Human enterovirus 71 (HEV71) is a member of the Human Enterovirus A species within the Family Picornaviridae. Since 1997, HEV71 has emerged as a major cause of epidemics of hand, foot and mouth disease (HFMD) associated with severe neurological disease in the Asia-Pacific region. At the present time, little is known about the pathogenesis of acute neurological disease caused by HEV71. The major aim of this study was to generate infectious cDNA clones of HEV71 and use them as tools for investigating the biology of HEV71 and molecular genetics of HEV71 virulence and pathogenesis. Two infectious cDNA clones of HEV71 clinical isolates, 26M (genotype B3) and 6F (genotype C2) were successfully constructed using a low copy number plasmid vector and an appropriate bacterial host. Transfection of cDNA clones or RNA transcripts derived from these clones produced infectious viruses. Phenotypic characterisation of clone-derived viruses (CDV-26M and CDV-6F) was performed, and CDV-26M and CDV-6F were found to have indistinguishable phenotypes compared to their wild type viruses. Strains HEV71-26M and HEV71-6F were found to have distinct cell culture growth phenotypes. To identify the genome regions responsible for the growth phenotypes of the two strains a series of chimeric viruses were constructed by exchanging the 5„S untranslated region (5„S UTR), structural protein (P1), and nonstructural protein (P2 and P3) gene regions using infectious cDNA clones of both virus strains. Analysis of reciprocal virus chimeras revealed that the 5„S UTR of both strains were compatible but not responsible for the observed phenotypes. Both the P1 and P2-P3 genome regions influence the HEV71 growth phenotype in cell culture, phenotype expression is dependent on specific P1/P2-P3 combinations and is not reciprocal. In the previous study, in order to investigate the pathogenesis of HEV71 infection, a mouse HEV71 model was developed using a mouse-adapted variant of HEV71-26M. Mouse-adapted strain MP-26M caused fore- and/or hindlimb paralysis in mice, whereas HEV71-26M-infected mice did not develop clinical signs of infection at any virus dose or route of inoculation tested. In this study, the molecular basis of mouse adaptation by HEV71 was identified. Nucleotide sequence analysis of HEV71-26M and MP-26M revealed three point mutations in the open reading frame, each resulting in an amino acid substitution in the VP1, VP2 and 2C proteins; no mutations were identified in the untranslated regions of the genome. To determine which of the three amino acid mutations were responsible for the adaptation and virulence of HEV71-26M in mice, recombinant cDNA clones containing one, or a combination of two or three mutations, were constructed. Mouse virulence assays of the mutated viruses clearly demonstrated that a non-conservative amino acid substitution (G710„_E) in the capsid protein VP1 alone was sufficient to confer the mouse virulence phenotype on HEV71. In addition, a mouse oral infection model was established in this study. Oral inoculation with the mouse-adapted HEV71 virus, MP-26M, induced fore-or hindlimb paralysis in newborn mice in an age- and dose-dependent manner. As oral transmission is the natural route of HEV71 infection, this murine HEV71 oral infection model will provide a suitable tool for studying HEV71 pathogenesis, for defining neurological determinants, and for testing vaccine efficacy and immunogenicity in the future.

