Human Influenza Virus Infection Research Articles

Prevalence of Human Metapneumovirus and Influenza Virus Infections Among Japanese Children During Two Successive Winters

Human metapneumoviruses (hMPVs) are recognized as a leading cause of respiratory infections in young infants in many countries. The objective of this study was to identify links between hMPV and influenza virus infections among children with influenza-like illness. This study was conducted in 2 influenza seasons (2002-2003 and 2003-2004) at 2 pediatric outpatient clinics in Niigata city, Japan. Nasopharyngeal swabs or aspirates were collected from influenza-like illness patients, and hMPV and influenza were detected by reverse transcription-polymerase chain reaction (RT-PCR). A nucleotide sequence of 352 nucleotides segment of the F gene was performed. A total of 765 influenza viruses and 84 hMPV were identified from 1498 nasopharyngeal swabs or aspirates by virus isolation and RT-PCR, respectively. hMPV-positive rates in patients with influenza-like illness were 5.7 and 5.2% in the 2002-2003 and 2003-2004 seasons, respectively. Epidemic curves of influenza and hMPV patients showed similar patterns with peaks in February in 2 influenza seasons. hMPV infections occurred frequently in infants and school children. Approximately 46% of hMPV patients were coinfected with influenza A viruses, but those coinfected cases were not clinically distinct from the others. No coinfection with influenza B viruses was found. Phylogenetic analysis of the hMPV fusion gene sequences revealed that 2 distinct hMPV cocirculated and that completely identical strains in subgroup A were observed over 2 years. HMPV plays an important pathogenic role in patients with influenza-like illness in winter seasons, often in coinfections with influenza A viruses.

Inhibition of influenza virus production in virus-infected mice by RNA interference.

Influenza A virus infection is a major source of morbidity and mortality worldwide. Because the effectiveness of existing vaccines and antiviral drugs is limited, development of new treatment modalities is needed. Here, we show that short interfering RNAs (siRNAs) specific for conserved regions of influenza virus genes can prevent and treat influenza virus infection in mice. Virus production in lungs of infected mice is reduced by siRNAs given either before or after initiating virus infection, by using slow i.v. administration of small volumes containing siRNAs in complexes with a polycation carrier. Similar effects also are observed when mice are given DNA vectors i.v. or intranasally, from which siRNA precursors can be transcribed. Development of delivery systems that may be compatible with human use demonstrates the potential utility of siRNAs for prophylaxis and therapy of influenza virus infections in humans.

Anti-influenza virus activity of disodium cromoglycate

In this study, we investigated the effect of disodium cromoglycate (DSCG) against viral infection in vitro and in vivo, particularly against the human influenza virus infection. The in vivo effect of DSCG on viral infection was assessed by using a murine model of respiratory tract infection. Administration of DSCG by the intranasal route remarkably protected mice from death induced by infection with the influenza virus, A/PR/8/34. In conclusion, DSCG exerts an anti-influenza virus effect in vitro and in vivo, with an especially potent effect in vivo. These findings strongly encourage us to apply DSCG to anti-influenza virus chemotherapy in the clinical field.

Surveillance of influenza isolates for susceptibility to neuraminidase inhibitors during the 2000–2002 influenza seasons

Neuraminidase (NA) inhibitors (NI) have recently been licensed for the prophylaxis and treatment of influenza virus infection in humans. This study has utilized a new chemiluminescent (CL) neuraminidase assay to routinely monitor more than a thousand influenza field isolates collected worldwide during the 2000–2002 seasons for susceptibility to both licensed NIs, zanamivir, and oseltamivir by determining the 50% inhibitory concentration (IC 50). Our data demonstrated that influenza A viruses of the N2 subtype were less susceptible to zanamivir, but not oseltamivir, than those of the N1 subtype such that 41 of 45 confirmed H1N2 isolates could be reliably differentiated from H1N1 viruses based on their zanamivir susceptibility. Pre-titration of influenza A viruses appeared to have no effect on IC 50 determined for either NI, while pre-titration of influenza B viruses significantly reduced oseltamivir IC 50 and increased zanamivir IC 50. Influenza B viruses were less susceptible to either compound than type A isolates. The CL assay is a rapid and reliable method for screening large numbers of influenza isolates for NI susceptibility. Reassortant viruses of the H1N2 subtype that started to circulate worldwide during the 2001–2002 season can be reliably separated from H1N1 viruses based on their zanamivir susceptibility, enabling large scale screening of H1 isolates for determining the prevalence of such reassortants.

