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Erschienen in: Archives of Virology 11/2015

01.11.2015 | Original Article

A porcine circovirus-2 mutant isolated in Brazil contains low-frequency substitutions in regions of immunoprotective epitopes in the capsid protein

verfasst von: Rafael Locatelli Salgado, Pedro Marcus Pereira Vidigal, Natalia F. Gonzaga, Luiz F. L. de Souza, Marcelo D. Polêto, Thiago Souza Onofre, Monique R. Eller, Carlos Eduardo Real Pereira, Juliana L. R. Fietto, Gustavo C. Bressan, Roberto M. C. Guedes, Márcia R. Almeida, Abelardo Silva Júnior

Erschienen in: Archives of Virology | Ausgabe 11/2015

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Abstract

Porcine circovirus-2 (PCV2) is the etiologic agent of several diseases in pigs, including multi-systemic wasting syndrome (PMWS). In this work, a new mutant PCV2b was isolated from PMWS-affected pigs on a Brazilian farm. Its genome showed high sequence similarity (>99 % identity) to those from a group of emerging mutants isolated from cases of PMWS outbreaks in vaccinated pigs in China, the USA and South Korea. Here, we show that these isolates share a combination of low-frequency substitutions (single amino acid polymorphisms with a frequency of ≤25 %) in the viral capsid protein, mainly in regions of immunoprotective epitopes, and an additional lysine residue at position 234. These isolates were phylogenetically grouped in the PCV2b clade, reinforcing the idea of the emergence of a new group of mutants PCV2b associated with outbreaks worldwide. The identification of these polymorphisms in the viral capsid highlights the importance of considering these isolates for the development of more-effective vaccines.
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Literatur
1.
Zurück zum Zitat Opriessnig T, Meng X-J, Halbur PG (2007) Porcine circovirus type 2 associated disease: update on current terminology, clinical manifestations, pathogenesis, diagnosis, and intervention strategies. J Vet Diagn Invest 19:591–615CrossRefPubMed Opriessnig T, Meng X-J, Halbur PG (2007) Porcine circovirus type 2 associated disease: update on current terminology, clinical manifestations, pathogenesis, diagnosis, and intervention strategies. J Vet Diagn Invest 19:591–615CrossRefPubMed
3.
4.
8.
Zurück zum Zitat Segalés J, Olvera A, Grau-Roma L, Charreyre C, Nauwynck H, Larsen L, Dupont K, McCullough K, Ellis J, Krakowka S, Mankertz A, Fredholm M, Fossum C, Timmusk S, Stockhofe-Zurwieden N, Beattie V, Armstrong D, Grassland B, Baekbo P, Allan G (2008) PCV-2 genotype definition and nomenclature. Vet Rec 162:867–868CrossRefPubMed Segalés J, Olvera A, Grau-Roma L, Charreyre C, Nauwynck H, Larsen L, Dupont K, McCullough K, Ellis J, Krakowka S, Mankertz A, Fredholm M, Fossum C, Timmusk S, Stockhofe-Zurwieden N, Beattie V, Armstrong D, Grassland B, Baekbo P, Allan G (2008) PCV-2 genotype definition and nomenclature. Vet Rec 162:867–868CrossRefPubMed
9.
Zurück zum Zitat Fraile L, Sibila M, Nofrarías M, López-Jimenez R, Huerta E, Llorens A, López-Soria S, Pérez D, Segalés J (2012) Effect of sow and piglet porcine circovirus type 2 (PCV2) vaccination on piglet mortality, viraemia, antibody titre and production parameters. Vet Microbiol 161:229–234. doi:10.1016/j.vetmic.2012.07.021 CrossRefPubMed Fraile L, Sibila M, Nofrarías M, López-Jimenez R, Huerta E, Llorens A, López-Soria S, Pérez D, Segalés J (2012) Effect of sow and piglet porcine circovirus type 2 (PCV2) vaccination on piglet mortality, viraemia, antibody titre and production parameters. Vet Microbiol 161:229–234. doi:10.​1016/​j.​vetmic.​2012.​07.​021 CrossRefPubMed
10.
