison et al.,1981;Serjeant et al.,1981),and chronic anemia due to persistent infection in immunocompromised patients (Kurtzman et al.,1989,1988).Infection during pregnancy can lead to hydrops fetalis with possible fetal loss (Kinney et al.,1988)and/or congenital infection (Brown et al.,1993b ).In common with other parvoviruses,B19V has a small (22nm),nonenveloped,icosahedral capsid,encapsidating a limited single-stranded DNA genome (5596nucleotides (nt)).The ends of the genome are long inverted terminal repeats (ITRs)of 383nt,of which the distal 365nt forms an imperfect palindrome (Deiss et al.,1990).Transcription of the B19viral genome is controlled by a single promoter (p6)located at map unit 6,which regulates the synthesis of all nine viral transcripts (Blundell et al.,1987;Ozawa et al.,1987).The single nonsplicedAvailable online at Virology 374(2008)444–452/locate/yviroCorresponding author.Bldg.10/CRC,Rm.3E5272National Institutes of Health,9000Rockville Pike,Bethesda,MD 20892,USA.Fax:+13014968396.E-mail address:zhin@ (N.Zhi).1These authors contributed equally to this work.2These authors equally supervised the project.0042-6822/$-see front matter ©2008Elsevier Inc.All rights reserved.doi:10.1016/j.virol.2008.01.002transcript encodes a nonstructural protein (NS)and,by a combination of different splicing events,the other eight tran-scripts encode the two capsid proteins (VP1and VP2)and two smaller proteins (7.5kDa and 11kDa)of yet unknown function (Cotmore et al.,1986;Ozawa et al.,1987;St Amand et al.,1991).In addition,a short open reading frame (ORF)putatively encoding protein X is present in the VP1region of the B19V genome.The B19V NS protein is a multifunctional protein;in addition to transregulation of the p6promoter (Doerig et al.,1990;Raab et al.,2002),NS contains motifs for nucleoside triphosphate (NTP)binding and hydrolysis (Momoeda et al.,1994)associated with helicase activity,suggesting a role of NS in B19V DNA replication.Accumulating evidence also suggest that the NTP-binding motif of NS is involved in the induction of apoptosis in erythroid lineage cells during B19V infection(Moffatt et al.,1998).The major capsid protein,VP2,which comprises 95%of the capsid,is a 58-kDa protein.Earlier studies showed that VP2expressed in insect cells self-assembles into virus-like particles (Kajigaya et al.,1991)and VP2binds directly to blood group P antigen,the cellular receptor of B19virus (Brown et al.,1993a ).The minor capsid protein,VP1,differs from VP2only in an N-terminal “unique region ”(VP1u)composed of an additional 227amino acids.(Ozawa and Young,1987).The VP1u region elicits a dominant immune response (Saikawa et al.,1993;Rosenfeld et al.,1992;Ros et al.,2006)and has phospholipase A 2(PLA 2)activity,which is necessary for B19V infection (Lu et al.,2006;Zadori et al.,2001).The two small proteins,7.5kDa and 11kDa,are encoded by the small,abundant mRNAs of B19V and are unique among the parvo-viruses characterized to date (Luo and Astell,1993;St Amand et al.,1991;St Amand and Astell,1993).The 11-kDa protein contains several proline-rich motifs that are conserved to Src homology 3(SH3)binding domain of eukaryotic proteins (Fan et al.,2001).What functions the 11-kDa or 7.5-kDa protein play in B19V replication and/or pathogenesis are unknown.We previously defined the specific roles of these viral proteins in B19V infectivity by mutagenesis analysis of the B19V infectious clone (Zhi et al.,2004,2006):null mutation of the NS and VP1proteins or deletion of the terminal hairpin sequence completely abolished the viral infectivity,and a null mutant of 11-kDa protein was significantly attenuated (Zhi et al.,2004,2006).Three independent full-length clones (pB19-M20,pB19-FL and pB19-HG1)have been produced in three different labora-tories (Zhi et al.,2004,2006).We have previously shown that pB19-M20produces infectious virus.However the other two full-length clones (pB19-FL and pB19-HG1)have not been proven to be infectious.In the present study,the infectivity of these full-length clones was evaluated in parallel by transfection and infec-tion assays.Mutagenesis analysis showed that a single amino acid substitution (E176K)in the VP1u region of pB19-FL resulted in loss of PLA 2activity and attenuation of viral infectivity.ResultsCloning and