Use of siRNAs to prevent and treat influenza virus infection

Influenza virus causes one of the most prevalent infections in humans. In a typical year, 10–20% of the population in the United States are infected by influenza virus, resulting in up to 40,000 deaths. Current vaccines can prevent illness in approximately 70–80% of healthy individuals under age 65, but the protection rate is much lower in those most susceptible to infection, namely infants, the elderly, and immunocompromised individuals. Although four antiviral drugs have been approved in the United States for treatment and/or prophylaxis of influenza, their use is limited because of concerns about side effects, compliance, and the possible emergence of resistant virus. We found that short interfering RNAs (siRNAs) specific for conserved regions of the influenza virus genome are potent inhibitors of influenza virus replication in both cell lines and embryonated chicken eggs. In this review, we discuss the potential value of siRNAs for preventing and treating influenza virus infections in humans and the challenges that have to be overcome to realize their potential.

Correlations between lung proinflammatory cytokine levels, virus replication, and disease after swine influenza virus challenge of vaccination-immune pigs.

During experimental infection of pigs with swine influenza virus (SIV), there is a strong temporal correlation between peak virus titers in the lungs, levels of different proinflammatory cytokines in bronchoalveolar lavage (BAL) fluids, and disease. Vaccination against SIV can greatly reduce or prevent virus replication after challenge and the resulting disease. Here, we took advantage of pigs from vaccination-challenge experiments, with different degrees of virological and clinical protection, to further correlate SIV replication with cytokines and disease. Forty-nine pigs were vaccinated twice with a commercial inactivated SIV vaccine or with experimental vaccines, and 35 control pigs were not vaccinated. Between 2 and 4 weeks after the last vaccination, all pigs were challenged intratracheally with SIV. Twenty-four hours after the challenge, we determined body temperatures, respiratory scores, lung virus titers, and neutrophils and cytokines in BAL fluids. Interferon-alpha (IFN-alpha), tumor necrosis factor (TNF-alpha), interleukin-1 (IL-1), and -6 (IL-6) were determined by bioassay, and IL-8 by a commercial ELISA. The results were analyzed for three comparison groups. The unvaccinated control pigs (group 1, n = 35) were positive for all or most parameters examined. Vaccinated pigs with challenge virus replication in the lungs (group 2, n = 28) had slightly lower virus titers than the challenge control pigs, and clear reductions in disease severity and mean titers of all five cytokines, but neutrophil numbers were not affected. Vaccinated pigs without detectable virus replication (group 3, n = 21) were largely protected against clinical signs and neutrophil infiltration. Mean levels of IFN-alpha, TNF-alpha, and IL-6, but not IL-1 or IL-8, were lower than in both other groups. Virus titers in the lungs of individual pigs showed highly significant correlations with IFN-alpha and IL-6, and lower correlations with TNF-alpha and IL-8. Clinical signs were most closely associated with IFN-alpha, IL-6, and TNF-alpha. The relationship between disease and IL-8 or IL-1 was much weaker. Our data provide further evidence for a role of IFN-alpha, TNF-alpha, and IL-6 in the pathogenesis of SIV. The similarities with cytokine profiles during human influenza virus infection are discussed.

Cyclopentane neuraminidase inhibitors with potent in vitro anti-influenza virus activities.

A novel series of cyclopentane derivatives have been found to exhibit potent and selective inhibitory effects on influenza virus neuraminidase. These compounds, designated RWJ-270201, BCX-1827, BCX-1898, and BCX-1923, were tested in parallel with zanamivir and oseltamivir carboxylate against a spectrum of influenza A (H1N1, H3N2, and H5N1) and influenza B viruses in MDCK cells. Inhibition of viral cytopathic effect ascertained visually and by neutral red dye uptake was used, with 50% effective (virus-inhibitory) concentrations (EC(50)) determined. Against the H1N1 viruses A/Bayern/07/95, A/Beijing/262/95, A/PR/8/34, and A/Texas/36/91, EC(50)s (determined by neutral red assay) of the novel compounds were < or =1.5 microM. Twelve strains of H3N2 and two strains of avian H5N1 viruses were inhibited at <0.3 microM. Influenza B/Beijing/184/93 and B/Harbin/07/94 viruses were inhibited at <0.2 microM, with three other B virus strains inhibited at 0.8 to 8 microM. The novel inhibitors were comparable in potency to (or slightly more potent than) zanamivir and oseltamivir carboxylate. No cytotoxicity was seen with the compounds at concentrations of < or =1 mM in cell proliferation assays. The antiviral activity of RWJ-270201, chosen for clinical development, was studied in greater detail. Its potency and that of oseltamivir carboxylate decreased with increasing multiplicity of virus infection. Time-of-addition studies indicated that treatment with either compound needed to begin 0 to 12 h after virus exposure for optimal activity. Exposure of cells to RWJ-270201 caused most of the virus to remain cell associated, with extracellular virus decreasing in a concentration-dependent manner. This is consistent with its effect as a neuraminidase inhibitor. RWJ-270201 shows promise in the treatment of human influenza virus infections.