Zurück zum Zitat Han K, Seo HW, Oh Y, Park C, Kang I, Jang H, Chae C (2013) Efficacy of a piglet-specific commercial inactivated vaccine against Porcine circovirus type 2 in clinical field trials. Can J Vet Res 77:237–240PubMedCentralPubMed Han K, Seo HW, Oh Y, Park C, Kang I, Jang H, Chae C (2013) Efficacy of a piglet-specific commercial inactivated vaccine against Porcine circovirus type 2 in clinical field trials. Can J Vet Res 77:237–240PubMedCentralPubMed
11.
Zurück zum Zitat Martelli P, Ferrari L, Morganti M, De Angelis E, Bonilauri P, Guazzetti S, Caleffi A, Borghetti P (2011) One dose of a porcine circovirus 2 subunit vaccine induces humoral and cell-mediated immunity and protects against porcine circovirus-associated disease under field conditions. Vet Microbiol 149:339–351. doi:10.1016/j.vetmic.2010.12.008 CrossRefPubMed Martelli P, Ferrari L, Morganti M, De Angelis E, Bonilauri P, Guazzetti S, Caleffi A, Borghetti P (2011) One dose of a porcine circovirus 2 subunit vaccine induces humoral and cell-mediated immunity and protects against porcine circovirus-associated disease under field conditions. Vet Microbiol 149:339–351. doi:10.​1016/​j.​vetmic.​2010.​12.​008 CrossRefPubMed
12.
Zurück zum Zitat Park C, Seo HW, Han K, Chae C (2014) Comparison of four commercial one-dose porcine circovirus type 2 (PCV2) vaccines administered to pigs challenged with PCV2 and porcine reproductive and respiratory syndrome virus at 17 weeks postvaccination to control porcine respiratory disease complex u. Clin Vaccine Immunol 21:399–406. doi:10.1128/CVI.00768-13 PubMedCentralCrossRefPubMed Park C, Seo HW, Han K, Chae C (2014) Comparison of four commercial one-dose porcine circovirus type 2 (PCV2) vaccines administered to pigs challenged with PCV2 and porcine reproductive and respiratory syndrome virus at 17 weeks postvaccination to control porcine respiratory disease complex u. Clin Vaccine Immunol 21:399–406. doi:10.​1128/​CVI.​00768-13 PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Takahagi Y, Toki S, Nishiyama Y, Morimatsu F, Murakami H (2010) Differential effects of porcine circovirus type 2 (PCV2) vaccination on PCV2 genotypes at Japanese pig farms. J Vet Med Sci 72:35–41CrossRefPubMed Takahagi Y, Toki S, Nishiyama Y, Morimatsu F, Murakami H (2010) Differential effects of porcine circovirus type 2 (PCV2) vaccination on PCV2 genotypes at Japanese pig farms. J Vet Med Sci 72:35–41CrossRefPubMed
14.
Zurück zum Zitat Opriessnig T, Gerber PF, Xiao C-T, Mogler M, Halbur PG (2014) A commercial vaccine based on PCV2a and an experimental vaccine based on a variant mPCV2b are both effective in protecting pigs against challenge with a 2013 U.S. variant mPCV2b strain. Vaccine 32:230–237. doi:10.1016/j.vaccine.2013.11.010 CrossRefPubMed Opriessnig T, Gerber PF, Xiao C-T, Mogler M, Halbur PG (2014) A commercial vaccine based on PCV2a and an experimental vaccine based on a variant mPCV2b are both effective in protecting pigs against challenge with a 2013 U.S. variant mPCV2b strain. Vaccine 32:230–237. doi:10.​1016/​j.​vaccine.​2013.​11.​010 CrossRefPubMed
15.
Zurück zum Zitat Toplak I, Lazić S, Lupulović D, Prodanov-Radulović J, Becskei Z, Došen R (2012) Petrović T (2012) Study of the genetic variability of porcine circovirus type 2 detected in Serbia and Slovenia. Acta Vet Hung 60:409–420. doi:10.1556/AVet.035 CrossRefPubMed Toplak I, Lazić S, Lupulović D, Prodanov-Radulović J, Becskei Z, Došen R (2012) Petrović T (2012) Study of the genetic variability of porcine circovirus type 2 detected in Serbia and Slovenia. Acta Vet Hung 60:409–420. doi:10.​1556/​AVet.​035 CrossRefPubMed
16.
