High genetic diversity and predominance of Rhinovirus A and C from Panamanian hospitalized children under five years with respiratory infections
© Franco et al.; licensee BioMed Central Ltd. 2012
Received: 23 November 2011
Accepted: 29 October 2012
Published: 1 November 2012
Human Rhinoviruses (HRVs) have high genetic diversity and three species have been described: HRV-A, HRV-B, and the recently recognized HRV-C, which has been rapidly identified worldwide.
In the present study, we report the frequency and diversity of Human Rhinovirus (HRV) strains circulating in Panama from children hospitalized with respiratory infections.
HRVs of species A, B and C have been identified with a predominance of HRV-A and HRV-C over HRV-B, and marked genetic diversity within each species.
Human rhinoviruses (HRVs) are the most common causative agents of upper respiratory tract infections, but are also associated with more severe diseases such as pneumonia or acute wheezing related to bronchiolitis and acute asthma in children [1–4]. HRV infection occurs in all age groups and is responsible for 25% to 50% of respiratory infections presenting as influenza-like illnesses [5–7].
HRVs have been classified into the genus Enterovirus, family Picornaviridae. As other picornaviruses, they are small, non-enveloped viruses with a 7200 bp single-stranded, positive-sense mRNA genome and a long open reading frame encoding four capsid proteins VP4, VP2, VP3 and VP1, and seven non-structural proteins 2A, 2B, 2C, 3A, 3B, 3C and 3D.
Reports that infection with different HRV species result in different clinical outcomes are controversial: some show correlations between a given viral serotype or species and its capacity to invade the upper or lower respiratory tract , whereas others provide evidence for a more frequent role for HRV-C in lower respiratory tract infections, associated with more severe disease [9, 11]. In a recent study, HRV rates were high among hospitalized children and the elderly, but HRV was also detected among asymptomatic children. HRV-A and HRV-C were associated with illness requiring hospitalization .
Very little in general is known about the genetic diversity of respiratory viruses in Central America or Panama, nor specifically about rhinoviruses. In this study we investigate the genetic variability of Rhinovirus from children under five years, hospitalized in Panama with respiratory infections. Stored nasal swab samples were used in this study and the protocol was approved by Ethics Committee of Gorgas Institute. Sixty-two nasal swab samples positive for HRV by real time PCR  from a total 118 samples from 420 study subjects, collected from August 2010 (n: 178) to June 2011 (n: 242), were analyzed by RT-PCR and sequencing. Briefly, the viral RNA was extracted using QIAamp Viral RNA Mini Kit (Qiagen, GmbH, Hilden, Germany) according to the manufacturer’s instructions. Amplification of a 542 bp fragment containing the HRV VP4 and partial VP2 region was performed by RT-PCR using a reverse primer identical to that described previously  and external and semi-nested forward primers designed by Xiaoyan Lu and Dean Erdman at CDC (unpublished data). cDNA synthesis and PCR were carried out using QIAGEN OneStep RT-PCR Kit and Taq PCR Master Mix Kit and PCR products were purified using a Wizard® SV Gel and PCR Clean-Up System (Promega Corporation Madison, WI 53711 USA). Sequencing was performed in both directions using the same primers as in the PCR with an ABI Prism BigDye Terminator Cycle Sequencing Ready Reaction Kit according to the manufacturer’s instructions on a 3130XL Genetic Analyzer (Applied Biosystems, Foster City, CA).
Alignment and sequence analyses were performed using Bioedit, ClustalW and MEGA5 software. The most suitable model for nucleotide substitution was estimated with Modelgenerator. Phylogenetic trees were constructed under maximum likelihood criteria and branch supports were calculated by the approximate likelihood ratio test (aLRT). One hundred and fifty published HRV sequences within the VP4-VP2 region were obtained from the GenBank database (NCBI). The VP4/VP2 region was used to analyze the sequence variability within the much larger data set of published sequences of all HRV-A, HRV-B serotypes, and also from the recently described species C variants, which have been assigned to 28 provisional types .
The same region of VP4-VP2 region for each positive sample amplified and sequenced was used to identify the serotypes within each species. To do this, we constructed phylogenetic trees with the dataset of published sequences belonging to all HRV-A, HRV-B serotypes, and also from the recently described HRV-C species variants [9, 12].
HRV serotypes detected among study subjects within each species
Species and serotype
No. of samples with the indicated serotype
Table 1 and Figure 2-A, show that of 37 HRV-A samples, 35 were assigned to previously reported serotypes, including 7 samples clustering with the recently assigned new HRV-A serotypes, named NS1 and NS2 . Two samples (308639 and 308868) could not be properly assigned to the actually defined serotypes. Sequence 308639 displayed a p-distance greater than 10% with respect to all of the HRV-A serotypes, except for serotypes 29 and 44. Because of this, and following the criterion postulated by Simmonds et al., for HRV-C (> 10% of divergence between types) , this strain should not be assigned to a new serotype. Sequence 308868 shows a p-distance greater than 10% with respect to every other serotype. Thus, following the same criterion, this strain could be provisionally assigned to a new serotype.
The HRV strains analyzed showed substantial genetic diversity, a fact that is supported by a Shannon entropy analysis performed with the sequences from Figure 1, which displayed values between 0.6 and 1 for the majority of the sites analyzed (data not shown, available on request).
Marked genetic diversity within HRV-A and HRV-C over HRV-B species has been demonstrated in this study, with HRV-B sequences being the most homogeneous species, showing an intra-species nucleotide p-distance of 0.19, followed by rhinovirus A, with 0.20. The most heterogeneous was species C, with a p-distance of 0.25.
The emergence of previously untyped serotypes of HRVs in our study represents a challenge for HRV researches to develop the necessary tools to allow for reliable classifications.
