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Erschienen in: Archives of Virology 1/2012

01.01.2012 | Original Article

Prevalence and genetic characterization of avian polyomavirus and psittacine beak and feather disease virus isolated from budgerigars in Mainland China

verfasst von: Qingye Zhuang, Jiming Chen, Muhammad Hassan Mushtaq, Jie Chen, Shuo Liu, Guangyu Hou, Jinping Li, Baoxu Huang, Wenming Jiang

Erschienen in: Archives of Virology | Ausgabe 1/2012

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Abstract

Budgerigar fledgling disease (BFD) and psittacine beak and feather disease (PBFD) are caused by avian polyomavirus (APV) and psittacine beak and feather disease virus (PBFDV), respectively. These diseases frequently infect psittacine birds and result in similar clinical manifestations. In this study, we observed the prevalence of PBFDV infection and a dual infection of APV and PBFDV in a budgerigar (Melopsittacus undulatus) in Mainland China for the first time. One PBFDV isolate and two APV isolates were harvested using chicken embryos. Genetic characterization and phylogenetic analysis of the complete genome of the two APV isolates revealed nucleotide similarity ranging from 99.0% to 99.6% to other sequences in GenBank, and a 14-bp insertion was observed in the genome of one APV isolate. The results of complete genome analysis of the PBFDV isolate showed nucleotide similarity ranging from 83.0% to 95.0% with other PBFDV sequences in GenBank. Genetic characterization and phylogenetic analysis of the APV and PBFDV strains isolated in this study indicated that the isolates from China were closely related to their Japanese counterparts. The results of this study will help to identify molecular determinants and will aid further research on the prevention and control of APV and PBFD infection.
Literatur
1.
Zurück zum Zitat Pass DA, Perry RA (1984) The pathology of psittacine beak and feather disease. Vet J 61:69–74 Pass DA, Perry RA (1984) The pathology of psittacine beak and feather disease. Vet J 61:69–74
2.
Zurück zum Zitat Raidal SR, McElnea CL, Cross GM (1993) Seroprevalence of psittacine beak and feather disease virus in wild psittacine birds in New South Wales. Vet J 70:137–139 Raidal SR, McElnea CL, Cross GM (1993) Seroprevalence of psittacine beak and feather disease virus in wild psittacine birds in New South Wales. Vet J 70:137–139
3.
Zurück zum Zitat Jacobson ER, Clubb S, Simpson C, Walsh M, Lothrop CD, Gaskin J Jr, Bauer J, Hines S, Kollias GV, Poulos P (1986) Feather and beak dystrophy and necrosis in cockatoos: clinicopathologic evaluations. J Am Vet Med Assoc 189:999–1005PubMed Jacobson ER, Clubb S, Simpson C, Walsh M, Lothrop CD, Gaskin J Jr, Bauer J, Hines S, Kollias GV, Poulos P (1986) Feather and beak dystrophy and necrosis in cockatoos: clinicopathologic evaluations. J Am Vet Med Assoc 189:999–1005PubMed
4.
Zurück zum Zitat Latimer KS, Rskich PM, Kircher IM, Ritchie BW, Niagro FD, Steffens WL 3rd, Lukert PD (1990) Extracutaneous viral inclusion in psittacine beak and feather disease. J Vet Diagn Invest 2:204–207PubMedCrossRef Latimer KS, Rskich PM, Kircher IM, Ritchie BW, Niagro FD, Steffens WL 3rd, Lukert PD (1990) Extracutaneous viral inclusion in psittacine beak and feather disease. J Vet Diagn Invest 2:204–207PubMedCrossRef
5.
Zurück zum Zitat Ritchie BW, Niagro FD, Lukert PD, Steffens WL 3rd, Latimer KS (1989) Characterization of a new virus from cockatoos with psittacine beak and feather disease. Virology 171:83–88PubMedCrossRef Ritchie BW, Niagro FD, Lukert PD, Steffens WL 3rd, Latimer KS (1989) Characterization of a new virus from cockatoos with psittacine beak and feather disease. Virology 171:83–88PubMedCrossRef
6.