17.
Zurück zum Zitat Seo HW, Park C, Kang I, Choi K, Jeong J, Park SJ, Chae C (2014) Genetic and antigenic characterization of a newly emerging porcine circovirus type 2b mutant first isolated in cases of vaccine failure in Korea. Arch Virol. doi:10.1007/s00705-014-2164-6 Seo HW, Park C, Kang I, Choi K, Jeong J, Park SJ, Chae C (2014) Genetic and antigenic characterization of a newly emerging porcine circovirus type 2b mutant first isolated in cases of vaccine failure in Korea. Arch Virol. doi:10.​1007/​s00705-014-2164-6
18.
Zurück zum Zitat Guo L, Fu Y, Wang Y, Lu Y, Wei Y, Tang Q, Fan P, Liu J, Zhang L, Zhang F, Huang L, Liu D, Li S, Wu H, Liu C (2012) A porcine circovirus type 2 (PCV2) mutant with 234 amino acids in capsid protein showed more virulence in vivo, compared with classical PCV2a/b strain. PLoS One 7:e41463. doi:10.1371/journal.pone.0041463 PubMedCentralCrossRefPubMed Guo L, Fu Y, Wang Y, Lu Y, Wei Y, Tang Q, Fan P, Liu J, Zhang L, Zhang F, Huang L, Liu D, Li S, Wu H, Liu C (2012) A porcine circovirus type 2 (PCV2) mutant with 234 amino acids in capsid protein showed more virulence in vivo, compared with classical PCV2a/b strain. PLoS One 7:e41463. doi:10.​1371/​journal.​pone.​0041463 PubMedCentralCrossRefPubMed
19.
Zurück zum Zitat Salgado RL, Vidigal PMP, de Souza LFL, Onofre TS, Gonzaga NF, Eller MR, Bressan GC, Fietto JLR, Almeida MR, Silva Júnior A (2014) Identification of an emergent porcine circovirus-2 in vaccinated pigs from a Brazilian farm during a postweaning multisystemic wasting syndrome outbreak. Genome Announc. doi:10.1128/genomeA.00163-14 PubMedCentralPubMed Salgado RL, Vidigal PMP, de Souza LFL, Onofre TS, Gonzaga NF, Eller MR, Bressan GC, Fietto JLR, Almeida MR, Silva Júnior A (2014) Identification of an emergent porcine circovirus-2 in vaccinated pigs from a Brazilian farm during a postweaning multisystemic wasting syndrome outbreak. Genome Announc. doi:10.​1128/​genomeA.​00163-14 PubMedCentralPubMed
20.
Zurück zum Zitat Segalés J, Rosell C, Domingo M (2004) Pathological findings associated with naturally acquired porcine circovirus type 2 associated disease. Vet Microbiol 98:137–149CrossRefPubMed Segalés J, Rosell C, Domingo M (2004) Pathological findings associated with naturally acquired porcine circovirus type 2 associated disease. Vet Microbiol 98:137–149CrossRefPubMed
21.
Zurück zum Zitat Corrêa AMR, Pescador CA, Schmitz M, Zlotowski P, Rozza DB, Oliveira EC, Barcellos DE, Driemeier D (2006) Aspectos clínico-patológicos associados à circovirose suína no Rio Grande do Sul. Pesqui Veterinária Bras 26:9–13 Corrêa AMR, Pescador CA, Schmitz M, Zlotowski P, Rozza DB, Oliveira EC, Barcellos DE, Driemeier D (2006) Aspectos clínico-patológicos associados à circovirose suína no Rio Grande do Sul. Pesqui Veterinária Bras 26:9–13
22.
