L'vov D K, Burtseva E I, Prilipov A G, Bogdanova V S, Shchelkanov M Iu, Bovin N V, Samokhvalov E I, Fediakina I T, Deriabin P G, Kolobukhina L V, Shtyria Iu A, Shevchenko E S, Malyshev N A, Merkulova L N, Bazarova M V, Maslov A I, Ishchenko N M, Iskhakova E A, Al'khovskiĭ S V, Grebennikova T V, Sadykova G K, L'vov D N, Zhuravleva M M, Iamnikova S S, Shliapnikova O V, Poglazov A B, Trushakova S V, Lavrishcheva V V, Aristova V A, Proshina E S, Vereshchagin N N, Kuz'michev A G, Iashkulov K B, Dzhambinov S D, Bushkieva B Ts, Eliseeva S M, Bystrakov S I, Sokolova I A, Dzhaparidzhe N I, Ledenev Iu A, Rosolovskiĭ A P, Gareev R V, Boldyreva V V, Anan'ev V Iu, Baranov N I, Gorelikov V N, Garbuz Iu A, Reznik V I, Ivanov L I, Zdanovskaia N N, Sergeeva N M, Podolianko I A, Elovskiĭ O V, Gromova M A, Kalaeva E E, Grigor'ev S N, Eremeeva Iu V, Dovgal' M V, Fedelesh I Iu, Sakharova E A, Burtnik V I, Avdoshina L N, Shapiro N P, Maslov D V, Ianovich V A, Ott V A, Lebedev G B
Vopr Virusol. 2010 Jul-Aug;55(4):4-9.
The paper gives the results of sequence analysis of 150 positive samples in real-time RT-PCR, including 47 autopsy materials from patients (including 10 pregnant women), who died from fatal pneumonia mainly in November-December 2009, in whom the lifetime etiological diagnosis had not been made and hence no early etiotropic therapy performed. 70% of the primary materials from the deceased patients were found to have pandemic influenza A(H1N1) v mutants in the lung tissue with D222G (15%), D222N (15%), D222E (2%) substitutions, as well as a mixture of mutants (38%). Nasopharyngeal lavages from 3 Chukotka deceased patients exhibited only consensus (nonmutant) D222 virus variants; there was a mixture of consensus and mutant virus variants in the trachea and a mixture of mutant ones in the lung. Preliminary data from the study of the interaction of the hemagglutinin of two strains having D222G and D222N mutations with 9 oligosaccharides imitating the variants of cell receptors for influenza A virus suggest that there is a double receptor specificity for alpha2'-3' and alpha2'-6'-sialosides with a preponderance of alpha2'-3'-specificity. Further spread of the mutants that have acquired a high virulence and preserved their capacity for the respiratory route of human infection may lead to the situation similar to that seen in the 1918-1919 pandemic. Another scenario for evolution of the virus is to preserve its receptor specificity for alpha2'-3'-sialosides and high virulence with losses of alpha2'-6' specificity and capacity for aerosol transmission, by damping the pandemic.
该论文给出了150份实时逆转录聚合酶链反应阳性样本的序列分析结果，其中包括47份来自患者（包括10名孕妇）的尸检材料，这些患者主要于2009年11月至12月死于致命性肺炎，生前未做出病因诊断，因此未进行早期病因特异性治疗。在死者患者的原始材料中，70%的肺组织发现有甲型H1N1大流行性流感病毒突变体，存在D222G（15%）、D222N（15%）、D222E（2%）替代，以及突变体混合物（38%）。3名楚科奇死者患者的鼻咽灌洗样本仅显示一致的（非突变的）D222病毒变体；气管中存在一致和突变病毒变体的混合物，肺中存在突变体混合物。对具有D222G和D222N突变的两种毒株的血凝素与9种模拟甲型流感病毒细胞受体变体的寡糖相互作用的研究初步数据表明，对α2'-3'和α2'-6'-唾液酸苷存在双重受体特异性，其中α2'-3'-特异性占优势。已获得高毒力并保留其人际呼吸道感染能力的突变体的进一步传播可能导致类似于1918 - 1919年大流行时的情况。病毒进化的另一种情况是通过抑制大流行，保留其对α2'-3'-唾液酸苷的受体特异性和高毒力，同时丧失α2'-6'特异性和气溶胶传播能力。