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With the absence of gut microbiota, gnotobiotic (Gn) pigs are a unique animal model for studying infection and immunity, and evaluating vaccine and therapeutics for human enteric pathogens. Here, we demonstrate Gn pigs as effective large animal models for human enteric viruses, through evaluating human enterovirus 71 (EV71) infection and immunity, and vaccine and therapeutics for human rotavirus (HRV). Gn pigs could be infected via oral or oronasal route, the natural route of infection. Infected pigs developed clinical signs including fever, neurological and respiratory signs, similar to those seen in human patients. Fecal shedding up to 18 days post infection and virus distribution in intestinal, respiratory and central nervous system tissues were observed. Strong mucosal and systemic T cell responses (IFN-γ producing CD4+ and CD8+ T cells) and systemic B cell responses (serum neutralizing antibodies) were also detected. The study demonstrates a novel large animal model for EV71 to investigate viral pathogenesis, immunity, and to evaluate vaccine and antiviral drugs. Using the well-established Gn pig model for HRV, the adjuvant and therapeutic effects of prebiotics rice bran (RB) and probiotics were evaluated. RB alone or RB plus probiotic Lactobacillus rhamnosus GG (LGG) and probiotic E. coli Nissle 1917 (EcN), were shown to protect against rotavirus diarrhea (80%-100% reduction in the incidence rate) significantly and display strong immune - stimulatory effects on the immunogenicity of an oral attenuated HRV (AttHRV) vaccine. Mechanisms for the adjuvant effect include stimulating the production of intestinal and systemic IFN-γ] producing T cells and promoting mucosal IgA antibody responses. The mechanisms for reducing rotavirus diarrhea include promoting LGG and EcN growth and colonization and host gut health, and maintaining gut integrity and permeability during rotavirus infection. We showed that RB plus LGG and EcN is a highly effective therapeutic regimen against HRV diarrhea. Together, these results indicated that Gn pigs may serve as an excellent animal model for the study of infection, immunity, vaccine and therapeutics for human enteric viruses. / Ph. D.

To enhance the global control of encephalitis and hepatitis caused by rabies virus (RABV), Japanese encephalitis virus (JEV), enterovirus 71 (EV71) and hepatitis B virus (HBV), novel immunisation strategies are needed. All four diseases particularly affect low income countries with marginal health services – an affordable combined vaccine strategy could alleviate the large burden of disease. Therefore, we aimed to construct a multipathogen vaccine assessing the immunising activity of a recombinant modified vaccinia Ankara (MVA), expressing key antigens (RABV-glycoprotein, JEV pre-membrane & envelope protein, EV71-P1 protein and large hepatitis B surface antigen) from the various pathogens. Successful delivery of the pathogen sequences into non-essential sites (deletion site I, II, VI) of MVA via homologous recombination with a transfer plasmid, was demonstrated by transient color selection (LacZ-marker) in vitro. The stable insertion of the expression cassettes was validated over ten virus passages by PCR with specific primer sets, targeting the pathogen sequence. Two recombinants, one carrying the EV71 and JEV pathogen sequence and one carrying the RABV-HBV pathogen sequence were generated and validated by PCR.To ensure similar expression of the key antigens, a T7-promoter was linked to the expression cassettes of all pathogen sequences. Direct regulation of this promoter was achieved through co-infection with a second T7-polymerase expressing MVA under the control of a vaccinia p7.5 promoter. Protein expression from recombinant MVA using the co-infection model of expression in vitro, was further characterised by Western blot, dot blot and immunocytochemistry. All inserted transgenes were expressed using an avian (chicken embryo fibroblasts) or mammalian (human fetal lung fibroblasts) cell culture system. To investigate the co-infection model of antigen delivery in vivo, a pilot murine immunogenicity study was performed in six Balb/c mice using the MVA-RABV-HBV recombinant in a homologous prime-boost regimen two weeks apart. To detect antibodies against the expressed pathogen sequences in the mouse serum an antibody-capture assay was performed (Western blot, dot blot). The antigen (used to capture murine antibodies) was purified RABV-glycoprotein or large hepatitis B surface antigen expressed from a baculovirus. The murine antibodies were detected by a secondary anti-mouse antibody, conjugated with horseradish peroxidase for a chemiluminescent reporter assay. Although, serum antibodies against MVA were induced in all mice, no serum antibodies against RABV or HBV could be detected. In summary, we were able to demonstrate that two transgenes, when inserted into one or two different loci in the MVA genome, can be expressed in vitro when using the co-infection model of gene expression with a T7-expression system. This project has provided new insights into a novel group of vaccines, the multipathogen viral vector vaccines, employing MVA as a vector. Future studies will be needed to further explore this vaccine-group, as well as the co-infection model of expression.