Virologic and serologic surveillance for human, swine and avian influenza virus infections among pigs in the north-central United States.

Summary. Influenza virus infection in pigs is both an animal health problem and a public health concern. As such, surveillance and characterization of influenza viruses in swine is important to the veterinary community and should be a part of human pandemic preparedness planning. Studies in 1976/1977 and 1988/1989 demonstrated that pigs in the U.S. were commonly infected with classical swine H1N1 viruses, whereas human H3 and avian influenza virus infections were very rare. In contrast, human H3 and avian H1 viruses have been isolated frequently from pigs in Europe and Asia over the last two decades. From September 1997 through August 1998, we isolated 26 influenza viruses from pigs in the north-central United States at the point of slaughter. All 26 isolates were H1N1 viruses, and phylogenetic analyses of the hemagglutinin and nucleoprotein genes from 11 representative viruses demonstrated that these were classical swine H1 viruses. However, monoclonal antibody analyses revealed antigenic heterogeneity among the HA proteins of the 26 viruses. Serologically, 27.7% of 2,375 pigs tested had hemagglutination-inhibiting antibodies against classical swine H1 influenza virus. Of particular significance, however, the rates of seropositivity to avian H1 (7.6%) and human H3 (8.0%) viruses were substantially higher than in previous studies.

Neuraminidase inhibitors as anti-influenza virus agents.

Influenza virus neuraminidase (NA) catalyses the cleavage of sialic acid residues terminally linked to glycoproteins and glycolipids and plays an important role in the replication of the virus. Recently, several potent NA inhibitors have been synthesized based on the rational design of mimicking the transition state of the sialic acid cleavage. Zanamivir and oseltamivir (GS 4104, the prodrug of GS 4071) have emerged as promising influenza NA inhibitors for the treatment and prophylaxis of human influenza virus infection. This review describes the recent work toward the discovery and development of influenza NA inhibitors.

Characterization of human influenza virus variants selected in vitro in the presence of the neuraminidase inhibitor GS 4071.

An oral prodrug of GS 4071, a potent and selective inhibitor of influenza neuraminidases, is currently under clinical development for the treatment and prophylaxis of influenza virus infections in humans. To investigate the potential development of resistance during the clinical use of this compound, variants of the human influenza A/Victoria/3/75 (H3N2) virus with reduced susceptibility to the neuraminidase inhibitor GS 4071 were selected in vitro by passaging the virus in MDCK cells in the presence of inhibitor. After eight passages, variants containing two amino acid substitutions in the hemagglutinin (A28T in HA1 and R124M in HA2) but no changes in the neuraminidase were isolated. These variants exhibited a 10-fold reduction in susceptibility to GS 4071 and zanamivir (GG167) in an in vitro plaque reduction assay. After 12 passages, a second variant containing these hemagglutinin mutations and a Lys substitution for the conserved Arg292 of the neuraminidase was isolated. The mutant neuraminidase enzyme exhibited high-level (30,000-fold) resistance to GS 4071, but only moderate (30-fold) resistance to zanamivir and 4-amino-Neu5Ac2en, the amino analog of zanamivir. The mutant enzyme had weaker affinity for the fluorogenic substrate 2'-(4-methylumbelliferyl)-alpha-D-N-acetylneuraminic acid and lower enzymatic activity compared to the wild-type enzyme. The viral variant containing the mutant neuraminidase did not replicate as well as the wild-type virus in culture and was 10,000-fold less infectious than the wild-type virus in a mouse model. These results suggest that although the R292K neuraminidase mutation confers high-level resistance to GS 4071 in vitro, its effect on viral virulence is likely to render this mutation of limited clinical significance.

In-vitro and in-vivo efficacy of influenza neuraminidase inhibitors

Influenza continues to be a major health concern and there is always the threat of a pandemic due to the emergence of a viral strain new to the human population, as exemplified by the avian influenza A/H5N1 virus which was responsible for six deaths in Hong Kong last year. Data reported in the past year, based on in-vitro, in-vivo (animal) and clinical studies, suggest that a new class of antiviral compounds targeting the viral neuraminidase is likely to be useful for the treatment and prevention of influenza virus infections in humans.

Natural killer (NK) cell response after vaccination of volunteers with killed influenza vaccine

Many experiments have shown convincingly that natural killer (NK) cell activity against viral infections is an important early defence mechanism in mice. Since the NK response occurs soon after infection, often long before clinical signs of disease become manifest, it has been difficult to design studies to monitor accurately NK cell kinetics following infection, without actually administering pathogens to volunteers. There is therefore little data pertaining to the role of NK cells in humans. Nevertheless, a number of studies have shown elevated NK activity in response to herpes simplex and influenza virus infections in humans. Our study was designed to show that NK activity could be provoked in humans by exposure to viral particles without actual live viral infection. The development of NK cell response in the peripheral blood of volunteers shortly after vaccination with killed influenza trivalent vaccine was studied. The results demonstrate that killed virus vaccine induces and augments NK cell activity for relatively long periods. Such data may prove valuable for designing possible modes of augmenting NK activity as a therapeutic tool.