sequencing analyses of full-length parvovirus B19genomesThree independent full-length clones (pB19-M20,pB19-FL and pB19-HG1)were produced using different strategies (Fig.1).Fig.1.Schematic representation of three full-length B19V genomic clones.The three full-length B19V genomic clones,pB19-M20,pB19-FL and pB19-HG1,were obtained from the B19V J35isolate (GenBank Accession no.AY386330),the NAN isolate (GenBank Accession no.AY504945)and the HV isolate (GenBank Accession no.AF162273),respectively.The recombinant plasmids were constructed using different plasmid vectors:pB19-M20,pPRoEX HTb vector;pB19-FL,pLITMUS19vector;and pB19-HG1,pUC18vector.Arrows indicate the genes in either B19V genome or vector,and shaded circles indicate the ITR at both ends of B19V genome.Important restriction enzyme sites for cloning and analyzing arelabeled.Fig.2.Alignment of amino acid sequences of VP1u regions of three full-length B19V genomic clones.Aligned positions of identical amino acids with the VP1u region of pB19-M20are shown with dashed lines.A boxed area indicates the PLA 2-like motif conserved among members of the Parvoviridae .Solid circles indicate conserved catalytic residues and Ca 2+-binding sites critical for enzymatic activity.The numbers on the right indicate the positions of amino acid residues in the VP1u region of parvovirus B19from the N terminus to C terminus.445C.Filippone et al./Virology 374(2008)444–452The entire B19V genomes in the three plasmids were sequenced.Since pB19-M20had been shown to produce infectious virus,it was used for reference in the analyses of the DNA and protein sequences.Although the hairpin sequences were similar to each other among three B19V genomic clones,except for a deletion in pB19-HG1at nucleotide 193,the secondary configurations of the hairpins in the palindromic regions were different:the hairpins in pB19-HG1and pB19-FL had flip/flip and flop/flip structures,respectively,but the structures were flip/flop in pB19-M20.Alignment of the primary amino acid sequences of the proteins showed eighteen substitutions among the B19V genomic clones (pB19-M20,pB19-FL and pB19-HG1)(Table 1).Fifteen of them were found in the VP2,NS and11-kDa proteins,and the putative X protein,but none were located in functionally impor-tant regions of the proteins (Ozawa et al.,1988;Fan et al.,2001).Among the three mutations found in VP1(Fig.2),a nucleotide point mutation (G3148A)of pB19-FL (corresponding to nt 3149of pB19-M20)resulted in an amino acid substitution (E176K),which is proximate to the catalytic residues of the PLA 2-like motif in the VP1u region.Production of infectious virusWe have previously shown that infectious virus was generated from the cells transfected with plasmid pB19-M20(Zhi et al.,2004).In an attempt to determine if full-length clones pB19-FL and pB19-HG1were also able to produce infectious virus,we used the supernatant prepared from the cell lysates of transfected cells to infect UT7/Epo-S1cells,and detected spliced transcripts of viral capsid genes by RT-PCR as a marker for successful viral infection.The spliced transcripts were present in all samples (Fig.3)at 72h post-transfection.Immediately after inoculation of the clarified supernatant into the UT7/Epo-S1cells,no RT-PCR product was detected in any of the samples (Fig.3),indicating that there was no carry-over of the RNA from the transfected cells.At 72h post-inoculation,spliced transcripts were detected in the samples derived from the cells transfected with pB19-M20or pB19-HG1,but not with pB19-FL (Fig.3);therefore both pB19-M20and pB19-HG1were infectious,but the production of infectious virus from the cells transfected with pB19-FL was below the level of detection.Excision of B19V genome from the plasmids after transfection into permissive cellsDuring the replication of parvovirus B19,viral single-stranded DNA is converted to a double-stranded replicative formwhichparison of infectivity of three full-length B19V genomic clones by RT-PCR.Total RNAs were extracted from UT7/Epo-S1cells at 72h post-transfection (hpt),or 0and 72h post-infection (hpi).PCR was performed with a primer pair of B19-1and B19-9.The products were analyzed by agarose gel electrophoresis.