• 한국미생물학회:학술대회논문집
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• 한국미생물학회 2008년도 International Meeting of the Microbiological Society of Korea
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• pp.76-77
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• 2008

• Clinical and Experimental Pediatrics
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• 제53권5호
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• pp.616-622
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• 2010

Enterovirus 71 (EV71) has been recognized as a frequent cause of epidemics of hand-foot-and-mouth disease (HFMD) associated with severe neurological symptoms. In the spring of 2009, HFMD was epidemic in Korea. Severe cases with complication, including death, have been reported and it has become a public health issue. Most symptomatic EV71 infections commonly result in HFMD or herpangina. These clinical manifestations can be associated with neurologic syndromes frequently. Neurologic syndromes observed in EV71 include meningitis, meningoencephalomyelitis, poliomyelitis-like paralytic disease, Guillain-Barr$\acute{e}$ syndrome, transverse myelitis, cerebellar ataxia, opsoclonus-myoclonus syndrome, benign intracranial hypertension, and brainstem encephalitis. Examinations for EV 71 were performed from the stools, respiratory secretion or CSF of the children by realtime PCR. Gene analysis showed that most of them were caused by EV71 subgenotype C4a which was prevalent in China, 2008. Public health measures including personal and environmental hygiene, must to target daycare centers, kindergartens, and schools where highly susceptible children congregate. To prevent the spread of infection, preschools where transmission persists for more than 2 incubation periods, have been recommended for closure, and trigger criteria for voluntary closure was instituted. During closure, operators are to thoroughly clean the centers before they are allowed to reopen. In addition, parents are advised to ensure that their children adopt a high standard of personal hygiene and to keep the infected child at home until full recovery. Because the outbreaks occur in a cyclical pattern, surveillance system to predict next outbreaks and adequate public health measures to control need to be planned for future. Control of EV71 epidemics through surveillance and public health intervention needs to be maintained in Korea. Future research should focus on understanding of EV71 virulence, identification of the receptor(s) for EV71, development of antiviral agents and development of vaccine.

• Journal of Microbiology and Biotechnology
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• 제30권1호
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• pp.38-43
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• 2020

Hand, foot, and mouth disease (HFMD) is caused by enterovirus 71 (EV71) in infants and children under six years of age. HFMD is characterized by fever, mouth ulcers, and vesicular rashes on the palms and feet. EV71 also causes severe neurological manifestations, such as brainstem encephalitis and aseptic meningitis. Recently, frequent outbreaks of EV71 have occurred in the Asia-Pacific region, but currently, no effective antiviral drugs have been developed to treat the disease. In this study, we investigated the antiviral effect of salvianolic acid B (SalB) on EV71. SalB is a major component of the Salvia miltiorrhiza root and has been shown to be an effective treatment for subarachnoid hemorrhages and myocardial infarctions. HeLa cells were cultured in 12-well plates and treated with SalB (100 or 10 ㎍/ml) and 10⁶ PFU/ml of EV71. SalB treatment (100 ㎍/ml) significantly decreased the cleavage of the eukaryotic eIF4G1 protein and reduced the expression of the EV71 capsid protein VP1. In addition, SalB treatment showed a dramatic decrease in viral infection, measured by immunofluorescence staining. The Akt signaling pathway, a key component of cell survival and proliferation, was significantly increased in EV71-infected HeLa cells treated with 100 ㎍/ml SalB. RT-PCR results showed that the mRNA for anti-apoptotic protein Bcl-2 and the cell cycle regulator Cyclin-D1 were significantly increased by SalB treatment. These results indicate that SalB activates Akt/PKB signaling and inhibits apoptosis in infected HeLa cells. Taken together, these results suggest that SalB could be used to develop a new therapeutic drug for EV71-induced HFMD.

