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Journal of Clinical Microbiology, July 2007, p. 2284-2286, Vol. 45, No. 7
0095-1137/07/$08.00+0 doi:10.1128/JCM.00921-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
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Department of Microbiology,1 Division of Research Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand,5 Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand,2 Department of Pathology, Faculty of Veterinary Medicine, Kasetsart University, Nakhon Pathom, Thailand,3 Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand4
Received 3 May 2007/ Accepted 9 May 2007
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160 in adjunct with a microneutralization (microNT) antibody titer of
80 in a single serum collected at day 14 or later as one among other criteria for a confirmed case of H5N1 infection (8).
Agglutination of erythrocytes by influenza viruses is mediated by the interaction between the receptor binding site (RBS) in hemagglutinin molecule and the sialyl receptor. Human influenza H1N1 and H3N2 viruses preferentially bind to a sialic acid receptor, the oligosaccharide side chain of which is linked with
2,6-galactose linkage (SA
2,6Gal), while avian and equine influenza viruses prefer an
2,3-galactose linkage (SA
2,3Gal). Horse and cow erythrocytes contain mainly an SA
2,3Gal linkage but no SA
2,6Gal (1). Chicken and goose erythrocytes contain more SA
2,3Gal linkage than SA
2,6Gal, while this is reversed with human O cells and pig, guinea pig, and turkey erythrocytes (1, 2).
Herein, five erythrocyte species (horse, goose, chicken, guinea pig and human O cells) were tested by HA assay against 14 H5N1 clade 1 isolates from Thailand, including five from humans, seven from wild and domestic birds, one from a tiger and, one from a clouded leopard, together with one human H1N1 isolate and five H3N2 isolates. Final concentrations of 0.5% goose, 0.5% chicken, 0.75% guinea pig, 0.75% human group O, and 1% horse erythrocytes were used. Except for those from the horse, erythrocytes were suspended in phosphate-buffered saline, pH 7.2. Horse erythrocytes were suspended in phosphate-buffered saline plus 0.5% bovine serum albumin. These protocols were followed as described previously (6, 7). A reaction well, consisting of 50 µl of diluted virus and 50 µl of erythrocyte suspensions, was incubated for 1 h at 4°C before the agglutination pattern was read. One HA unit is defined as the highest virus dilution that yields complete HA.
The experiments demonstrated that 13 of 14 H5N1 isolates could agglutinate erythrocytes from all five species with a statistical difference in the extent of titer (Friedman test, P < 0.05). Interestingly, an isolate from the clouded leopard could not agglutinate horse erythrocytes (Table 1). The result was consistent, as repeatedly tested with erythrocytes from three donors within one species. Goose erythrocytes yielded the highest HA titer, followed in order of sensitivity by chicken, guinea pig, human, and horse erythrocytes (Wilcoxon's signed-rank test, P < 0.005).
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TABLE 1. HA titers of influenza A viruses as assayed with erythrocytes from different species
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2,3Gal (1, 3). Therefore, loss of the ability to agglutinate horse erythrocytes may be related to loss of the ability to recognize either NeuGc or galactose linkage (1, 3). The study of human influenza H1N1 and H3N2 viruses showed that all six isolates could not agglutinate horse erythrocytes (Table 1). An A/Sydney/05/97(H3N2)-like isolate could agglutinate chicken erythrocytes, while all three A/Fujian/411/02(H3N2)-like isolates and one A/California/07/04(H3N2)-like isolate could not. This result supported previous findings that current H3N2 isolates have lost their agglutinating activity with chicken erythrocytes (2, 4). However, all of the data, including ours, were discrete and could not conclude that there was a correlation between certain mutational positions and loss of the agglutinating activity (data not shown).
Fourteen serum samples from seven H5N1 patients, including the survivors, were assayed for H5N1 antibody. Two H5N1 strains, A/Thailand/1(KAN-1)/04 which was the first human isolate from the country (5), and A/Thailand/676(NYK)/05, as described above, were selected as the test antigens. This study was approved by the Institution Ethical Committee for Human Research.
In the HI test, serum was pretreated with a receptor-destroying enzyme (Denka Seiken, Japan) at final dilution of 1:4 for 16 h at 37°C followed by heat inactivation for 30 min at 56°C and absorbed with a 50% erythrocyte suspension for 60 min at 4°C. A mixture of 25 µl of the diluted serum and 25 µl of the test virus at a concentration of 4 HA units was incubated for 30 min at room temperature before addition of 50 µl of erythrocyte suspension. The end result was read after incubation for 1 h at 4°C. HI antibody titer is defined as the final serum dilution that completely inhibits HA. Again, three donors from each of the five erythrocyte species were tested in separate runs with consistent results.
The results demonstrated that horse erythrocytes, which were the least sensitive in HA, gave the highest geometric mean titer (GMT) of antibody when A/Thailand/1(KAN-1)/04 was used as the test antigen (Wilcoxon's signed-rank test, P < 0.005). Goose erythrocytes were ranked second, followed by human, guinea pig, and chicken erythrocytes. In contrast, when A/Thailand/676(NYK)/05 was used as the test antigen, goose erythrocytes yielded the highest GMT, followed in order by chicken, horse, human, and guinea pig erythrocytes. However, a statistically significant difference was not found (Wilcoxon's signed-rank test, P > 0.005) (Table 2). Collectively, the level of HI antibody titer was dependent on both the erythrocyte species and the test antigen used. We also showed that HI is more sensitive for strain differentiation than microNT.
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TABLE 2. H5N1 HI antibody titers as tested by different erythrocyte species
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We also thank Stephen Durako, Westat, for manuscript review and Jarunee Prasertsophon, Kannika Nateerom, and Rasameepen Po-ngakern for laboratory support.
Published ahead of print on 23 May 2007. ![]()
Supplemental material for this article may be found at http://jcm.asm.org/. ![]()
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