As doenças respiratórias agudas (DRAs) são as causas mais comuns de morbidez e mortalidade infantil mundial, podendo ser causadas por uma grande variedade de microorganismos. A fim de se detectar os vírus respiratórios mais comumente associados às infecções agudas do trato respiratório e traçar seu perfil epidemiológico, utilizamos um protocolo de GS RT-PCR (GeneScan Transcrição Reversa-Reação em Cadeia da Polimerase) para a rápida detecção simultânea do, vírus influenza A e B, parainfluenzavirus tipo 1, 2 e 3, picornavirus, metapneumovirus e o adenovírus. As amostras clínicas foram colhidas de crianças menores de cinco anos de idade, apresentando sintomas respiratórios, no Hospital Universitário (HU) da Universidade de São Paulo (USP), durante o ano de 2003. O GS RT-PCR se mostrou uma metodologia sensível e específica, capaz de detectar uma diversidade maior de agentes infecciosos do trato respiratório em relação à Imunofluorescência Indireta (IFI), reduzindo neste estudo a porcentagem de amostras negativas de 69,9% (235 amostras) para 22% (74 amostras). / A reverse transcription polymerase chain reaction (RT-PCR) assay based on automated fluorescent capillary electrophoresis and GeneScan software analysis was used to detect nine common respiratory viruses in clinical specimens from young children. Assays for human respiratory syncytial virus (HRSV), human parainfluenza viruses 1, 2, and 3, influenza A and B viruses, human metapneumovirus, adenovirus and picornavirus were incorporated into a screening PCR standard assay format. The optimized assay panel was used to test 336 respiratory specimens obtained from children hospitalized with acute respiratory illness (ARI) that had been previously tested by viral culture and indirect immunofluorescence staining (IIF). GS RT-PCR showed be a sensitive and specific methodology, able to detect a larger diversity of respiratory viruses regarding IFI, reducing in this study the percentage of negative samples of 69,9% (235 samples) to 22% (74 samples).

Le métapneumovirus humain (hMPV) est un virus responsable d'infections aiguës des voies respiratoires telles que des bronchiolites, des bronchites ou des pneumonies, principalement chez les populations à risques que sont les jeunes enfants de moins de 5 ans, ainsi que les personnes âgées ou immunodéprimées. Découvert en 2001, ce virus et sa pathogénèse ne restent encore aujourd'hui que partiellement caractérisés. De ce fait et malgré les besoins, il n'y a aucun vaccin ou traitement thérapeutique spécifique et efficace contre le HMPV disponible sur le marché. Dans ce contexte, mon projet de thèse s'est articulé autour de deux axes principaux : (i) L'étude de la protéine de fusion F du virus hMPV, protéine majeure antigénique de surface et responsable de l'entrée du virus dans la cellule cible. Elle a pour particularité d'induire de manière autonome la fusion membranaire in vitro et d'être associée à des effets cytopathiques variable selon les souches virales. De par son rôle clé pour le virus hMPV, la protéine F a déjà fait l'objet de plusieurs études structurales et fonctionnelles mais les déterminants de cette activité fusogénique ne sont pas encore entièrement caractérisés. Nous nous sommes donc intéressés à l'identification de déterminants du phénotype viral hyperfusogénique, localisés dans les domaines heptad repeats de la protéine F du hMPV. (ii) L'atténuation de deux souches virales cliniques (CAN98-75 et C-85473) par délétion de gènes accessoires dans le but de développer des candidats vaccinaux adaptés aux enfants en bas âge. Différents virus ont été générés par génétique inverse et les délétions des gènes accessoires SH et G dans les deux fonds génétiques viraux ont été étudiées pour leur impact sur l'infectivité, la réplication et la pathogénèse virale in vitro et in vivo ainsi que leur contribution pour le développement de virus atténués candidats vaccinaux / Human metapneumovirus (hMPV) is a major pathogen responsible of acute respiratory tract infections, such as bronchiolitis or pneumonia, affecting especially infants, under five years old, elderly individuals and immunocompromised adults. Identified since 2001, this virus and its pathogenesis still remain largely unknown and no licensed vaccines or specific antivirals against hMPV are currently available. In this context, my research project was built over two main subjects: (i) The study of the fusion F glycoprotein which is the major antigenic protein of hMPV and is responsible of viral entry into host cell. By its crucial role for the virus, the F protein has already been characterized in several structural and/or functional studies. Thus, it has been described that the hMPV F protein induces membrane fusion autonomously, resulting in variable cytopathic effects in vitro, in a strain-dependent manner. However, as the determinants of the hMPV fusogenic activity are not well characterized yet, we focused on identification of some of these, located in heptad repeats domains of the protein. (ii) The evaluation of hMPV SH and G gene deletion for viral attenuation. Liveattenuated hMPV vaccine candidates for infants’ immunization has been constructed thank to this deletion approach at the beginning of hMPV vaccine development efforts. Despite encouraging results, these candidates have not been further characterized and the importance of the viral background has not been evaluated

