Institut für Virologie, Medizinische Hochschule, Hannover, Germany.
Institut für Virologie, Albert-Ludwigs-Universität, Freiburg, Germany.
J Infect. 2014 Nov;69(5):490-9. doi: 10.1016/j.jinf.2014.06.015. Epub 2014 Jun 27.
Between 2005 and 2013 six severe pneumonia cases (all requiring mechanical ventilation, two fatal outcomes) caused by human adenovirus type 21 (HAdV-B21) were observed in Germany. So far, HAdV-B21 was mainly associated with non-severe upper and lower respiratory tract infections. However, a few highly virulent HAdV types, e.g. HAdV-B14p1, were previously associated with severe, fatal pneumonia. Complete genomic sequences of the German HAdV-B21 pneumonia isolates formed a single phylogenetic cluster with very high sequence identity (≥ 99.897%). Compared to the HAdV-B21 prototype (only 99.319% identity), all isolates had a unique 15 amino acid deletion and a 2 amino acid insertion in the RGD loop of the penton base which may affect binding to the secondary receptor on the host cells. Moreover, a recombinant E4 gene region derived of HAdV-B3 was identified by bootscan analysis. Thus, the highly virulent, pneumotropic HAdV-B21 was denominated as subtype 21a. Surprisingly, there was 99.963% identity with agent Y/SIBU97 (only 13.4 kb available in GenBank of the 35.4 kb genome) which was associated with 10 fatalities due to cardiopulmonary failure in Sarawak, Malaysia, in 1997. In conclusion, a HAdV-B21 subtype (21a) associated with severe pneumonia in Germany was phylogenetically linked to an adenovirus isolated in Malaysia.
在 2005 年至 2013 年期间，德国观察到六例由人腺病毒 21 型（HAdV-B21）引起的严重肺炎病例（均需机械通气，两例死亡）。到目前为止，HAdV-B21 主要与非严重上下呼吸道感染有关。然而，一些高毒力的腺病毒类型，如 HAdV-B14p1，以前与严重的、致命的肺炎有关。德国 HAdV-B21 肺炎分离株的完整基因组序列形成了一个单一的进化枝，具有非常高的序列同一性（≥99.897%）。与 HAdV-B21 原型（仅 99.319%的同一性）相比，所有分离株在五邻体基底的 RGD 环中都有一个独特的 15 个氨基酸缺失和 2 个氨基酸插入，这可能影响与宿主细胞上的辅助受体的结合。此外，通过启动扫描分析鉴定了源自 HAdV-B3 的重组 E4 基因区。因此，这种高毒力、嗜肺性的 HAdV-B21 被命名为 21a 亚型。令人惊讶的是，它与 1997 年在马来西亚沙捞越导致心肺衰竭的 10 例死亡相关的 Y/SIBU97 病毒（仅在 GenBank 中有 13.4kb 的 35.4kb 基因组）具有 99.963%的同一性。总之，德国严重肺炎相关的 HAdV-B21 亚型（21a）与在马来西亚分离的腺病毒在系统进化上有关。