Additional studies involving subject of all ages hospitalized and also ambulatory will be done in Panama, in order to elucidate the relationships between HRV species and to define the epidemiological profile and genetic characteristics of each one.
Panamanian strains were deposited in the GenBank Database under accession numbers [Gen-Bank: JN797533 to JN797594].
This study was supported by Grants from Senacyt-Panama (JA) (CAP10-001) and Ministerio Economia y Finanzas-Panama (COD. SINIP 9044.019). The authors thank Dr Rebecca Smith and Santiago Mirazo for critical reading of the paper.
- Andrewes CH: The complex epidemiology of respiratory virus infections. Science. 1964, 146: 1274-1277. 10.1126/science.146.3649.1274.PubMedView ArticleGoogle Scholar
- Arruda E, Pitkaranta A, Witek TJ, Doyle CA, Hayden FG: Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997, 35: 2864-2868.PubMedPubMed CentralGoogle Scholar
- Hayden FG: Rhinovirus and the lower respiratory tract. Rev Med Virol. 2004, 14: 17-31. 10.1002/rmv.406.PubMedView ArticleGoogle Scholar
- Mackay IM: Human rhinoviruses: the cold wars resume. J Clin Virol. 2008, 42: 297-320. 10.1016/j.jcv.2008.04.002.PubMedView ArticleGoogle Scholar
- Nicholson KG, Kent J, Hammersley V, Cancio E: Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden. Br Med J. 1997, 315: 1060-1064. 10.1136/bmj.315.7115.1060.View ArticleGoogle Scholar
- Boivin G, Osterhaus AD, Gaudreau A, Jackson HC, Groen J, Ward P: Role of picornaviruses in flu-like illnesses of adults enrolled in an oseltamivir treatment study who had no evidence of influenza virus infection. J Clin Microbiol. 2002, 40: 330-334. 10.1128/JCM.40.2.330-334.2002.PubMedPubMed CentralView ArticleGoogle Scholar
- Bellei N, Carraro E, Perosa A, Watanabe A, Arruda E, Granato C: Acute respiratory infection and influenza-like illness viral etiologies in Brazilian adults. J Med Virol. 2008, 80: 1824-1827. 10.1002/jmv.21295.PubMedView ArticleGoogle Scholar
- Stanway G, Brown F, Christian P, Hovi T, Hyypia T, King AM Q, Knowles NJ, Lemon SM, Minor PD, Pallansch MA, Palmenberg AC, Skern T: Family Picornaviridae. Virus taxonomy. Edited by: Fauquet CM, Mayo MA, Maniloff J, Desselberger U, Ball LA. 2005, Eighth Report of the International Committee on Taxonomy of Viruses. Elsevier/Academic Press, London, United Kingdom, 757-778.Google Scholar
- Lau SK, Yip CC, Tsoi HW, Lee RA, So LY, Lau YL, Chan KH, Woo PC, Yuen KY: Clinical features and complete genome characterization of a distinct human rhinovirus (HRV) genetic cluster, probably representing a previously undetected HRV species, HRVC, associated with acute respiratory illness in children. J Clin Microbiol. 2007, 45: 3655-3664. 10.1128/JCM.01254-07.PubMedPubMed CentralView ArticleGoogle Scholar
- Huang T, Wang W, Bessaud M, Ren P, Sheng J, Yan H, Zhang J, Lin X, Wang Y, Delpeyroux F, Deubel V: Evidence of recombination and genetic diversity in human rhinoviruses in children with acute respiratory infection. PLoS One. 2009, 4: e6355-10.1371/journal.pone.0006355.PubMedPubMed CentralView ArticleGoogle Scholar
- Wisdom A, Leitch EC, Gaunt E, Harvala H, Simmonds P: Screening respiratory samples for detection of human rhinoviruses (HRVs) and enteroviruses: comprehensive VP4-VP2 typing reveals high incidence and genetic diversity of HRV species C. J Clin Microbiol. 2009, 47: 3958-3967. 10.1128/JCM.00993-09.PubMedPubMed CentralView ArticleGoogle Scholar
- Simmonds P, McIntyre C, Savolainen-Kopra C, Tapparel C, Mackay IM, Hovi T: Proposals for the classification of human rhinovirus species C into genotypically assigned types. J Gen Virol. 2010, 91: 2409-2419. 10.1099/vir.0.023994-0.PubMedView ArticleGoogle Scholar
- Tapparel C, Cordey S, Junier T, Farinelli L, Van Belle S, Soccal PM, Aubert JD, Zdobnov E, Kaiser L: Rhinovirus genome variation during chronic upper and lower respiratory tract infections. PLoS One. 2011, 6 (6): e21163-10.1371/journal.pone.0021163.PubMedPubMed CentralView ArticleGoogle Scholar
- Fry AM, Lu X, Olsen SJ, Chittaganpitch M, Sawatwong P, Chantra S, Baggett HC, Erdman D: Human rhinovirus infections in rural Thailand: epidemiological evidence for rhinovirus as both pathogen and bystander. PLoS One. 2011, 6 (3): e17780-10.1371/journal.pone.0017780. 29PubMedPubMed CentralView ArticleGoogle Scholar
- Lu X, Holloway B, Dare RK, Kuypers J, Yagi S, Williams JV, Hall CB, Erdman DD: Real-time reverse transcription-PCR assay for comprehensive detection of human rhinoviruses. J Clin Microbiol. 2008, 46: 533-539. 10.1128/JCM.01739-07.PubMedPubMed CentralView ArticleGoogle Scholar
- Savolainen C, Blomqvist S, Mulders MN, Hovi T: Genetic clustering of all 102 human rhinovirus prototype strains: serotype 87 is close to human enterovirus 70. J Gen Virol. 2002, 83: 333-340.PubMedView ArticleGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.