中国首例iVDPVs病例粪便标本中病毒血清型分布和Ⅲ型iVDPVs VP1区基因特征  

The Poliovirus Serotype Distribution in Serial Stool Samples from a First iVDPVs Case in China and the VP1 Genetic Characterization of Type Ⅲ iVDPVs

作　　者：许文波[1] 张勇[1] 严冬梅[1] 赵月萍[2] 冷红英[3] 王东艳[1] 赵蓉[1] 李黎[4] 陈晓琴[2] 胡莹[3] 祝双利[1] 李崇山[1] 温宁[4] 安洪秋[1] 李杰[1] 严旭玲[3] 梁晓峰[4] 

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,北京100050 [2]安徽省疾病预防控制中心,合肥230061 [3]江苏省疾病预防控制中心,南京210094 [4]中国疾病预防控制中心免疫规划中心,北京100050

出　　处：《病毒学报》2006年第3期159-165,共7页Chinese Journal of Virology

基　　金：2005卫生部疾控专项;WHO项目2004~2005西太地区脊灰参比试验室职能

摘　　要：分析中国首例免疫缺陷疫曲衍生脊髓灰质炎病毒（immunodeficient vaccine-derived polioviruses，iVDPVs）急性弛缓性麻痹（acute flaccid paralysis，AFP）病例（实验室编号为9230）12份便标本中病毒血清型分布和分离物中Ⅲ型VP1区的基因特征。31个省的疾病预防控制中心脊髓灰质炎（脊灰）实验室网络，在2005年采用细胞培养、病毒分离和微量中和试验从5231例AFP病例中的293例的便标本中分离到脊灰病毒，其中从1例编号为9230的AFP病例发病2～150天的12份便标本中分离到17株脊灰病毒株，包括Ⅱ型12株，Ⅲ型5株。用PCR-RFLP和ELISA两种方法对送检的293例AFP病例中分离的病毒进行型内鉴定，VP1区序列测定和分析发现：从9230号病例粪便标本中分离的12株Ⅱ型为混合不同变异数目的Ⅱ型iVDPVs，5株Ⅲ型病毒为单一Ⅲ型iVDPVs；除9230号病例外未发现其它iVDPVs或疫苗衍生脊灰病毒（vaccine-derived polioviruses，VDPVs）。5株Ⅲ型iVDPVs的VP1基因和SabinⅢ相比有22～24个碱基突变，同源性为97．33％～97．56％，是中国至今发现变异最大的Ⅲ型VDPVs。9230号病例临床诊断为X-连锁低／无丙种球蛋白血症，是在中国首次发现的iVDPVs病例，该病例的病毒分离物中同时存在Ⅱ型和Ⅲ型iVDPVs，Ⅲ型iVDPVs在患者体内至少复制2．5年以上，iVDPVs病例的持续排毒已经给中国维持无脊灰状态提山了新的挑战。This paper was to analyze the poliovirus serotype distribution in 12 serial stool specimens from a first immunodefieient vaccine-derived poliovirus（iVDPVs） case in China and the VP1 genetic characterization of the type ⅢiVDPVs was also studied. In 2005, polioviruses were isolated from 293 of 5231 AFP cases in 31 provincial polio laboratories using cell culture, virus isolation and micro-neutralization. From one AFP case, numbered CHN9230, 12 serial stool specimens had been collected within 2-150 days after onset of AFP and 17 polioviruses were isolated, of which 12 were polio type Ⅱ viruses and 5 were poliovirus type Ⅱand type Ⅲ coinfeeted. PCR-RFLP intratypie differentiation （ITD） method and ELISA assay were used to identify the 293 polio isolates. The ITD results indicated the 17 poliovirus isolates were drafted. The VP1 sequence analysis suggested that 12 type Ⅱisolates were mixture of 2 or more type Ⅱ viruses and 5 type Ⅲ were respectively single viruses. VP1 sequencing of type Ⅲ showed there were 22 to 24 nueleotide substitutions among 5 type Ⅲ polioviruses, the identity was 97.33 % to 97.56 % as compared with type Ⅲ Sabin strain, all the type Ⅲ strains match the vaccine-derived poliovirus （VDPVs） diagnosis criteria （ 〉 1% but〈 15% nucleotide identity in VPI capsid region） of Word Health Organization （WHO）. The type Ⅲ poliovirus probably had been replicated for two and half years in this AFP patient who had been immunized five times with the last time in Jan. 2005. This study firstly reported the iVDPVs case in China and polioviruses both types Ⅱ and Ⅲ VDPVs were isolated from this iVDPVs case. The iVDPVs appearing in China constitutes a serious challenge to the wild-type poliovirus-free status in China.

关 键 词：免疫缺陷疫苗衍生脊髓灰质炎病毒(iVDPVs) VP1编码区 序列测定和分析 

分 类 号：R373.22[医药卫生—病原生物学]