(+)or (−)indicates the presence or absence of the reverse transcriptase in the reaction,respectively.Numbers on the right indicate the respective ampliconsizes.parison of B19V replication following transfection of UT7/Epo-S1cells with full-length B19V genomic clones.(A)Schematic representation of the replication of B19V genome.(B)Southern blot analysis of B19genome replication.DNA was extracted by the Hirt method at 72h post-transfection and analyzed by Southern blotting after digestion with EcoRI (−)or BamHI (+)in order to investigate the presence of characteristic replicative forms.The fragments were separated by agarose gel,transferred to a nylon membrane and hybridized with a 32P-random-primed probe of the complete B19V genome.446 C.Filippone et al./Virology 374(2008)444–452has either an“extended”or a“turnaround”structure at the ter-minal region.These intermediate structures provide evidence for viral DNA replication and can be distinguished by BamHI restriction enzyme digestion(Fig.4A).We performed Southern blot analysis to test whether the lack of production of infectious virus in pB19-FL was due to a defect in generation of progeny viral DNA.The UT7/Epo-S1cells were transfected with the DNA frag-ments containing full-length B19genomes which were released from the plasmids by restriction enzyme digestions.After trans-fection,distinct doublets of1.5kb and1.4kb were detected in all the transfected cell samples digested with BamHI,(Fig.4B).This result indicated that progeny viral DNA was generated from the cells transfected with the three full-length clones,including pB19-FL which was unable to produce infectious virus.Viral capsid protein productionViral capsid proteins in UT7/Epo-S1cells transfected with each of three full-length clones(pB19-M20,pB19-FL or pB19-HG1)were compared using immunoblot analysis and immuno-fluorescence(IF)staining.For pB19-M20and pB19-HG1,an expression level of the viral capsid protein was slightly lower than in the cells transfected with pB19-FL(Fig.5A).Whentransfected UT7/Epo-S1cells were examined by IF staining with a monoclonal antibody specific for the viral capsid,the capsid proteins were detected in both nucleus and cytoplasm at48h post-transfection(Fig.5B).No difference was found among the cells transfected with different plasmids.VP1u PLA2activity is critical for the infectivity of full-length B19clonesComparison of amino acid sequences of capsid proteins among the three full-length B19V clones revealed a substitution (E176K)in pB19-FL(Table1),which resulted from a nucleotide point mutation(G3148A)of pB19-FL(corresponding to nt3149 of pB19-M20)and is next to the catalytic residues of the PLA2-like motif(Zadori et al.,2001)in the VP1u region.This mutation is unique to the pB19-FL clone and was not found in the B19V sequences which are available in the GenBank.Since the E176K substitution identified in pB19-FL clone was proximate to the catalytic residues of the PLA2-like motif in the VP1u region,we tested the impact of the mutation on enzyme activity of PLA2by constructing a mutant based on the VP1u region of pB19-M20, in which the E176was altered to K.In addition,to confirm the importance of conserved amino acid residues inthe parison of B19V capsid production following transfection of UT7/Epo-S1cells with B19V full-length genomic clones.(A)Detection of the B19VVP2capsid protein by immunoblotting.The samples were collected at72h post-transfection and tested by immunoblotting with MAB8293antibody to the viralcapsid protein.Bands were visualized by chemiluminescence.(B)Detection ofB19V capsid proteins by IF staining.UT7/Epo-S1cells were transfected withpB19-M20,pB19-HG1or pB19-FL,respectively.At72h post-transfection,thecapsid proteins were detected using MAB521-5D antibody and then FITC-labeled goat anti-mouse IgGs.Magnification×750.Table1Comparison of amino acid sequences among proteins encoded by three B19Vfull-length genomic clonesProteinnamesPosition ofmutation aSubstitutions in three B19full-length clonespB19-m20(J35isolate)PB19-FL(NAN isolate)PB19-FL(HV isolate)NS57L F F71A V V11F L L183T A T205F F I526F L F558P P SVP114E K K107D N N176E K E377C C S574T T PVP2150C C S347T T P7.5kDa No change No change No change11kDa7D D G10M M T54I V VX51A V Aa Positions and amino acid residues are described for each protein.Table2Impact of mutations in PLA2enzyme activity and B19V infectivityProtein