Zurück zum Zitat Todd D (2000) Circoviruses: immunosuppressive threats to avian species: a review. Avian Pathol 29:373–394PubMedCrossRef Todd D (2000) Circoviruses: immunosuppressive threats to avian species: a review. Avian Pathol 29:373–394PubMedCrossRef
7.
Zurück zum Zitat Bassami MR, Ypelaar I, Berryman D, Wilcox GE, Raidal SR (2001) Genetic diversity of beak and feather disease virus detected in psittacine species in Australia. Virology 279:392–400PubMedCrossRef Bassami MR, Ypelaar I, Berryman D, Wilcox GE, Raidal SR (2001) Genetic diversity of beak and feather disease virus detected in psittacine species in Australia. Virology 279:392–400PubMedCrossRef
8.
Zurück zum Zitat Niagro FD, Forsthoefel AN, Lawther RP, Kamalanathan L, Ritchie BW, Latimer KS, Lukert PD (1998) Beak and feather disease virus and porcine circovirus genomes: intermediates between the geminiviruses and plant circoviruses. Arch Virol 143:1723–1744PubMedCrossRef Niagro FD, Forsthoefel AN, Lawther RP, Kamalanathan L, Ritchie BW, Latimer KS, Lukert PD (1998) Beak and feather disease virus and porcine circovirus genomes: intermediates between the geminiviruses and plant circoviruses. Arch Virol 143:1723–1744PubMedCrossRef
9.
Zurück zum Zitat de Kloet E, de Kloet SR (2004) Analysis of the beak and feather disease viral genome indicates the existence of several genotypes which have a complex psittacine host specificity. Arch Virol 149:2393–2412PubMedCrossRef de Kloet E, de Kloet SR (2004) Analysis of the beak and feather disease viral genome indicates the existence of several genotypes which have a complex psittacine host specificity. Arch Virol 149:2393–2412PubMedCrossRef
10.
Zurück zum Zitat Martin D, Rybicki E (2000) RDP: detection of recombination amongst aligned sequences. Bioinformatics 16:562–563PubMedCrossRef Martin D, Rybicki E (2000) RDP: detection of recombination amongst aligned sequences. Bioinformatics 16:562–563PubMedCrossRef
11.
Zurück zum Zitat Lester T, Gerlach H (1986) Isolation of a virus from the feathers of a cockatoo with feather loss syndrome. Isrsel J Vet Med 42:120–123 Lester T, Gerlach H (1986) Isolation of a virus from the feathers of a cockatoo with feather loss syndrome. Isrsel J Vet Med 42:120–123
12.
Zurück zum Zitat Lowenstine LJ (1984) Cockatoo feather disease: a summary of preliminary findings. In: Proceedings of the 33rd western poultry disease conference, Davis, pp 94–96 Lowenstine LJ (1984) Cockatoo feather disease: a summary of preliminary findings. In: Proceedings of the 33rd western poultry disease conference, Davis, pp 94–96
13.
Zurück zum Zitat Raidal SR (1994) Studies on psittacine beak and feather disease. PhD thesis, University of Sydney Raidal SR (1994) Studies on psittacine beak and feather disease. PhD thesis, University of Sydney
14.
Zurück zum Zitat Pass DA, Perry RA (1985) Psittacine beak and feather disease: an update. Aust Vet Pract 15:55–59 Pass DA, Perry RA (1985) Psittacine beak and feather disease: an update. Aust Vet Pract 15:55–59
15.
Zurück zum Zitat Bernier G, Morin M, Marsolais G (1981) A generalized inclusion body disease in the budgerigar (Melopsittacus undulatus) caused by a papovarius-like agent. Avian Dis 25:1083–1092PubMedCrossRef Bernier G, Morin M, Marsolais G (1981) A generalized inclusion body disease in the budgerigar (Melopsittacus undulatus) caused by a papovarius-like agent. Avian Dis 25:1083–1092PubMedCrossRef
16.
Zurück zum Zitat Davis RB, Bozeman LH, Gaudry D, Fletcher OJ, Lukert PD, Dykstra MJ (1981) A viral disease of fledgling budgerigars. Avian Dis 25:179–183PubMedCrossRef Davis RB, Bozeman LH, Gaudry D, Fletcher OJ, Lukert PD, Dykstra MJ (1981) A viral disease of fledgling budgerigars. Avian Dis 25:179–183PubMedCrossRef
17.