Zurück zum Zitat Souza NN, Lobato ZIP, Guedes RMC (2008) Estudo retrospectivo de diagnóstico de circovirose suína pela técnica de imunohistoquímica. Arq Inst Biol (Sao Paulo) 75:521–525 Souza NN, Lobato ZIP, Guedes RMC (2008) Estudo retrospectivo de diagnóstico de circovirose suína pela técnica de imunohistoquímica. Arq Inst Biol (Sao Paulo) 75:521–525
24.
Zurück zum Zitat Sorden SD, Harms PA, Nawagitgul P, Cavanaugh D, Paul PS (1999) Development of a polyclonal-antibody-based immunohistochemical method for the detection of type 2 porcine circovirus in formalin-fixed, paraffin-embedded tissue. J Vet Diagn Invest 11:528–530CrossRefPubMed Sorden SD, Harms PA, Nawagitgul P, Cavanaugh D, Paul PS (1999) Development of a polyclonal-antibody-based immunohistochemical method for the detection of type 2 porcine circovirus in formalin-fixed, paraffin-embedded tissue. J Vet Diagn Invest 11:528–530CrossRefPubMed
25.
Zurück zum Zitat Vidigal PMP, Mafra CL, Silva FMF, Fietto JLR, Silva Júnior A, Almeida MR (2012) Tripping over emerging pathogens around the world: a phylogeographical approach for determining the epidemiology of Porcine circovirus-2 (PCV-2), considering global trading. Virus Res 163:320–327. doi:10.1016/j.virusres.2011.10.019 CrossRefPubMed Vidigal PMP, Mafra CL, Silva FMF, Fietto JLR, Silva Júnior A, Almeida MR (2012) Tripping over emerging pathogens around the world: a phylogeographical approach for determining the epidemiology of Porcine circovirus-2 (PCV-2), considering global trading. Virus Res 163:320–327. doi:10.​1016/​j.​virusres.​2011.​10.​019 CrossRefPubMed
28.
Zurück zum Zitat Guindon S, Gascuel O (2003) A simple, fast, and accurate algorithm to estimate large phylogenies by maximum likelihood. Syst Biol 52:696–704CrossRefPubMed Guindon S, Gascuel O (2003) A simple, fast, and accurate algorithm to estimate large phylogenies by maximum likelihood. Syst Biol 52:696–704CrossRefPubMed
29.
Zurück zum Zitat Ronquist F, Teslenko M, van der Mark P, Ayres DL, Darling A, Höhna S, Larget B, Liu L, Suchard MA, Huelsenbeck JP (2012) MrBayes 3.2: efficient Bayesian phylogenetic inference and model choice across a large model space. Syst Biol 61:539–542. doi:10.1093/sysbio/sys029 PubMedCentralCrossRefPubMed Ronquist F, Teslenko M, van der Mark P, Ayres DL, Darling A, Höhna S, Larget B, Liu L, Suchard MA, Huelsenbeck JP (2012) MrBayes 3.2: efficient Bayesian phylogenetic inference and model choice across a large model space. Syst Biol 61:539–542. doi:10.​1093/​sysbio/​sys029 PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Zwickl D (2006) Genetic algorithm approaches for the phylogenetic analysis of large biological sequence datasets under the maximum likelihood criterion. The University of Texas, Austin Zwickl D (2006) Genetic algorithm approaches for the phylogenetic analysis of large biological sequence datasets under the maximum likelihood criterion. The University of Texas, Austin
34.
Zurück zum Zitat Eddicks M, Fux R, Szikora F, Eddicks L, Majzoub-Altweck M, Hermanns W, Sutter G, Palzer A, Banholzer E, Ritzmann M (2015) Detection of a new cluster of porcine circovirus type 2b strains in domestic pigs in Germany. Vet Microbiol 176:337–343. doi:10.1016/j.vetmic.2015.01.013 CrossRefPubMed Eddicks M, Fux R, Szikora F, Eddicks L, Majzoub-Altweck M, Hermanns W, Sutter G, Palzer A, Banholzer E, Ritzmann M (2015) Detection of a new cluster of porcine circovirus type 2b strains in domestic pigs in Germany. Vet Microbiol 176:337–343. doi:10.​1016/​j.​vetmic.​2015.​01.​013 CrossRefPubMed
35.