• 한국환경보건학회지
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• 제39권2호
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• pp.178-186
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• 2013

Objective: Human enteroviruses (HEVs) are a common causative agent of gastrointestinal or respiratory infections. In this study, to examine the genotypic diversity and characteristics of HEVs associated with patients in Seoul, we collected and analyzed stool and throat swab samples taken from patients with acute gastroenteritis or a common cold from 2011 to 2012. We researched the difference in genetic characteristics of HEVs from gastroenteritis and respiratory patients. Methods: For genetic analysis, we amplified the 5'-noncoding region and partial VP1 region of HEVs by RT-PCR. The genotypes of HEVs were further identified based on nucleotide sequences of the VP1 region. Results: The majority of the HEV infections in Seoul occurred from June to August. The molecular characteristic assay showed that although the majority of HEVs can be propagated by a fecal-oral route, Coxsackievirus A2 (n=13, 19.4%), A4 (n=8, 11.9%), and A5 (n=4, 6.0%) can be preferentially transmitted by a respiratory route. Conclusions: This Enterovirus surveillance system plays an important role in preparing for a severe outbreak. The genotypic characteristics of HEV may provide potentially useful data needed for epidemiological studies.

• Clinical and Experimental Pediatrics
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• 제58권3호
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• pp.112-115
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• 2015

Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

• Clinical and Experimental Pediatrics
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• 제58권3호
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• pp.102-107
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• 2015

Purpose: Human parechovirus (HPeV) and enterovirus (EV) are causative agents of a sepsis-like illness in neonates and of infections of the central nervous system in young children. The objectives of this study were to assess the prevalence of HPeV3 and EV infection in young children with a sepsis-like illness or with meningitis in Jinju, Korea. Methods: Cerebrospinal fluid (CSF) samples were collected from 267 patients (age range, 1 day to 5 years) and assessed for HPeV and EV by performing reverse transcription polymerase chain reaction assay. Amplification products of the VP3/VP1 region of HPeV and of the VP1 region of EV were sequenced to identify the virus type. Results: HPeV and EV were detected in 3.4% and 7.5% of the total CSF samples assessed, respectively. The age distribution of EV-positive patients (median age, 1.4 months) had a significantly broader range than that of HPeV-positive patients (median age, 7.8 months). The peak seasons for HPeV and EV infection were spring and summer, respectively. The clinical symptoms for HPeV and EV infection were similar, and fever was the most common symptom. Pleocytosis was detected in 22.2% of HPeV-positive patients and 35.5% of EV-positive patients. The VP3/VP1 gene sequence of the nine Korean strains clustered most closely with the Japanese strain (AB759202). Conclusion: The data indicate that HPeV infection is predominant in young infants (<6 months) and that meningitis without pleocytosis was caused by both HPeV and EV infection in children.

• 한국미생물·생명공학회지
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• 제32권2호
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• pp.179-183
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• 2004

2002년도 부산지역의 병ㆍ의원으로부터 의뢰된 바이러스성 뇌수막염으로 의심되는 환자의 가검물을 대상으로 바이러스 분리를 시도한 결과 703건의 검체 중 83건의 장내바이러스를 분리하였다. 이 중 echovirus 2, 3, 6, 7, 9, 13, 25, 29, 30 혈청형이 72건으로 가장 많았고, coxsackievirus B3과 B4혈청형이 11건으로 예전에 비해 보다 다양한 경향을 나타내었다. 월별발생 양상은 4월부터 11월까지 넓은 발생 분포를 나타내었지만 특히 6월과 7월에 가장 발생률이 높았다. Echovirus와 coksackievirus는 Veroft HEp-2 세포주에서 강한 병변 효과를 나타내었다. 연령별 및 성별 감염현황은 0-10세 사이의 어린이가 주로 발생하였고, 여아에 비해 남아의 비율이 비교적 높게 나타내었다. 전자현미경으로 촬영한 echovirus 및 coxsackievirus의 형태학적 양상은 모두 envelope가 없고 크기가 30∼35nm로 아주 작은 구형의 특징을 나타내었다. 세포병변 효과가 나타난 세포배양액에 대하여 nested PCR을 수행한 결과 echovirus 및 coxsackievirus 모두 437 bp위치에 단일 띠를 나타내었으며, serotype은 국립보건원 소화기바이러스과에 의뢰하여 확인 동정하였다.