Zurück zum Zitat Taylor TG (1982) French molt. In: Petrak ME (ed) Diseases of cage and aviary birds, 2nd edn. Lea and Febiger, Philadelphia, 28:361–367 Taylor TG (1982) French molt. In: Petrak ME (ed) Diseases of cage and aviary birds, 2nd edn. Lea and Febiger, Philadelphia, 28:361–367
18.
Zurück zum Zitat Bernier G, Morin M, Marsolais G (1984) Papovavirus induced feather abnormalities and skin lesions in the budgerigar: clinical and pathological findings. Can Vet J 25:307–310PubMed Bernier G, Morin M, Marsolais G (1984) Papovavirus induced feather abnormalities and skin lesions in the budgerigar: clinical and pathological findings. Can Vet J 25:307–310PubMed
19.
Zurück zum Zitat Bozeman LH, Davis RB, Gaudry D, Lukert PD, Fletcher OJ, Dykstra MJ (1981) Characterization of a papovavirus isolated from fledgling budgerigars. Avian Dis 25:972–980PubMedCrossRef Bozeman LH, Davis RB, Gaudry D, Lukert PD, Fletcher OJ, Dykstra MJ (1981) Characterization of a papovavirus isolated from fledgling budgerigars. Avian Dis 25:972–980PubMedCrossRef
20.
Zurück zum Zitat Dykstra MJ, Dykstra CC, Lukert PD, Bozeman LH (1984) Investigations of Budgerigar fledgling disease virus. Am J Vet Res 45:1883–1887PubMed Dykstra MJ, Dykstra CC, Lukert PD, Bozeman LH (1984) Investigations of Budgerigar fledgling disease virus. Am J Vet Res 45:1883–1887PubMed
21.
Zurück zum Zitat Kingston RS (1992) Budgerigar fledgling disease (papovavrius) in pet birds. J Vet Diagn Invest 4:455–458PubMedCrossRef Kingston RS (1992) Budgerigar fledgling disease (papovavrius) in pet birds. J Vet Diagn Invest 4:455–458PubMedCrossRef
22.
Zurück zum Zitat Ritchie BW, Niagro FD, Latimer KS, Davis RB, Pesti D, Lukert PD (1991) Avian polyomavirus: an overview. J Assoc Avian Vet 5:147–153CrossRef Ritchie BW, Niagro FD, Latimer KS, Davis RB, Pesti D, Lukert PD (1991) Avian polyomavirus: an overview. J Assoc Avian Vet 5:147–153CrossRef
23.
Zurück zum Zitat Lehn H, Müller H (1986) Cloning and characterization of budgerigar fledgling disease virus, an avian polyomavirus. Virology 151:362–370PubMedCrossRef Lehn H, Müller H (1986) Cloning and characterization of budgerigar fledgling disease virus, an avian polyomavirus. Virology 151:362–370PubMedCrossRef
24.
Zurück zum Zitat Fenner F, Bachmann PA, Gibbs EPJ, Murphy FA, Studdert MJ, White DO (1987) Classification and nomenclature of viruses. In veterinary virology. Academic Press, San Diego, pp 25–26 Fenner F, Bachmann PA, Gibbs EPJ, Murphy FA, Studdert MJ, White DO (1987) Classification and nomenclature of viruses. In veterinary virology. Academic Press, San Diego, pp 25–26
25.
Zurück zum Zitat Stoll R, Luo D, Kouwenhoven B, Hobom G, Müller H (1993) Molecular and biological characteristics of avian polyomaviruses: isolates from different species of birds indicate that avian polyomaviruses form a distinct subgenus within the polyomavirus genus. J Gen Virol 74:229–237PubMedCrossRef Stoll R, Luo D, Kouwenhoven B, Hobom G, Müller H (1993) Molecular and biological characteristics of avian polyomaviruses: isolates from different species of birds indicate that avian polyomaviruses form a distinct subgenus within the polyomavirus genus. J Gen Virol 74:229–237PubMedCrossRef
26.