Efficacy of high dose-short duration ribavirin aerosol in the treatment of respiratory syncytial virus infected cotton rats and influenza B virus infected mice

Fifteen to 20 mg/ml ribavirin administered as a small particle aerosol for 10 – 18 h per day is currently the regimen generally used to treat experimental or naturally-occurring respiratory syncytial (RS) or influenza virus infections in humans. To determine if such prolonged treatment schedules could be reduced, cotton rats and mice were inoculated with RS or influenza B virus, respectively, and then treated with different concentrations of ribavirin small particle aerosols. Aerosols generated from reservoirs containing 60 mg/ml ribavirin given 2 h twice daily, protected cotton rats from RS virus and mice from influenza B virus as well as aerosols generated from reservoirs containing 20 mg/ml ribavirin given 11 h daily. Aerosols generated from reservoirs containing 40 or 20 mg/ml given 2 h daily were less efficacious. There was no evidence of intolerance or pulmonary histopathology in infected or uninfected animals exposed to any of the doses of ribavirin tested. These studies indicate that use of aerosols containing higher concentrations of ribavirin than generally used to treat respiratory virus diseases may permit significantly shorter treatment schedules without loss of efficacy or increase in toxicity.

Limited efficacy of aerosolized recombinant alpha interferon against virulent influenza A/HK infection in mice.

Hybrid recombinant human alpha interferon A/D (rIFN A/D) is unusual in that it has equivalent antiviral activity in in vitro assays using mouse or human tissue cells. This interferon was delivered to outbred Swiss mice in small particle aerosols before and/or after these mice were inoculated with virulent influenza A/HK/68 virus. Although rIFN A/D was effective in inhibiting influenza virus replication in vitro in primary mouse embryo cells, it had only a limited degree of effectiveness in the in vivo tests; only animals exposed to rIFN A/D for 4 hr and inoculated with influenza virus 4 hr later exhibited a significant decrease in mortality (approximately 25% reduction in deaths; P less than 0.025) compared with that of the untreated control animals. The limited effectiveness of rIFN A/D seen in these studies indicated that the use of this or similar recombinant alpha interferons alone to prevent or treat influenza virus infection in humans is not promising.

Prevalence of Hong Kong (H3N2) influenza virus-antibody in swine.

In order to elucidate Hong Kong (H3N2) influenza virus infection in swine population, a serological survey was conducted on a total of 3, 701 swine sera collected at an abattoir in Obihiro, Hokkaido during the years 1980 to 1983. The swine sera possessing antibodies to corresponding current epidemic strains were 14.7% in 1980, 3.9% in 1981 and 7.1% in 1982 between June and September in each year. In 1983, however, a high prevalence (31.4%) of the antibodies was observed from March to July. These results suggest that the swine were infected with the human influenza virus as piglets in the first three years, and as adults in the last year, throughout an epidemic of human influenza virus infection which occurred among the human populations during the period from January to March in these years.

Human influenza virus infection in mink: Serological evidence of infection in summer and autumn

During the period from July to November 1981, 42 out of 128 young mink of a flock were found to possess antibodies against the viruses A/Bangkok/1/79 (H3N2) and A/Kumamoto/37/79 (H1N1), which were currently prevailing human influenza viruses. Seroconversion against A/Bangkok/1/79 was found in 12 mink from August to November. HI antibody titers of > 1: 128 were found in 8 out of 42 mink at the first examination in July and August. These findings suggest that infection with these human influenza viruses was present in this flock during the period from birth (the beginning of May) to autumn, the non-prevalent season in man. Attempts at virus isolation were unsuccessful.

SEROLOGICAL EVIDENCE FOR THE OCCURRENCE OF INFECTION WITH HUMAN INFLUENZA VIRUS IN SWINE

Antibodies capable of neutralizing human influenza virus were present in the sera of old swine on two New Jersey institution farms, but absent from the sera of young swine on the same farms. The old animals had lived through the winter of 1936-37 in which outbreaks of upper respiratory tract disease were prevalent among the human inmates of the two institutions, while the young swine studied were born long after these outbreaks. It is believed that the swine whose sera neutralized human influenza virus had undergone an unrecognized human influenza virus infection acquired from man. The possible bearing of these observations upon the theory that swine influenza was originally of human origin is discussed.