• 대한바이러스학회지
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• 제30권1호
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• pp.29-37
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• 2000

The aim of this study was to investigate viral etiology in dilated cardiomyopathy (DCM) by polymerase chain reaction (PCR) or nested reverse transcription PCR (RT-PCR), and characterize the enteroviral RNA presented in the clinical specimens. Twenty-eight paraffin-embedded heart tissue samples were assayed to detect cytomegalovirus, herpes simplex virus type 1, type 2, parvovirus, adenovirus, and enterovirus (EV) with each specific primer. Of these 28 patients (mean age: 27, M: 24, F: 4), 26 were histologically diagnosed as DCM and 2 as myocardial infarction (MI). Nested RT-PCR detected enteroviral RNA in 7 (26.9%) of 26 patients with DCM, and none of patients with MI. And none of DNA viruses tested were detected from the samples. Amplified products were also genotyped by single-strand conformation polymorphism (SSCP). Three subtypes can be differentiated from 7 clinical specimens. Furthermore, direct sequence analysis was performed to determine whether genetic variation of EV is present in the explanted heart tissues from patients with DCM. Although most of the sequences among the wild isolates have the greatest similarity to those of coxsackievirus B3, there are specific regions of variable sequences (no 490 - no 510). The data suggest that enterovirus may be a major viral pathogen for the DCM in Korea and nucleotide sequence data indicate that coxsackievirus B3 may be a leading etiologic agent of DCM.

• Biomolecules & Therapeutics
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• 제22권1호
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• pp.41-46
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• 2014

Enterovirus 71 (EV71) is the predominant cause of hand, foot and mouth disease (HFMD). The antiviral activity of hederasaponin B from Hedera helix against EV71 subgenotypes C3 and C4a was evaluated in vero cells. In the current study, the antiviral activity of hederasaponin B against EV71 C3 and C4a was determined by cytopathic effect (CPE) reduction method and western blot assay. Our results demonstrated that hederasaponin B and 30% ethanol extract of Hedera helix containing hederasaponin B showed significant antiviral activity against EV71 subgenotypes C3 and C4a by reducing the formation of a visible CPE. Hederasaponin B also inhibited the viral VP2 protein expression, suggesting the inhibition of viral capsid protein synthesis.These results suggest that hederasaponin B and Hedera helix extract containing hederasaponin B can be novel drug candidates with broad-spectrum antiviral activity against various subgenotypes of EV71.

• 미생물학회지
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• 제35권1호
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• pp.41-46
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• 1999

수계에 분포하는 장바이러스를 검출하기 위해 민감도가 높고 검출시간이 빠른 PCR법을 이용하였다. 바이러스입자를 보다 순수하게 농축하기 위해 몇 가지 바이러스농축법을 비교조사하고 그것의 변형을 통하여 개선된 방법을 확립하였다. 비교한 농축방법중 흡탈착/Polyethyleneglycol(PEG) 침전법과 플록화/촉속원심분리법을 통해 10 PFU $ml^{-1}$ 까지 검출이 가능하여 다른 방법에 비해 효과적임이 판명되어Te. Sephadex resin을 이용한 부가적인 시료정제 과정을 통해 시료의 순도를 높일 수 있어검출한계를 10배정도 낮추었다. 서정된 검출법을 통해 한강수계에서 장바이러스의 분포를 조사한 결과 조사한 시료중 한강의 지천에서는 75%, 본류에서는 20%의 시료에서 바이러스가 검출되었다. 본 조사결과 흡탈착/PEG 침전법-PCR 검출기법이 수계의 바이러스 오염도를 간편하고 신속하게 검출하는데 매우 유용하였으며 국내 수계에도 바이러스 오염이 광범위함을 확인하였다.