Zurück zum Zitat Rott O, Kröger M, Müller H, Hobom G (1988) The genome of budgerigar fledgling disease virus, an avian polyomavirus. Virology 165:74–86PubMedCrossRef Rott O, Kröger M, Müller H, Hobom G (1988) The genome of budgerigar fledgling disease virus, an avian polyomavirus. Virology 165:74–86PubMedCrossRef
27.
Zurück zum Zitat Pérez-Losada M, Christensen RG, McClellan DA, Adams BJ, Viscidi RP, Demma JC, Crandall KA (2006) Comparing phylogenetic codivergence between polyomavirus and their hosts. J Virol 80:5663–5669PubMedCrossRef Pérez-Losada M, Christensen RG, McClellan DA, Adams BJ, Viscidi RP, Demma JC, Crandall KA (2006) Comparing phylogenetic codivergence between polyomavirus and their hosts. J Virol 80:5663–5669PubMedCrossRef
28.
Zurück zum Zitat Stoll R, Hobom G, Müller H (1994) Host restriction in the productive cycle of avian polyomavirus budgerigar fledgling disease virus type 3 depends on a single amino acid change in the common region of structural proteins VP2/VP3. J Gen Virol 75:2261–2269PubMedCrossRef Stoll R, Hobom G, Müller H (1994) Host restriction in the productive cycle of avian polyomavirus budgerigar fledgling disease virus type 3 depends on a single amino acid change in the common region of structural proteins VP2/VP3. J Gen Virol 75:2261–2269PubMedCrossRef
29.
Zurück zum Zitat Kou Z, Zhang Z, Chen S, Fan Z, Tang S, Zhao L, Li T (2008) Molecular characterizations of avian polyomavirus isolated from budgerigar in China. Avian Dis 52:451–454PubMedCrossRef Kou Z, Zhang Z, Chen S, Fan Z, Tang S, Zhao L, Li T (2008) Molecular characterizations of avian polyomavirus isolated from budgerigar in China. Avian Dis 52:451–454PubMedCrossRef
30.
Zurück zum Zitat Ogawa H, Yamaguchi T, Fukushi H (2005) Duplex shuttle PCR for differential diagnosis of Budgerigar fledgling disease and Psittacine beak and feather disease. Microbiol Immunol 49:227–237PubMed Ogawa H, Yamaguchi T, Fukushi H (2005) Duplex shuttle PCR for differential diagnosis of Budgerigar fledgling disease and Psittacine beak and feather disease. Microbiol Immunol 49:227–237PubMed
31.
Zurück zum Zitat Tamura K, Dudley J, Nei M, Kumar S (2007) MEGA4: molecular evolutionary genetics analysis (MEGA) software version 4.0. Mol Biol Evol 24:1596–1599PubMedCrossRef Tamura K, Dudley J, Nei M, Kumar S (2007) MEGA4: molecular evolutionary genetics analysis (MEGA) software version 4.0. Mol Biol Evol 24:1596–1599PubMedCrossRef
32.
Zurück zum Zitat Saitou N, Nei M (1987) The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol 4:406–425PubMed Saitou N, Nei M (1987) The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol 4:406–425PubMed
33.
Zurück zum Zitat Mushtaq MH, Juan H, Jiang P, Li Y, Li T, Du Y, Mukhtar MM (2008) Complete genome analysis of a highly pathogenic H5N1 influenza A virus isolated from a tiger in China. Arch Virol 153:1569–1574PubMedCrossRef Mushtaq MH, Juan H, Jiang P, Li Y, Li T, Du Y, Mukhtar MM (2008) Complete genome analysis of a highly pathogenic H5N1 influenza A virus isolated from a tiger in China. Arch Virol 153:1569–1574PubMedCrossRef
34.
Zurück zum Zitat Kimura M (1980) A simple method for estimating evolutionary rate of base substitutions through comparative studies of nucleotide sequences. J Mol Evo 16:111–120CrossRef Kimura M (1980) A simple method for estimating evolutionary rate of base substitutions through comparative studies of nucleotide sequences. J Mol Evo 16:111–120CrossRef
35.
