Mutations in the non-structural protein region contribute to intra-genotypic evolution of enterovirus 71.
BACKGROUND
Clinical manifestations of enterovirus 71 (EV71) range from herpangina, hand-foot-and-mouth disease (HFMD), to severe neurological complications. Unlike the situation of switching genotypes seen in EV71 outbreaks during 1998-2008 in Taiwan, genotype B5 was responsible for two large outbreaks in 2008 and 2012, respectively. In China, by contrast, EV71 often persists as a single genotype in the population and causes frequent outbreaks. To investigate genetic changes in viral evolution, complete EV71 genome sequences were used to analyze the intra-genotypic evolution pattern in Taiwan, China, and the Netherlands.


RESULTS
Genotype B5 was predominant in Taiwan's 2008 outbreak and was re-emergent in 2012. EV71 strains from both outbreaks were phylogenetically segregated into two lineages containing fourteen non-synonymous substitutions predominantly in the non-structural protein coding region. In China, genotype C4 was first seen in 1998 and caused the latest large outbreak in 2008. Unlike shifting genotypes in Taiwan, genotype C4 persisted with progressive drift through time. A majority of non-synonymous mutations occurred in residues located in the non-structural coding region, showing annual increases. Interestingly, genotype B1/B2 in the Netherlands showed another stepwise evolution with dramatic EV71 activity increase in 1986. Phylogeny of the VP1 coding region in 1971-1986 exhibited similar lineage turnover with genotype C4 in China; however, phylogeny of the 3D-encoding region indicated separate lineage appearing after 1983, suggesting that the 3D-encoding region of genotype B2 was derived from an unidentified ancestor that contributed to intra-genotypic evolution in the Netherlands.


CONCLUSIONS
Unlike VP1 coding sequences long used for phylogenetic study of enteroviruses due to expected host immune escape, our study emphasizes a dominant role of non-synonymous mutations in non-structural protein regions that contribute to (re-)emergent genotypes in continuous stepwise evolution. Dozens of amino acid substitutions, especially in non-structural proteins, were identified via genetic changes driven through intra-genotypic evolution worldwide. These identified substitutions appeared to increase viral fitness in the population, affording valuable insights not only for viral evolution but also for prevention, control, and vaccine against EV71 infection.
Sheng-Wen
SW
Huang
Hui-Li
HL
Cheng
Hsin-Yi
HY
Hsieh
Chia-Lun
CL
Chang
Huey-Pin
HP
Tsai
Pin-Hwa
PH
Kuo
Shih-Min
SM
Wang
Ching-Chuan
CC
Liu
Ih-Jen
IJ
Su
Center of Infectious Disease and Signaling Research, National Cheng Kung University Hospital, Tainan, Taiwan. jrwang@mail.ncku.edu.tw.
Jen-Ren
JR
Wang
D019943:Amino Acid Substitution / Q000235:genetics; D000818:Animals; D036022:Capsid Proteins / Q000235:genetics*; D029821:Enterovirus A, Human / Q000235:genetics* / Q000472:pathogenicity; D004769:Enterovirus Infections / Q000235:genetics / Q000473:pathology; D019143:Evolution, Molecular; D005536:Foot-and-Mouth Disease / Q000235:genetics* / Q000473:pathology / Q000821:virology; D016679:Genome, Viral; D006801:Humans; D009154:Mutation; D017361:Viral Nonstructural Proteins / Q000235:genetics
D036022:Capsid Proteins; C442501:VP1 protein, Foot-and-mouth disease virus; D017361:Viral Nonstructural Proteins