As doenças respiratórias agudas (DRAs) são as causas mais comuns de morbidez e mortalidade infantil mundial, podendo ser causadas por uma grande variedade de microorganismos. A fim de se detectar os vírus respiratórios mais comumente associados às infecções agudas do trato respiratório e traçar seu perfil epidemiológico, utilizamos um protocolo de GS RT-PCR (GeneScan Transcrição Reversa-Reação em Cadeia da Polimerase) para a rápida detecção simultânea do, vírus influenza A e B, parainfluenzavirus tipo 1, 2 e 3, picornavirus, metapneumovirus e o adenovírus. As amostras clínicas foram colhidas de crianças menores de cinco anos de idade, apresentando sintomas respiratórios, no Hospital Universitário (HU) da Universidade de São Paulo (USP), durante o ano de 2003. O GS RT-PCR se mostrou uma metodologia sensível e específica, capaz de detectar uma diversidade maior de agentes infecciosos do trato respiratório em relação à Imunofluorescência Indireta (IFI), reduzindo neste estudo a porcentagem de amostras negativas de 69,9% (235 amostras) para 22% (74 amostras). / A reverse transcription polymerase chain reaction (RT-PCR) assay based on automated fluorescent capillary electrophoresis and GeneScan software analysis was used to detect nine common respiratory viruses in clinical specimens from young children. Assays for human respiratory syncytial virus (HRSV), human parainfluenza viruses 1, 2, and 3, influenza A and B viruses, human metapneumovirus, adenovirus and picornavirus were incorporated into a screening PCR standard assay format. The optimized assay panel was used to test 336 respiratory specimens obtained from children hospitalized with acute respiratory illness (ARI) that had been previously tested by viral culture and indirect immunofluorescence staining (IIF). GS RT-PCR showed be a sensitive and specific methodology, able to detect a larger diversity of respiratory viruses regarding IFI, reducing in this study the percentage of negative samples of 69,9% (235 samples) to 22% (74 samples).

Ma thèse a porté sur l’étude des activités enzymatiques impliquées dans la formation de la coiffe de deux virus à ARN: le virus du Nil Occidental (WNV) et le métapneumovirus humain (hMPV). Ces virus codent pour des enzymes assurant l’ajout de la coiffe de type-1 (m7GpppN2’Om) à l’extrémité 5’ de leur ARNm.Le domaine N-terminal de la protéine NS5 (NS5MTase) du WNV porte les activités N7- et 2’O-méthyltransférases (N7- et 2’O-MTases) et il a été proposé que NS5MTase puisse également porter l’activité guanylyltransférase (GTase). J’ai identifié in vitro des résidus clés impliqués dans l’interaction entre NS5MTase et des ARN substrats de chaque activité MTase. Nos résultats démontrent que le site de fixation de la coiffe est nécessaire lors de la 2’O-méthylation et ne l’est pas pour la N7-méthylation. En parallèle, j’ai recherché des résidus catalytiques de la GTase par la méthode de génétique inverse. Des résultats préliminaires indiquent que la mutation K29A induit un défaut de réplication. Ce résidu pourrait donc être impliqué dans l’activité GTase de NS5MTase.Concernant hMPV, j’ai effectué une analyse fonctionnelle du domaine CR-VI+ de la protéine L. J’ai démontré que CR-VI+ possède les activités N7- et 2’O-MTases et j’ai identifié les résidus impliqués dans le recrutement de l’ARNm. L’ordre de méthylation est non canonique avec la 2’O-méthylation qui précède la N7-méthylation. Enfin, j’ai également démontré que CR-VI+ possède une activité d’hydrolyse du GTP.Ce travail démontre que ces MTases possèdent 2 voire 3 des activités enzymatiques nécessaires à la formation de la coiffe, et représentent donc une cible de choix pour le développement d’inhibiteurs. / My PhD project is focus on the study of the enzymatic activities involved in the RNA capping pathway of two RNA viruses: the West Nile Virus (WNV) and the human metapneumovirus (hMPV). These viruses encode for enzymes allowing the addition of a cap-1 structure (m7GpppN2’Om) to their mRNA 5’ ends. The NS5 N-terminal domain (NS5MTase) of WNV harbours the N7- and 2’O-methyltransferase activities (N7- and 2’O-MTase); and it has been proposed that NS5MTase also bears a guanylyltransferase activity (GTase). I have identified residues involved in the NS5MTase interaction sites with their RNAs substrate. My assays demonstrate the importance of the cap-binding site for the 2’O-methylation but not for the N7-methylation. In parallel, I have tried to identify putative catalytic residues of the GTase activity by reverse genetics. Preliminary results suggest that NS5MTase K29 could be a catalytic residue.Concerning hMPV, I performed a functional analysis of CR-VI+ domain of the protein L. I demonstrated that the CR-VI+ domain harbours the N7- and 2’O-MTase activities and identified the residues involved in the mRNA recruitment. I showed that the methylation order is not canonical with the 2’O-methylation preceding the N7-methylation. Finally, I showed that the domain harbours an additional GTP hydrolysis activity, representing the first step of RNA cap formation for Mononegavirales.This work demonstrates that this MTase domains harbour 2 or 3 of the enzymatic activities required for viral RNA cap synthesis and represent attractive targets for the development of antivirals.