Zurück zum Zitat Mankertz A, Persson F, Mankertz J, Blaess G, Buhk HJ (1997) Mapping and characterization of the origin of DNA replication of porcine circovirus. J Virol 71:2562–2566PubMed Mankertz A, Persson F, Mankertz J, Blaess G, Buhk HJ (1997) Mapping and characterization of the origin of DNA replication of porcine circovirus. J Virol 71:2562–2566PubMed
36.
Zurück zum Zitat Meehan BM, Creelan JL, McNulty MS, Todd D (1997) Sequence of porcine circovirus DNA: affinities with plant circoviruses. J Gen Virol 78:221–227PubMed Meehan BM, Creelan JL, McNulty MS, Todd D (1997) Sequence of porcine circovirus DNA: affinities with plant circoviruses. J Gen Virol 78:221–227PubMed
37.
Zurück zum Zitat Ritchie BW (1995) Psittacine beak and feather disease. In: Ritchie BW, Carter K (eds) Avian viruses: function and control. Wingers Publishing Inc., Lake Worth, Florida, pp 223–251 Ritchie BW (1995) Psittacine beak and feather disease. In: Ritchie BW, Carter K (eds) Avian viruses: function and control. Wingers Publishing Inc., Lake Worth, Florida, pp 223–251
38.
Zurück zum Zitat Dalhausen MS, Radabaugh MS (1997) Update on psittacine beak and feather disease and avian polyomavirus-epidemiology and diagnositics. In: Proc. MASAAV conference, pp 51–57 Dalhausen MS, Radabaugh MS (1997) Update on psittacine beak and feather disease and avian polyomavirus-epidemiology and diagnositics. In: Proc. MASAAV conference, pp 51–57
39.
Zurück zum Zitat Raue R, Johne R, Crosta L, Bürkle M, Gerlach H, Müller H (2004) Nucleotide sequence analysis of a C1 gene fragment of psittacine beak and feather disease virus amplified by real-time polymerase chain reaction indicates a possible existence of genotypes. Avian Pathol 33:41–50PubMedCrossRef Raue R, Johne R, Crosta L, Bürkle M, Gerlach H, Müller H (2004) Nucleotide sequence analysis of a C1 gene fragment of psittacine beak and feather disease virus amplified by real-time polymerase chain reaction indicates a possible existence of genotypes. Avian Pathol 33:41–50PubMedCrossRef
40.
Zurück zum Zitat Phalen DN, Wilson VG, Gaskin JM, Derr JN, Graham DL (1999) Genetic diversity in twenty variants of the avian polyomavirus. Avian Dis 43:207–218PubMedCrossRef Phalen DN, Wilson VG, Gaskin JM, Derr JN, Graham DL (1999) Genetic diversity in twenty variants of the avian polyomavirus. Avian Dis 43:207–218PubMedCrossRef
41.
Zurück zum Zitat Johne R, Müller H (1998) Avian polymavirus in wild birds: genome analysis of isolates from Falconiformes and Psittaciformes. Arch Virol 43:1501–1512CrossRef Johne R, Müller H (1998) Avian polymavirus in wild birds: genome analysis of isolates from Falconiformes and Psittaciformes. Arch Virol 43:1501–1512CrossRef
42.
Zurück zum Zitat Ogawa H, Katoh H, Sanada N, Sanada Y, Ohya K, Yamaguchi T, Fukushi H (2010) A novel genotype of beak and feather disease virus in budgerigars (Melopsittacus undulatus). Virus Genes 41:231–235PubMedCrossRef Ogawa H, Katoh H, Sanada N, Sanada Y, Ohya K, Yamaguchi T, Fukushi H (2010) A novel genotype of beak and feather disease virus in budgerigars (Melopsittacus undulatus). Virus Genes 41:231–235PubMedCrossRef
43.