Zurück zum Zitat Franzo G, Cortey M, De Castro AMMG, Piovezan U, Szabo MPJ, Drigo M, Segalés J, Richtzenhain LJ (2015) Genetic characterisation of Porcine circovirus type 2 (PCV2) strains from feral pigs in the Brazilian Pantanal: an opportunity to reconstruct the history of PCV2 evolution. Vet Microbiol 178:158–162. doi:10.1016/j.vetmic.2015.05.003 CrossRefPubMed Franzo G, Cortey M, De Castro AMMG, Piovezan U, Szabo MPJ, Drigo M, Segalés J, Richtzenhain LJ (2015) Genetic characterisation of Porcine circovirus type 2 (PCV2) strains from feral pigs in the Brazilian Pantanal: an opportunity to reconstruct the history of PCV2 evolution. Vet Microbiol 178:158–162. doi:10.​1016/​j.​vetmic.​2015.​05.​003 CrossRefPubMed
37.
Zurück zum Zitat Gerber PF, Johnson J, Shen H, Striegel D, Xiao C-T, Halbur PG, Opriessnig T (2013) Association of concurrent porcine circovirus (PCV) 2a and 2b infection with PCV associated disease in vaccinated pigs. Res Vet Sci 95:775–781. doi:10.1016/j.rvsc.2013.06.004 CrossRefPubMed Gerber PF, Johnson J, Shen H, Striegel D, Xiao C-T, Halbur PG, Opriessnig T (2013) Association of concurrent porcine circovirus (PCV) 2a and 2b infection with PCV associated disease in vaccinated pigs. Res Vet Sci 95:775–781. doi:10.​1016/​j.​rvsc.​2013.​06.​004 CrossRefPubMed
39.
Zurück zum Zitat Mahé D, Blanchard P, Truong C, Arnauld C, Le Cann P, Cariolet R, Madec F, Albina E, Jestin A (2000) Differential recognition of ORF2 protein from type 1 and type 2 porcine circoviruses and identification of immunorelevant epitopes. J Gen Virol 81:1815–1824CrossRefPubMed Mahé D, Blanchard P, Truong C, Arnauld C, Le Cann P, Cariolet R, Madec F, Albina E, Jestin A (2000) Differential recognition of ORF2 protein from type 1 and type 2 porcine circoviruses and identification of immunorelevant epitopes. J Gen Virol 81:1815–1824CrossRefPubMed
40.
Zurück zum Zitat Truong C, Mahe D, Blanchard P, Le Dimna M, Madec F, Jestin A, Albina E (2001) Identification of an immunorelevant ORF2 epitope from porcine circovirus type 2 as a serological marker for experimental and natural infection. Arch Virol 146:1197–1211CrossRefPubMed Truong C, Mahe D, Blanchard P, Le Dimna M, Madec F, Jestin A, Albina E (2001) Identification of an immunorelevant ORF2 epitope from porcine circovirus type 2 as a serological marker for experimental and natural infection. Arch Virol 146:1197–1211CrossRefPubMed
41.
Zurück zum Zitat Guo L, Lu Y, Wei Y, Huang L, Wu H, Liu C (2011) Porcine circovirus genotype 2a (PCV2a) and genotype 2b (PCV2b) recombinant mutants showed significantly enhanced viral replication and altered antigenicity in vitro. Virology 419:57–63. doi:10.1016/j.virol.2011.08.004 CrossRefPubMed Guo L, Lu Y, Wei Y, Huang L, Wu H, Liu C (2011) Porcine circovirus genotype 2a (PCV2a) and genotype 2b (PCV2b) recombinant mutants showed significantly enhanced viral replication and altered antigenicity in vitro. Virology 419:57–63. doi:10.​1016/​j.​virol.​2011.​08.​004 CrossRefPubMed
42.