A reação em cadeia por polimerase (PCR) e suas variantes tem sido, desde o isolamento do metapneumovírus humano (hMPV), a técnica mais utilizada para a detecção do vírus em secreções respiratórias de diferentes grupos de pacientes. Entretanto, a interpretação de estudos abordando aspectos epidemiológicos e patogenéticos da infecção pelo hMPV tem sido dificultada pelo uso de uma grande variedade de técnicas de PCR \"in house\" na ausência de uma técnica \"padrão ouro\" claramente definida. A avaliação da sensibilidade, especificidade e reprodutibilidade de qualquer técnica molecular \"in house\" é um passo crucial para podermos comparar estudos realizados por diferentes grupos de pesquisa e diferentes grupos de pacientes. Este estudo teve como objetivos a padronização de duas técnicas de PCR - convencional e em tempo real - para a detecção do hMPV em secreções respiratórias e a avaliação da concordância existente entre as técnicas. Entre 228 amostras de lavado de nasofaringe coletadas de receptores de transplante de células tronco hematopoiéticas com sintomas de infecção respiratória aguda, 10 (4,4%) foram positivas para a presença do hMPV pela técnica de PCR convencional enquanto que 11 (4,8%) foram positivas pela técnica de PCR em tempo real. A concordância entre as técnicas, medida pelo índice Kappa para um intervalo de confiança de 95%, foi de 0,95, ou seja, quase perfeita. / The polymerase chain reaction (PCR) has been, since the isolation of the virus in 2001, the most used technique for detection of human metapneumovirus (hMPV) in respiratory specimens of several groups of patients. However, the interpretation of studies regarding the epidemiology and pathogenesis of hMPV infection has been hindered by the use of a great variety of PCRs techniques for hMPV detection, in the absence of a clearly defined \"gold standard\". The assessment of the sensitivity, specificity and reproducibility of any in-house molecular technique is a crucial step to allow the comparison of studies conducted in different settings and different groups of patients. The aim of the present study was to standardize two in-house PCR assays a conventional PCR and a real-time PCR for detecting hMPV in nasopharyngeal aspirates and to evaluate the agreement between the two assays. Of 228 samples of nasopharyngeal aspirates obtained from hematopoietic stem cell transplant recipients with acute respiratory symptoms, 10 (4.4%) were positive for hMPV by conventional PCR whereas 11 (4.8%) were positive by real-Time PCR. The agreement of both assays, measured by Kappa Index, was almost perfect (0.95, 95% confidence interval).

No description available.

Introduction: Epidemiological studies have indicated that 5-38% of influenza like illnesses (ILI) develop into severe disease due to, among others, factors such as; underlying chronic diseases, age, pregnancy, and viral mutations. There are suggestions that dual or multiple virus infections may affect disease severity. This study investigated the association between co-infection between influenza A viruses and other respiratory viruses and disease severity. Methodology: Datum for samples from North West England tested between January 2007 and June 2012 was analysed for patterns of co-infection between influenza A viruses and ten respiratory viruses. Risk of hospitalization to a general ward ICU or death in single versus mixed infections was assessed using multiple logistic regression models. Results: One or more viruses were identified in 37.8% (11,715/30,975) of samples, of which 10.4% (1,214) were mixed infections and 89.6% (10,501) were single infections. Among patients with influenza A(H1N1)pdm09, co-infections occurred in 4.7% (137⁄2,879) vs. 6.5% (59⁄902) in those with seasonal influenza A virus infection. In general, patients with mixed respiratory virus infections had a higher risk of admission to a general ward (OR: 1.43, 95% CI: 1.2 – 1.7, p = <0.0001) than those with a single infection. Co-infection between seasonal influenza A viruses and influenza B virus was associated with a significant increase in the risk of admission to ICU/ death (OR: 22.0, 95% CI: 2.21 – 219.8 p = 0.008). RSV/seasonal influenza A viruses co-infection also associated with increased risk but this was not statistically significant. For the pandemic influenza A(H1N1)pdm09 virus, RSV and AdV co-infection increased risk of hospitalization to a general ward, whereas Flu B increased risk of admission to ICU/ death, but none of these were statistically significant. Considering only single infections, RSV and hPIV1-3 increased risk of admission to a general ward (OR: 1.49, 95% CI: 1.28 – 1.73, p = <0.0001 and OR: 1.34, 95% CI: 1.003 – 1.8, p = 0.05) and admission to ICU/ death (OR: 1.5, 95% CI: 1.20 – 2.0, p = <0.0001 and OR: 1.60, 95% CI: 1.02 – 2.40, p = 0.04). Conclusion: Co-infection is a significant predictor of disease outcome; there is insufficient public health data on this subject as not all samples sent for investigation of respiratory virus infection are tested for all respiratory viruses. Integration of testing for respiratory viruses’ co-infections into routine clinical practice and R&D on integrated drugs and vaccines for influenza A&B, RSV, and AdV, and development of multi-target diagnostic tests is encouraged.