Zurück zum Zitat Bassami MR, Berryman D, Wilcox GE, Raidal SR (1998) Psittacine beak and feather disease virus nucleotide sequence analysis and its relationship to porcine circovirus, plant circovirus, and chicken anaemia virus. Virology 249:453–459PubMedCrossRef Bassami MR, Berryman D, Wilcox GE, Raidal SR (1998) Psittacine beak and feather disease virus nucleotide sequence analysis and its relationship to porcine circovirus, plant circovirus, and chicken anaemia virus. Virology 249:453–459PubMedCrossRef
44.
Zurück zum Zitat Mankertz A, Mankertz J, Wolf K, Buhk HJ (1998) Identification of a protein essential for replication of porcine circovirus. J Gen Virol 79:381–384PubMed Mankertz A, Mankertz J, Wolf K, Buhk HJ (1998) Identification of a protein essential for replication of porcine circovirus. J Gen Virol 79:381–384PubMed
45.
Zurück zum Zitat Katoh H, Ohya K, Une Y, Yamaguchi T, Fukushi H (2009) Molecular characterization of avian polyomavirus isolated from psittacine birds based on the whole genome sequence analysis. Vet Microbiol 138:69–77PubMedCrossRef Katoh H, Ohya K, Une Y, Yamaguchi T, Fukushi H (2009) Molecular characterization of avian polyomavirus isolated from psittacine birds based on the whole genome sequence analysis. Vet Microbiol 138:69–77PubMedCrossRef
46.
Zurück zum Zitat Heath L, Martin DP, Warburton L, Perrin M, Horsfield W, Kingsley C, Rybicki EP, Williamson AL (2004) Evidence of unique genotypes of beak and feather disease virus in South Africa. J Virol 78:9277–9284PubMedCrossRef Heath L, Martin DP, Warburton L, Perrin M, Horsfield W, Kingsley C, Rybicki EP, Williamson AL (2004) Evidence of unique genotypes of beak and feather disease virus in South Africa. J Virol 78:9277–9284PubMedCrossRef
47.
Zurück zum Zitat Lynch J, Swinton J, Pettit J, Key D (1984) Isolation and experimental chicken-embryo-inoculation studies with budgerigar papovavirus. Avian Dis 28:1135–1139PubMedCrossRef Lynch J, Swinton J, Pettit J, Key D (1984) Isolation and experimental chicken-embryo-inoculation studies with budgerigar papovavirus. Avian Dis 28:1135–1139PubMedCrossRef
48.
Zurück zum Zitat Khalesi B (2007) Studies of beak and feather disease virus infection. PhD thesis, Moudoch University Khalesi B (2007) Studies of beak and feather disease virus infection. PhD thesis, Moudoch University
49.
Zurück zum Zitat Raidal SR, Cross GM (1994) Control by vaccination of psittacine beak and feather disease in a mixed flock of Agapornis species. Aust Vet Pract 24:178–180 Raidal SR, Cross GM (1994) Control by vaccination of psittacine beak and feather disease in a mixed flock of Agapornis species. Aust Vet Pract 24:178–180
50.
Zurück zum Zitat Bert E, Tomassone L, Peccati C, Navarrete MG, Sola SC (2005) Detection of beak and feather disease virus (BFDV) and Avian Polyomavirus(APV) DNA in psittacine birds in Italy. J Vet Med B Infect Dis Vet Public Health 52:64–68PubMedCrossRef Bert E, Tomassone L, Peccati C, Navarrete MG, Sola SC (2005) Detection of beak and feather disease virus (BFDV) and Avian Polyomavirus(APV) DNA in psittacine birds in Italy. J Vet Med B Infect Dis Vet Public Health 52:64–68PubMedCrossRef
Metadaten
Titel
Prevalence and genetic characterization of avian polyomavirus and psittacine beak and feather disease virus isolated from budgerigars in Mainland China
verfasst von
Qingye Zhuang
Jiming Chen
Muhammad Hassan Mushtaq
Jie Chen
Shuo Liu
Guangyu Hou
Jinping Li
Baoxu Huang
Wenming Jiang
Publikationsdatum
01.01.2012
Verlag
Springer Vienna
Erschienen in
Archives of Virology / Ausgabe 1/2012
Print ISSN: 0304-8608
Elektronische ISSN: 1432-8798
DOI
https://doi.org/10.1007/s00705-011-1138-1

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