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