Les entérovirus (EV) sont des agents étiologiques de nombreuses pathologies chez les adultes et les enfants, y compris la poliomyélite qui a été éradiquée en France. Aujourd’hui, la surveillance d’EV se déroule dans le cadre de la vigilance post-éradication, et fournit des données épidémiologiques importants sur des entérovirus non polio.A Marseille, la surveillance a amené à l’analyse de 654 souches isolées entre 1985 et 2005. Les EV de l'espèce B étaient prédominants, parmi lesquels l’echovirus 30 (E30) a été le plus fréquemment isolé et l’E13 a émergé lors de l’épidémie en 2000. Notre analyse des souches cliniques sur 20 ans renforce la stratégie de sérotypage par la VP1. L'analyse phylogénétique a identifié des souches de différents sérotypes, avec des régions nonstructurales génétiquement proches associées aux VP1 divergents. Ceci contredit le modèle actuel de la recombinaison et pourrait être à l’origine de l'émergence d’E13 épidémique.Deux épidémies majeures d’E30 ont été décrites en 2000 et 2005. Entre elles, le protocole de diagnostic d’EV a été modifié: en 2000, la détection s’est fait par la culture cellulaire et la RT-PCR classique; en 2005, la technique de la RT-PCR en temps réel a été utilisée. Ainsi, l’épidémie de 2005 a été caractérisée par une réduction significative du délai nécessaire de livrer les résultats du diagnostic et de la durée du séjour hospitalier.Nous avons également adapté un système moléculaire pour la détection d'EV71. EV71 est associé à des épidémies du syndrome pied, main, bouche en Asie, mais peut aussi engendrer des complications neurologiques fatales. Nous avons testé 365 échantillons positifs pour l’EV. 3 cas d'EV71 du génogroupe C2 ont été détectés entre 2009 et 2011 chez les enfants sans histoires de voyage récent, ce qui confirme la circulation actuelle de ce génogroupe en France.Les entérovirus ont le potentiel de provoquer des épidémies fréquentes, à cause de leur diversité génétique importante et de leur capacité de réémergence. Il est nécessaire de maintenir la surveillance d'EV par la détection et l'analyse des virus en circulation, et de développer d’autres techniques rapides de détection et d’identification. / Enteroviruses are single-stranded RNA viruses associated with a myriad of pathologies in adult and paediatric populations, the most notable of which, poliomyelitis, has been eradicated in France. Today, enterovirus surveillance is carried out in the context of post-eradication monitoring, and provides important epidemiological data for nonpolio enteroviruses.In Marseille, surveillance efforts culminated in the compilation and analysis of 654 strains isolated between 1985 and 2005. Predominant serotypes belonged to the B species: Echovirus 30 (E30) was the most frequently isolated serotype and E13 emerged during the 2000 epidemic. Our analysis of clinical strains over 20 years lends credence to the VP1 serotyping strategy. Phylogenetic analysis identified strains of different serotypes which were genetically similar in the nonstructural regions despite distinct VP1 regions. This observation contradicts the current model of recombination and could explain the emergence of epidemic E13.Two large outbreaks of E30 were described in 2000 and 2005, in between which EV diagnostic protocol was changed: in 2000, detection was performed using cell culture and classic RT-PCR techniques; in 2005, this was done via real-time RT-PCR. As a result, the 2005 outbreak was characterised by a significant decrease in the time needed to deliver diagnostic results, as well as in the length of hospital stay.We also adapted a real-time molecular assay for the detection of EV71. EV71 is associated with major outbreaks of hand, foot and mouth disease in the Asia-Pacific region, but can also cause fatal neurological complications. We screened 356 EV-positive samples and detected three cases of genogroup C2 EV71 infection between 2009 and 2011 in young children with no history of travel, confirming the current circulation of EV71 in France.Enteroviruses have the potential to cause frequent epidemics, due to their great genetic diversity and their propensity for re-emergence. This underscores the need to maintain EV surveillance by analysing past and present circulating viruses, as well as to develop more rapid detection and identification techniques.