Oseltamivir Resistance in Influenza A(H6N2) Caused by an R292K Substitution in Neuraminidase Is Not Maintained in Mallards without Drug Pressure.

BACKGROUND: Wild waterfowl is the natural reservoir of influenza A virus (IAV); hosted viruses are very variable and provide a source for genetic segments which can reassort with poultry or mammalian adapted IAVs to generate novel species crossing viruses. Additionally, wild waterfowl act as a reservoir for highly pathogenic IAVs. Exposure of wild birds to the antiviral drug oseltamivir may occur in the environment as its active metabolite can be released from sewage treatment plants to river water. Resistance to oseltamivir, or to other neuraminidase inhibitors (NAIs), in IAVs of wild waterfowl has not been extensively studied. AIM AND METHODS: In a previous in vivo Mallard experiment, an influenza A(H6N2) virus developed oseltamivir resistance by the R292K substitution in the neuraminidase (NA), when the birds were exposed to oseltamivir. In this study we tested if the resistance could be maintained in Mallards without drug exposure. Three variants of resistant H6N2/R292K virus were each propagated during 17 days in five successive pairs of naïve Mallards, while oseltamivir exposure was decreased and removed. Daily fecal samples were analyzed for viral presence, genotype and phenotype. RESULTS AND CONCLUSION: Within three days without drug exposure no resistant viruses could be detected by NA sequencing, which was confirmed by functional NAI sensitivity testing. We conclude that this resistant N2 virus could not compete in fitness with wild type subpopulations without oseltamivir drug pressure, and thus has no potential to circulate among wild birds. The results of this study contrast to previous observations of drug induced resistance in an avian H1N1 virus, which was maintained also without drug exposure in Mallards. Experimental observations on persistence of NAI resistance in avian IAVs resemble NAI resistance seen in human IAVs, in which resistant N2 subtypes do not circulate, while N1 subtypes with permissive mutations can circulate without drug pressure. We speculate that the phylogenetic group N1 NAs may easier compensate for NAI resistance than group N2 NAs, though further studies are needed to confirm such conclusions.

Influenza A(H7N9) virus acquires resistance-related neuraminidase I222T substitution when infected mallards are exposed to low levels of oseltamivir in water.

Influenza A virus (IAV) has its natural reservoir in wild waterfowl, and new human IAVs often contain gene segments originating from avian IAVs. Treatment options for severe human influenza are principally restricted to neuraminidase inhibitors (NAIs), among which oseltamivir is stockpiled in preparedness for influenza pandemics. There is evolutionary pressure in the environment for resistance development to oseltamivir in avian IAVs, as the active metabolite oseltamivir carboxylate (OC) passes largely undegraded through sewage treatment to river water where waterfowl reside. In an in vivo mallard (Anas platyrhynchos) model, we tested if low-pathogenic avian influenza A(H7N9) virus might become resistant if the host was exposed to low levels of OC. Ducks were experimentally infected, and OC was added to their water, after which infection and transmission were maintained by successive introductions of uninfected birds. Daily fecal samples were tested for IAV excretion, genotype, and phenotype. Following mallard exposure to 2.5 µg/liter OC, the resistance-related neuraminidase (NA) I222T substitution, was detected within 2 days during the first passage and was found in all viruses sequenced from subsequently introduced ducks. The substitution generated 8-fold and 2.4-fold increases in the 50% inhibitory concentration (IC50) for OC (P < 0.001) and zanamivir (P = 0.016), respectively. We conclude that OC exposure of IAV hosts, in the same concentration magnitude as found in the environment, may result in amino acid substitutions, leading to changed antiviral sensitivity in an IAV subtype that can be highly pathogenic to humans. Prudent use of oseltamivir and resistance surveillance of IAVs in wild birds are warranted.

Identification of in vivo released products of Onchocerca with diagnostic potential, and characterization of a dominant member, the OV1CF intermediate filament.

A sensitive and specific test for the routine diagnosis of active Onchocerca infection is currently lacking. A major drawback in the development of such a test has been the paucity of knowledge of suitable parasite antigens that can serve as targets in antigen-detection assays. In the present investigation, we employed mass spectrometry, bioinformatics and molecular techniques to identify and characterize several potentially diagnostic Onchocerca antigens in the in vivo nodular fluid, which is being investigated for the first time. The majority of the 27 identified antigens lacked a secretory signal. One of them, also identified and characterized in greater detail with the aid of previously developed monoclonal antibodies (Mabs), was a dominant circulating cytoplasmic intermediate filament protein, previously identified and named, OV1CF. Although OV1CF lacks a secretory signal in its amino acid sequence and is not detected in the pure 42 h in vitro released products, it is easily detected in the in vivo nodular fluid. We conclude that these in vivo released products offer promise as diagnostics markers in onchocerciasis.

Preparation and characterization of specific monoclonal antibodies for the detection of adult worm infections in onchocerciasis.

Suitable molecular tests for monitoring the viability of adult worms of Onchocerca in vivo are required to accelerate the development of new macrofilaricides in river blindness (onchocerciasis). Hence, three monoclonal antibodies (MAbs) were prepared and evaluated in a sandwich enzyme-linked immunosorbent assay (ELISA) for their abilities to detect circulating adult worm antigens in onchocercal bovine and human sera. The MAbs did not cross-react with a number of control antigens, which included extracts of Ascaris suum, Loa loa, and O. ochengi microfilariae. They were all IgG1 molecules. Their targets in O. ochengi total extract were a set of the same 15 polypeptides with apparent molecular weights of 21-220 Kda. Immunohistochemical studies confirmed their adult worm specificity and showed their binding to the hypodermis of the adult worm. The ELISA could detect as little as 100 pg/mL of the affinity-purified target antigens. It also detected the antigens with 94.1% specificity in 50 out of 56 infected bovine sera (90% sensitivity) and in 21 out of 43 infected human sera (48.8% sensitivity, which could go up to 72.1% on elimination of two skewed control cases). We conclude that the MAbs could be field tested and used in responder populations as described herein or employed as components of more sensitive assays for the evaluation of novel Onchocerca macrofilaricides.

Delayed anti-kappa response in kappa-deficient mice after neonatal, oral immunization with kappa-containing IgG.

Antibody responses to kappa (kappa)-light (L) chain are absent in normal (Ckappa+/+) animals because of tolerance due to the abundance of kappa-L chains expressed on more than 95% of all B cells and serum Ig.When heterozygous kappa-sufficient (Ckappa+/-) females are bred with homozygous kappa-deficient (Ckappa-/-) males, half of their offspring will become kappa-deficient but have received kappa-L chain containing maternal Ig, mainly IgG and IgA, through placental and intestinal transmission. The kappa-containing maternal Ig persists for more than 2 months in the circulation of the offspring. Starting from weeks 15 to 20 of age, a spontaneous antibody response towards the maternal kappa-L chains can be recorded. The time of onset, as well as the magnitude of the responses differ among individuals of the same litter. Invariably, once a response has been initiated, it transits into an IgG-type of response, which upon injection with kappa-containing protein shows the features of a secondary type of immune response.