Clinical and Immunological Characteristics of Human Infections With H5N6 Avian Influenza Virus

被引：54

作者：

Bi, Yuhai ^{[1
,2
]}

Tan, Shuguang ^{[1
,2
]}

Yang, Yang ^{[2
]}

Wong, Gary ^{[2
]}

Zhao, Min ^{[1
]}

Zhang, Qingchao ^{[3
]}

Wang, Qiang ^{[2
]}

Zhao, Xiaonan ^{[4
]}

Li, Liqiang ^{[5
]}

Yuan, Jing ^{[2
]}

Li, Hao ^{[6
]}

Li, Hong ^{[4
]}

Xu, Wen ^{[4
]}

Shi, Weifeng ^{[7
]}

Quan, Chuansong ^{[8
]}

Zou, Rongrong ^{[2
]}

Li, Jianming ^{[2
]}

Zheng, Haixia ^{[2
]}

Yang, Liuqing ^{[2
]}

Liu, William J. ^{[8
]}

Liu, Di ^{[1
]}

Wang, Huijun ^{[9
]}

Qin, Yantao ^{[9
]}

Liu, Lei ^{[2
]}

Jiang, Chengyu ^{[3
]}

Liu, Wenjun ^{[1
]}

Lu, Lin ^{[4
]}

Gao, George F. ^{[1
,2
,8
,10
]}

Liu, Yingxia ^{[2
]}

机构：

[1] Chinese Acad Sci, Key Lab Pathogen Microbiol & Immunol, Collaborat Innovat Ctr Diag & Treatment Infect Di, Inst Microbiol,Ctr Influenza Res & Early Warning, Beijing, Peoples R China

[2] Southern Univ Sci & Technol, Shenzhen Key Lab Pathogen & Immun, State Key Discipline Infect Dis, Hosp Affiliated 2,Shenzhen Peoples Hosp 3, Shenzhen, Peoples R China

[3] Tsinghua Univ, State Key Lab Med Mol Biol, Inst Basic Med Sci, Chinese Acad Med Sci,Peking Union Med Coll, Beijing, Peoples R China

[4] Yunnan Ctr Dis Control & Prevent, Shenzhen, Peoples R China

[5] BGI Shenzhen, Shenzhen, Peoples R China

[6] Sun Yat Sen Univ, Intens Care Unit, Affiliated Hosp 8, Shenzhen, Peoples R China

[7] Taishan Med Coll, Inst Pathogen Biol, Tai An, Shandong, Peoples R China

[8] Chinese Ctr Dis Control & Prevent, Natl Inst Viral Dis Control & Prevent, Beijing, Peoples R China

[9] Diqing Tibetan Autonomous Prefecture Ctr Dis Cont, Shangri La, Peoples R China

[10] Univ Chinese Acad Sci, Sch Med, Beijing, Peoples R China

来源：

CLINICAL INFECTIOUS DISEASES | 2019年 / 68卷 / 07期

基金：

中国国家自然科学基金; 美国国家科学基金会;

关键词：

AIVs; H5N6; clinical characteristics; humoral and cellular immunity; A H7N9 VIRUS; RECEPTOR-BINDING; EPIDEMIOLOGIC CHARACTERISTICS; MONOCLONAL-ANTIBODIES; REASSORTANTS; EVOLUTION; YUNNAN;

D O I：

10.1093/cid/ciy681

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background H5N6 avian influenza virus (AIV) has caused sporadic, recurring outbreaks in China and Southeast Asia since 2013, with 19 human infections and 13 deaths. Seventeen of these infections occurred since December 2015, indicating a recent rise in the frequency of H5N6 cases. Methods To assess the relative threat of H5N6 virus to humans, we summarized and compared clinical data from patients infected with H5N6 (n = 19) against data from 2 subtypes of major public health concern, H5N1 (n = 53) and H7N9 (n = 160). To assess immune responses indicative of prognosis, we compared concentrations of serum cytokines/chemokines in patients infected with H5N6, H5N1, H7N9, and 2009 pandemic H1N1 and characterized specific immune responses from 1 surviving and 2 nonsurviving H5N6 patients. Results H5N6 patients were found to have higher incidences of lymphopenia and elevated alanine aminotransferase and lactate dehydrogenase levels compared with H5N1 and H7N9 patients. Hypercytokinemia was detected at substantially higher frequencies from H5N6 patients compared to those infected with other AIV subtypes. Evaluation of adaptive immunity showed that both humoral and cellular responses could be detected in the H5N6-infected survivor, but cellular responses were absent in the nonsurvivors. In addition, the surviving patient had lower concentrations of both pro- and anti-inflammatory cytokines/chemokines compared to the nonsurvivors. Conclusions Our results support that H5N6 virus could potentially be a major public health threat, and suggest it is possible that the earlier acquisition of cellular immunity and lower concentrations of cytokines/chemokines contributed to survival in our patient. Analysis of more patient samples will be needed to draw concrete conclusions. Analysis of the clinical data from patients shows that H5N6 virus is a potential public health threat. Analysis of samples from 1 human survivor vs 2 nonsurvivors shows that an earlier acquisition of cell-mediated response and lower concentrations of cytokines/chemokines may have contributed to survival.

引用

页码：1100 / 1109

页数：10

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