Zurück zum Zitat Fraile L, Grau-Roma L, Sarasola P, Sinovas N, Nofrarías M, López-Jimenez R, López-Soria S, Sibila M, Segalés J (2012) Inactivated PCV2 one shot vaccine applied in 3-week-old piglets: improvement of production parameters and interaction with maternally derived immunity. Vaccine 30:1986–1992. doi:10.1016/j.vaccine.2012.01.008 CrossRefPubMed Fraile L, Grau-Roma L, Sarasola P, Sinovas N, Nofrarías M, López-Jimenez R, López-Soria S, Sibila M, Segalés J (2012) Inactivated PCV2 one shot vaccine applied in 3-week-old piglets: improvement of production parameters and interaction with maternally derived immunity. Vaccine 30:1986–1992. doi:10.​1016/​j.​vaccine.​2012.​01.​008 CrossRefPubMed
43.
44.
Zurück zum Zitat Opriessnig T, Ramamoorthy S, Madson DM, Patterson AR, Pal N, Carman S, Meng XJ, Halbur PG (2008) Differences in virulence among porcine circovirus type 2 isolates are unrelated to cluster type 2a or 2b and prior infection provides heterologous protection. J Gen Virol 89:2482–2491. doi:10.1099/vir.0.2008/001081-0 CrossRefPubMed Opriessnig T, Ramamoorthy S, Madson DM, Patterson AR, Pal N, Carman S, Meng XJ, Halbur PG (2008) Differences in virulence among porcine circovirus type 2 isolates are unrelated to cluster type 2a or 2b and prior infection provides heterologous protection. J Gen Virol 89:2482–2491. doi:10.​1099/​vir.​0.​2008/​001081-0 CrossRefPubMed
45.
Zurück zum Zitat Opriessnig T, Gerber PF, Xiao CT, Halbur PG, Matzinger SR, Meng XJ (2014) Commercial PCV2a-based vaccines are effective in protecting naturally PCV2b-infected finisher pigs against experimental challenge with a 2012 mutant PCV2. Vaccine 32:4342–4348. doi:10.1016/j.vaccine.2014.06.004 CrossRefPubMed Opriessnig T, Gerber PF, Xiao CT, Halbur PG, Matzinger SR, Meng XJ (2014) Commercial PCV2a-based vaccines are effective in protecting naturally PCV2b-infected finisher pigs against experimental challenge with a 2012 mutant PCV2. Vaccine 32:4342–4348. doi:10.​1016/​j.​vaccine.​2014.​06.​004 CrossRefPubMed
46.
Zurück zum Zitat Chiarelli-Neto O, Yotoko KSC, Vidigal PMP, Silva FMF, Castro LA, Fietto JLR, Silva A, Almeida MR (2009) Classification and putative origins of Brazilian porcine circovirus 2 inferred through phylogenetic and phylogeographical approaches. Virus Res 140:57–63. doi:10.1016/j.virusres.2008.11.002 CrossRefPubMed Chiarelli-Neto O, Yotoko KSC, Vidigal PMP, Silva FMF, Castro LA, Fietto JLR, Silva A, Almeida MR (2009) Classification and putative origins of Brazilian porcine circovirus 2 inferred through phylogenetic and phylogeographical approaches. Virus Res 140:57–63. doi:10.​1016/​j.​virusres.​2008.​11.​002 CrossRefPubMed
47.
Metadaten
Titel
A porcine circovirus-2 mutant isolated in Brazil contains low-frequency substitutions in regions of immunoprotective epitopes in the capsid protein
verfasst von
Rafael Locatelli Salgado
Pedro Marcus Pereira Vidigal
Natalia F. Gonzaga
Luiz F. L. de Souza
Marcelo D. Polêto
Thiago Souza Onofre
Monique R. Eller
Carlos Eduardo Real Pereira
Juliana L. R. Fietto
Gustavo C. Bressan
Roberto M. C. Guedes
Márcia R. Almeida
Abelardo Silva Júnior
Publikationsdatum
01.11.2015
Verlag
Springer Vienna
Erschienen in
Archives of Virology / Ausgabe 11/2015
Print ISSN: 0304-8608
Elektronische ISSN: 1432-8798
DOI
https://doi.org/10.1007/s00705-015-2567-z

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