Clinical symptoms, immune factors, and molecular characteristics of an adult male in Shenzhen, China infected with influenza virus H5N1
Clinical symptoms, immune factors, and molecular characteristics of an adult male in Shenzhen, China infected with influenza virus H5N1
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DOI：
10.1002/jmv.23492
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发表时间：
2013-05-01
影响因子：
12.7
通讯作者：
Cheng, Jinquan
中科院分区：
文献类型：
--
作者：
Wu, Chunli;Lu, Xing;Cheng, Jinquan
2011年12月29日，中国深圳确诊一名男子感染H5 N1亚型病毒。调查患者的临床症状和免疫因素，分析病毒的系统发育和分子特征。高热、迅速发展为重症肺炎和多器官功能衰竭为主要临床症状。动脉血气分析显示PaCO 2急剧升高，PO 2下降。白细胞和血小板计数迅速下降。外周血淋巴细胞计数显示淋巴细胞减少和CD 4 +/CD 8+细胞比例倒置。细胞因子分析显示，血清IL-6，IL-10和IFN-r水平持续升高，而IL-12和TNF水平在临床过程中下降。MCP-1和IP-10在感染后仍保持较高水平。系统发育分析证实病毒A/Shenzhen/1/2011属于新的亚支2.3.2.1。在病毒中检测到P6处的Arg（R）插入和HA切割位点基序中的RP 8I取代。与疫苗株相比，HA 1蛋白发生了16个特异性替换。部分位于受体结合位点、糖基化位点和抗原决定簇区域。综上所述，严重的并发症和免疫系统紊乱是H5 N1感染的主要特征。基因变异并没有削弱病毒的高致病性特征，新亚型病毒的致病性和抗原性发生了改变。医学病毒学杂志85：760768，2013。(c)2013 Wiley Periodicals，Inc.
On December 29, 2011, a man infected with a subclade of the H5N1 virus was confirmed in Shenzhen, China. The clinical symptoms and immune factors of the patient were investigated and the phylogenetic and molecular characteristics of the virus were analyzed. High fever, rapid development of serious pneumonia and multi-organ failure were the main clinical symptoms. Arterial blood gas analysis showed that PaCO2 rose sharply and PO2 decreased. Leukocyte and platelet counts decreased rapidly. Peripheral blood lymphocyte counts indicated lymphopenia and inverted ratios of CD4+ to CD8+ cells. Cytokine analysis showed that the levels of serum IL-6, IL-10, and IFN-r continued to increase, whereas the levels of IL-12 and TNFs decreased during the clinical course. MCP-1 and IP-10 remained at a high level after infection. Phylogenetic analysis confirmed that the virus A/Shenzhen/1/2011 belongs to the new subclade 2.3.2.1. An Arg (R) insertion at P6 and an RP8I substitution in the HA cleavage site motif were detected in the virus. Compared to the vaccine strain, 16 specific substitutions occurred in the HA1 protein. Some of them were located on the receptor-binding site, glycosylation site and the region of the antigenic determinant. In summary, serious complications and immune system disorders were the main features of the infection with H5N1. Gene variation did not weaken the highly pathogenic features of viruses and the pathogenicity and antigenicity of the new subclade virus were changed. J. Med. Virol. 85:760768, 2013. (c) 2013 Wiley Periodicals, Inc.