[日本结核分枝杆菌北京家族的种群结构分析]

[Population structure analysis of Mycobacterium tuberculosis Beijing family in Japan].

作者信息

Iwamoto Tomotada

机构信息

Department of Microbiology, Kobe Institute of Health, 4-6, Minatojima-nakamachi, Chuo-ku, Kobe-shi, Hyogo 650-0046, Japan.

出版信息

Kekkaku. 2009 Dec;84(12):755-9.

DOI:
Abstract

The Beijing family is a genotypic lineage of M. tuberculosis that reportedly predominates throughout eastern Asia and in parts of Russia yet dispersed worldwide. About 80% of clinical isolates in Japan are belonging to this family. The predominance of a narrow range of genotypes, in this case predominance by Beijing family strains, hypothesized that these strains may have a selective advantage either with virulence or transmissibility that led to clonal expansion. The strains are monophyletic within the M. tuberculosis species and also reveal further sublineages within this family. It is believed that the genetic and evolutionary background of M. tuberculosis strains influence on the propensity to gain drug resistance as well as the pathogen's transmissibility. Thus, understanding the population genetic structure and its dynamics of Beijing family strains will undoubtedly help to unravel the basis for the considerable success and spread of this genotype in Japan. During the past few years, we intensively studied this notorious clade, M. tuberculosis Beijing family, to reconstruct their evolutionary events and phylogeny and to elucidate their epidemiological characteristics at the sublineage levels through the population structure analysis. Here, I summarized the findings of our research in the past few years. Singularity of the genetic diversity of Beijing family strains in Japan. We reconstructed the phylogenetic trees of Beijing family strains by the 15-MIRU-VNTR genotyping method and validated them through profiling of the NTF region, large sequence polymorphisms (LSP), and single-nucleotide polymorphisms (SNPs). Interestingly, we could demonstrate that the ancient Beijing sublineage has remained endemic to Japan, in contrast to the worldwide spread of the modern Beijing sublineage. Moreover, we found that the ancient sublineage strains corresponding to four monophyletic subgroups. The singularity of the genetic diversity of Beijing family strains in Japan, i.e., its high diversity and dominance of the ancient sublineage in contrast to the modern sublineage found worldwide, suggested that they became endemic independently from the evolutionary stream that led to the dominant modern Beijing sublineage in outside Japan. Population structure dynamics of Beijing family strains in Japan. We inferred the population structure dynamics of Beijing family strains during the past decades in Japan by comparing the isolates from elderly TB patients (these strains represent the population structure that existed decades ago) and young TB patients (these strains reflect the population structure of currently prevalent strains). The comparison between the cohorts born in different years suggested that the population structure of the M. tuberculosis Beijing family strains in Japan before World War II--when TB was highly prevalent--was significantly different from that of the currently prevalent strains. The results revealed that the spread of a modern sub-lineage that has high transmissibility is currently increasing, while the spread of an ancient sublineage, STK, has significantly decreased in younger generations. It is interesting to assume that the observed trends in the case of the modern and STK strains may be associated with the Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccination. Association between sublineages of Beijing family and multidrug resistance. Mycobacterium tuberculosis Beijing family strains are suspected to be an evolving lineage of M. tuberculosis that has acquired the advantage of drug resistance. However, the association between this genotype and drug resistance varies in different countries. This may be due to heterogeneity in the fitness of the sublineages of the Beijing family and different proportions of these sublineages in the local population. To determine whether certain sublineages are associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis, the population structure of the Beijing strains based on 10 synonymous single nucleotide polymorphisms (sSNPs) was analyzed in pan drug-sensitive (DS), MDR, and XDR strains. The results revealed that two evolutionary subgroups (ST 26 and ST3), which are belonging to an ancient sublineage, occurred with a significantly higher frequency in the MDR/XDR population than in the DS population. This suggests that different sublineages of the Beijing family may differ in their mechanism of adaptation to drug-selective pressure. The greater vigilance in monitoring the occurrence of these strains is indispensable for achieving better TB control in this region. In the combination of molecular epidemiological data with recent advances in mycobacterial genomics and population genetics, we could provide novel insights into genetic diversity and phylogeny of M. tuberculosis Beijing family strains circulating in Japan. This would be a good start to approaching the genetic determinants causing variations in virulence and transmissibility of M. tuberculosis. We are currently applying the next-generation sequencing technology to get the whole genome sequencing of the representative strains from each monophyletic subgroup within M. tuberculosis Beijing family.

