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人肠道病毒71型与手足口病的分子流行病学及其分子进化

         

摘要

人肠道病毒71血清型(Enterovirus 71, EV71)是手足口病(Hand, foot and mouth disease, HFMD)的主要病原体之一,除了引起手、足和口腔等部位出现疱疹的手足口病典型症状,还能引起无菌性脑膜炎和急性迟缓性麻痹等神经系统并发症并致死亡.EV71在历史上曾经造成多起手足口病疫情,尤其是1997年之后,在亚太地区发生了大规模的手足口病疫情,造成了大量的手足口病病例和死亡病例.手足口病尚无上市疫苗和抗病毒药物,主要依赖对症治疗,因此对EV71的分子流行病学和分子进化研究对手足口病的监测和防控具有重要意义.文章对EV71基因型的分类、时空分布、进化特征和模式以及所造成的代表性疫情进行了综述,为EV71致病机制、抗病毒药物和疫苗的研究以及对手足口病疫情的监测和防控提供启发.%Human enterovirus 71(EV71), one of the major pathogens of the hand, foot and mouth disease (HFMD), causes skin rashes in palms, feet and mouth ulcers and complications in the central nervous system such as aseptic meningi-tis and acute flaccid paralysis that may lead to death. EV71 infection has been reported to be associated with many out-breaks of HFMD worldwide, especially the great outbreaks that occurred in the Asia-Pacific region and caused numerous death since 1997. The studies of molecular epidemiology and evolution of EV71 are important for the prevention and con-trol of HFMD since no vaccines and antiviral drugs have been developed except symptomatic treatment for HFMD. In this review, we summarize genotype classification, temporal and spatial distribution, evolutionary characteristics and modes of EV71 as well as typical EV71 epidemics. Further studies on EV71 and HFMD may lead to better understanding of patho- logical mechanisms of EV71, development of antiviral drugs and vaccines, and prevention and control of HFMD.

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