Mutagenesis site a PLA2activity b Relative infectivity cμmol/min/ml%VPlu(pB19-M20)0.187100P133R C to G at nt30210.00120H153A C to G at nt30800.00562A to C at nt3081A174G C to G at nt31440.001 2.1D175A A to C at nt31470.001 1.2E176K d G to A at nt31490.00520bv sPLA20.630.63TBS0Result shown are the mean values for three independent experiments.a Nucleotide numbers are based on the sequence of the J35isolate(GenBankaccession no.AY386330).b Measured by the colorimetric kit.Protein concentration tested:recombinantproteins(VPlu,PI33R,HI53R,AI74G,DI75A and EI76K),20μg;bee venom(bv)secreted PLA2,10ng.c Relative infectivity¼MT:fold change of viral transcript of day0vs day3postÀinfectionWT:fold change of viral transcript of day0vs day3postÀinfectionÂ100kd Mutation EI76K converted the VPlu of pB19-M20to pB19-FL.447C.Filippone et al./Virology374(2008)444–452Ca 2+-binding loop and enzyme catalytic site of B19V-PLA 2,four additional VP1u mutants,including P133R,H153A,A174G and D175A,were made and tested for their PLA 2activities.All of the mutations in the Ca 2+-binding loop and enzymatic catalytic sites that were tested abolished PLA 2activity (Table 2).In contrast to the wild-type (pB19-M20),PLA 2activity was completely abolished when the E176K substitution identified in pB19-FL was introduced into the VP1u region of pB19-M20.In order to test the impact of the PLA 2activity on infectivity of B19V full-length clone,mutations P133R,H153A,A174G,D175A or E176K were introduced into the B19V infectious clone (pB19-M20).The five mutants were termed pB19-M20/PLA 2-P133R,pB19-M20/PLA 2-H153A,pB19-M20/PLA 2-A174G,pB19-M20/PLA 2-D175A and pB19-M20/PLA 2-E176K.After transfection of these mutants into UT7/Epo-S1cells,the supernatants prepared from the cell lysates of trans-fected cells were used to infect CD36+erythroid progenitor cells (CD36+EPCs),and infectivity was quantitatively analyzed by real-time RT-PCR for the transcripts of the viral NS gene.In comparison with pB19-M20,the wild-type infectious clone,only 21%of relative infectivity was retained in the pB19-M20/PLA 2-E176K.Moreover,the relative infectivity of B19V mu-tants of pB19-M20/PLA 2-P133R,pB19-M20/PLA 2-H153A,pB19-M20/PLA 2-A174G and pB19-M20/PLA 2-D175A was decreased to 21,62,2.1,and 1.2%,respectively.Taken together,our data suggest that decreasing enzyme activity of PLA 2due to the E176K mutation attenuated B19viral infectivity.We also confirmed that VP1u-PLA 2activity is critical to the infectivity of full-length B19V clones.VP1u-PLA 2mutation (E176K)identified in the native B19V NAN isolateTo exclude the possibility that the nucleotide point mutation (G3148A)of B19-FL clone was artifactually generated in theprocess of cloning,the VP1u region was PCR-amplified from a DNA sample of the patient serum (NAN)from which pB19-FL had been cloned.After TA cloning,inserts of 20plasmids were sequenced:all contained the G3148A mutation,indicating that this mutation was carried in the original B19virus.To compare the infectivity of the NAN isolate with the J35isolate,the diluted patient sera containing similar numbers of B19V genome copies (108copies/ml)were inoculated into UT7/Epo-S1cells.Viral replication was evaluated by real-time PCR for viral capsid transcripts.At 72h post-inoculation,the viral NS transcripts produced in the cells inoculated with the NAN isolate were approximately 100-fold less than those with the J35isolate Fig.6.In comparison with B19V J35isolate,the relative infectivity of the NAN isolate was only 0.2%,indicating a marked attenuation of infectivity in the NAN isolate.DiscussionThe availability of three full-length B19V genomic clones (pB19-M20,pB19-FL and pB19-HG1)permitted a systematic elucidation of molecular determinants of B19V pathogenicity.Clone pB19-M20had been previously shown to be able to produce infectious virus after transfection into UT7/Epo-S1cells (Zhi et al.,2004,2006).Using a similar approach,we demon-strated that clone pB19-HG1was infectious,but the infectivity of pB19-FL was much lower in comparison with those of pB19-M20and pB19-HG1.Attenuated infectivity was also found in native virus (the NAN isolate)from which the pB19-FL was cloned.In order to determine why pB19-FL did not produce infectious virus,three viral sequences were compared:in the capsid region a nucleotide