摘要

北京家族是结核分枝杆菌的一个基因型谱系,据报道在整个东亚和俄罗斯部分地区占主导地位,但在全球范围内都有分布。日本约80%的临床分离株属于这个家族。少数基因型占主导地位,在这种情况下是北京家族菌株占主导,据推测这些菌株可能在毒力或传播性方面具有选择优势,从而导致克隆性扩张。这些菌株在结核分枝杆菌物种内是单系的,并且在这个家族中还显示出进一步的亚谱系。据信结核分枝杆菌菌株的遗传和进化背景会影响获得耐药性的倾向以及病原体的传播性。因此,了解北京家族菌株的群体遗传结构及其动态变化无疑将有助于揭示该基因型在日本取得巨大成功并广泛传播的基础。在过去几年中,我们深入研究了这个臭名昭著的分支,即结核分枝杆菌北京家族,通过群体结构分析来重建其进化事件和系统发育,并阐明其在亚谱系水平上的流行病学特征。在此,我总结了我们过去几年的研究结果。日本北京家族菌株遗传多样性的独特性。我们通过15-MIRU-VNTR基因分型方法重建了北京家族菌株的系统发育树,并通过NTF区域分析、大序列多态性(LSP)和单核苷酸多态性(SNP)对其进行了验证。有趣的是,我们可以证明古老的北京亚谱系在日本仍然是地方病,这与现代北京亚谱系在全球的传播形成对比。此外,我们发现古老的亚谱系菌株对应于四个单系亚组。日本北京家族菌株遗传多样性的独特性,即其高多样性以及古老亚谱系相对于全球发现的现代亚谱系的优势,表明它们是独立于导致日本境外占主导地位的现代北京亚谱系的进化流而成为地方病的。日本北京家族菌株的群体结构动态。通过比较老年结核病患者的分离株(这些菌株代表几十年前存在的群体结构)和年轻结核病患者的分离株(这些菌株反映当前流行菌株的群体结构),我们推断了过去几十年日本北京家族菌株的群体结构动态。不同年份出生队列之间的比较表明,二战前结核病高度流行时日本结核分枝杆菌北京家族菌株的群体结构与当前流行菌株的群体结构有显著差异。结果显示,具有高传播性的现代亚谱系的传播目前正在增加,而古老亚谱系STK在年轻一代中的传播已显著减少。有趣的是,可以推测现代菌株和STK菌株的观察趋势可能与卡介苗(BCG)接种有关。北京家族亚谱系与多药耐药性之间的关联。结核分枝杆菌北京家族菌株被怀疑是结核分枝杆菌的一个不断进化的谱系,已获得耐药优势。然而,这种基因型与耐药性之间的关联在不同国家有所不同。这可能是由于北京家族亚谱系适应性的异质性以及这些亚谱系在当地人群中的不同比例。为了确定某些亚谱系是否与多药耐药(MDR)和广泛耐药(XDR)结核病相关,我们在全药物敏感(DS)、MDR和XDR菌株中分析了基于10个同义单核苷酸多态性(sSNP)的北京菌株的群体结构。结果显示,属于古老亚谱系的两个进化亚组(ST 26和ST3)在MDR/XDR群体中出现的频率明显高于DS群体。这表明北京家族的不同亚谱系在适应药物选择压力的机制上可能有所不同。对于在该地区实现更好的结核病控制而言,更加警惕地监测这些菌株的出现必不可少。将分子流行病学数据与分枝杆菌基因组学和群体遗传学的最新进展相结合,我们可以为在日本传播的结核分枝杆菌北京家族菌株的遗传多样性和系统发育提供新的见解。这将是接近导致结核分枝杆菌毒力和传播性变异的遗传决定因素的一个良好开端。我们目前正在应用下一代测序技术对结核分枝杆菌北京家族中每个单系亚组的代表性菌株进行全基因组测序。

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