sequence difference,resulting in an amino acid substitution (E176K)in the PLA 2-like motif of the VP1u,was observed.The recombinant VP1u protein bearing this mutation had no catalytic activity compared with the wild-type recombinant proteins.Moreover,when this mutation was introduced into pB19-M20,there was a significant attenuation of infectivity,confirming a critical role of the PLA 2-like motif in viral infectivity.Although a total of eighteen substitutions were found in viral proteins among pB19-M20,pB19-HG1and pB19-FL,only three were unique in pB19-FL.In addition to the PLA 2mutation (E176K)identified in VP1u,F526L in the NS protein and A51V in the X protein were present.Since no phenotypic change had been found between pB19-M20and pB19-HG1,these three mutations unique for pB19-FL were likely responsible for the attenuation of infectivity in pB19-FL.NS is a multifunctional protein and plays important roles in regulation of the viral p6promoter and DNA replication.The B19V NS sequence con-tains a conserved helicase motif (amino acids 306–344)and a putative NTP binding site (amino acids 326–393)(Momoeda et al.,1994).We have previously shown that a NS-null mutant was unable to replicate in permissive cells (Zhi et al.,2006).In this study,Southern blot analysis demonstrated that the replication form or newly synthesized viral DNA was detected in all cells transfected with the three B19V clones,suggesting that the substitution F526L in NS of pB19-FL had no impact on viral replication.No difference had been found betweentheparison of infectivity of the B19V J35isolate and NAN isolates by real-time RT-PCR.The cells were inoculated with 50genome copies/cell of virus.Total RNA was extracted from the cells at 0,24,48and 72h post-inoculation.The abundance of viral NS transcripts was measured by real-time RT-PCR.Quantitations are given as copy numbers of NS transcripts/μl of cDNA reaction.Results shown are mean values from three independent experiments.448 C.Filippone et al./Virology 374(2008)444–452wild-type and the X protein null mutant in respect to infectivity and viral DNA replication(Zhi et al.,2006).Therefore,it is unlikely that the substitution A51V in the X protein had a significant impact on viral infectivity of pB19-FL.We have reported that a VP1-null mutation completely abolished the infectivity of B19virus(Zhi et al.,2006).The minor capsid protein,VP1,differs from VP2only in the VP1u region composed of an additional227amino acids(Ozawa and Young,1987).The main neutralizing epitopes of B19V are in VP1u region(Saikawa et al.,1993).Accessibility of the VP1u region in native viral capsids required a conformation change induced by acidification in vitro or cell-mediated stimulus during viral entry(Ros et al.,2006).Recently,a conserved PLA2-like motif(HDXXY)was identified in the N-terminal extension of the VP1u region of members of the Parvoviridae(Zadori et al.,2001; Canaan et al.,2004),including B19V(Dorsch et al.,2002;Lu et al.,2006).Several amino acids in the highly conserved domain of the VP1u region share homologies to the Ca2+-binding loop and catalytic site of secreted PLA2.The residue P133in the Ca2+-binding loop,and H152,D153and D175in the catalytic site of B19V PLA2that corresponds to P21,H41,D42and D63in porcine parvovirus(PPV)are highly conserved in the PLA2-like motif found in members of Parvoviridae.In PPV,mutation in these critical amino acid residues resulted in loss of PLA2activity and viral infectivity.In the present study,we constructed five PLA2mutants based on the B19V infectious clone(pB19-M20): the P133R mutant(the Ca2+-binding loop),the H153A,A174G or D175A mutant(the enzyme catalytic site)or the E176K mutant (the VP1u region present in pB19-FL clone).The infectivity of viruses carrying these PLA2mutations was significantly atten-uated,with relative infectivity ranging from2to62%,implicating an important role of PLA2in the VP1protein in the B19V life cycle.Although data obtained by in vitro PLA2activity assay showed that all mutations abolished the PLA2activity,the results of the infection assay revealed that the infectivity of viruses derived from these B19V mutant clones appeared to be variable. The viruses derived from two B19V infectious clones carrying point mutations in the enzyme catalytic site(A174G or D175A) completely lost infectivity.However,although PLA2enzyme activity was significantly decreased,viruses containing the point mutation P133R in the Ca2+-binding loop and another mutation H153A in the enzyme catalytic site retained21%and62%of infectivity,respectively,in comparison with the wild-type infec-tious clone,pB19-M20.Similarly,viruses having the point muta-tion E176K were attenuated and retained only21%of infectivity. Although E176was less conserved,in comparison with other amino acid residues in the catalytic motif,conversion of an acidic residue(E)to a basic residue(K)likely disturbs the molecular structure of the enzyme.The attenuation of viral infectivity did not completely correlate with the reduction of PLA2enzyme activity of these mutants when tested by the in vitro assay.Although we cannot exclude the possibility that the VP1unique region might have additional functions,the phenomena observed in our study likely implies a complexity of in vivo environment in which certain cellular factors may compensate for viral PLA2enzyme activity,and therefore help to retain the infectivity of these mutants to some degree.In order to test if the infectivity of the NAN isolate could be rescued by changing the VP1unique region sequence to the wild-type sequence,we attempted to correct the E176K mutation in the VP1unique sequence of pB19-FL(clone of NAN isolate)by insertion of the corrected sequence into the pB19-clone.However,due to the instability of the genome in the plasmid backbone,we were never been able to rescue a full-length corrected genome,and have therefore been unable to test the construct.In immunocompetent individuals,B19V infection may be associated with arthralgia and arthropathy.The PLA2-like motif in the exposed VP1u region may have a direct role in initiating and/or accelerating the inflammatory response in the synovial tissue and thus contributes to B19-associated arthropathy(Lu et al.,2006;Zadori et al.,2001).Studies of the original serum sample that was used as the source for cloning pB19-FL con-firmed that the PLA2(E176K)mutant was present in the native virus(the NAN isolate).The B19V NAN isolate was identified in an individual without symptom of viral infection.The serum was found by real-time PCR to contain~108genome copies of B19/ml,much less than that of J35(3.3×1013genome copies/ ml(Wong and Brown,2006).The relative infectivity of the NAN isolate versus the J35isolate was approximately0.2%. The attenuation of the B19V NAN isolate for both viral repli-cation and infectivity was at least partially due to the mutation in the PLA2-like motif of its capsid protein.This naturally atten-uated B19V could be an important candidate in development of an attenuated vaccine against B19V infection.Materials and methodsCells and virusesUT7/Epo-S1cells,a subclone of UT7/Epo(Shimomura et al.,1992)previously reported to have an increased sensitivity for parvovirus B19were kindly provided by Kazuo Sugamura (Tohoku University Graduate School of Medicine,Japan).The cells were maintained in Iscove's modified Dulbecco's medium (IMDM,Mediatech,Herndon,V A)containing10%fetal calf serum(FCS),2U/ml recombinant human(rhu)erythropoietin (Epo,Amgen,Thousand Oaks,CA)and antibiotics.Human CD36+EPCs which are fully permissive for B19V infection were generated from G-CSF mobilized CD34+periph-eral blood stems cells.The cells were cultured in a serum-free expansion medium containing a1:5dilution of BIT9500(Stem Cell Technologies,Vancouver,British Columbia,Canada)in alpha minimum essential medium(AMEM,Mediatech),obtain-ing a final concentration of10mg/ml of BSA,10μg/ml of rhu insulin,200μg/ml of iron-saturated human transferrin,900ng/ml of ferrous sulfate(Sigma,St.Louis,MO),90ng/ml of ferric nitrate(Sigma),10nM hydrocortisone(Sigma),100ng/ml of rhu SCF(Stem Cell Technologies),5ng/ml of rhu IL-3(R&D Systems,Minneapolis,MN)and3U/ml of rhu EPO(Amgen).The B19V J35isolate(GenBank Accession no.AY386330) (Zhi et al.,2004),was obtained from the serum of a child with sickle cell anemia undergoing aplastic crisis and sent to the National Institutes of Health for diagnostic purposes.The serum was found to contain3.3×1013genome copies of B19/ml by449C.Filippone et al./Virology374(2008)444–452。

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