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豬繁殖與呼吸障礙綜合征病毒的免疫學(xué)研究進(jìn)展

2013-04-18 09:43伊順仁黃藝珠陳景容福州大北農(nóng)生物技術(shù)有限公司福州350014
福建畜牧獸醫(yī) 2013年3期
關(guān)鍵詞:中和糖基化滴度

伊順仁 黃藝珠 陳景容 福州大北農(nóng)生物技術(shù)有限公司 福州 350014

對于豬繁殖與呼吸障礙綜合征病毒免疫學(xué)方面的研究盡管還有許多令人期待的未知,但近年來的研究報(bào)道也有很多值得關(guān)注的內(nèi)容。文中針對豬繁殖與呼吸障礙綜合征病毒的特異性免疫應(yīng)答在保護(hù)性免疫中的作用、免疫調(diào)節(jié)及免疫逃避等內(nèi)容做一綜述,為臨床免疫的研究應(yīng)用提供借鑒。

1 PRRSV的特異性免疫應(yīng)答

1.1 體液免疫

1.1.1 PRRSV體液反應(yīng)動力學(xué)及ADE現(xiàn)象 健康豬感染PRRSV后可引發(fā)機(jī)體產(chǎn)生全身性的體液免疫應(yīng)答。體液免疫由胸腺依賴性抗原和非胸腺依賴性抗原(TI)誘發(fā)[1]。一些豬在感染 PRRSV 5~7 d就可檢測到抗體,到14 d時,所有豬的血清發(fā)生轉(zhuǎn)陽[2]。特異性IgM抗體在14 d時達(dá)到高峰,然后下降,到42 d時基本檢測不到。特異性IgG抗體在感染后21~49 d達(dá)到高峰[3]。但是,這些感染早期快速產(chǎn)生的IgM、IgG并沒有中和作用,其主要作用對象是GP5和N蛋白[4-5],結(jié)合在病毒粒子表面,可促進(jìn)病毒粒子進(jìn)入巨噬細(xì)胞。能迅速增強(qiáng)PRRSV在巨噬細(xì)胞中復(fù)制的能力,即所謂的抗體依賴性增強(qiáng)作用(Antibody-Dependent Enhancement,ADE)現(xiàn)象[4,6]。在肺泡巨噬細(xì)胞培養(yǎng)物中,加入一定效價的PRRSV抗體,可使PRRSV產(chǎn)量明顯增加,甚至?xí)岣?0~100倍。通過母源抗體獲得被動免疫的仔豬,一旦母源抗體水平下降至保護(hù)水平以下,PRRSV就會表現(xiàn)ADE現(xiàn)象,從而增加了仔豬的易感性。所以,亞中和水平的體液抗體反而能促進(jìn)PRRSV的感染。

Ne1son等(1994)研究了豬抗PRRSV美洲株的體液反應(yīng)動力學(xué),結(jié)果顯示:最早檢測到的抗體是抗N蛋白抗體,接著是抗M蛋白抗體,然后是抗GP5蛋白抗體[7]。另有研究顯示:非結(jié)構(gòu)蛋白2(Nsp2)包含一組非中和的B表位,可能是PRRSV的免疫活性蛋白[8-9]。目前大多數(shù)診斷檢測方法主要是針對N蛋白誘導(dǎo)產(chǎn)生的抗體,這些抗體出現(xiàn)在感染后第1周并持續(xù)幾個月,但抗體的滴度與保護(hù)力不相關(guān)。

1.1.2 PRRSV的中和抗體及其保護(hù)意義 中和抗體在抗PRRSV的保護(hù)性免疫反應(yīng)中起重要的作用。有人進(jìn)行了血清輸入實(shí)驗(yàn),證實(shí)單獨(dú)使用中和抗體可以完全防止PRRSV感染妊娠母豬。另外,無論是仔豬還是母豬,被動輸入的中和抗體可消除病毒血癥,對感染豬輸入中和抗體后,病毒分離和RTPCR等方法不能從這些豬的淋巴器官中檢測到病毒。同樣,中和抗體對幼豬也有保護(hù)作用,能夠100%保護(hù)易感動物抵抗PRRSV病毒血癥的最低抗體滴度是1:8[10]。但由于PRRSV感染后中和抗體的產(chǎn)生比較慢而且不規(guī)則,所以中和抗體在保護(hù)機(jī)體免受PRRSV感染中所起的作用也是有限的[11-12]。

通過被動免疫產(chǎn)生的中和抗體可以使易感動物受到暫時的保護(hù)[13]。在感染后一個月內(nèi),用常規(guī)病毒中和試驗(yàn)檢測不到中和抗體。添加新鮮的補(bǔ)體或延長病毒與血清的作用時間可以增加中和試驗(yàn)的敏感性,可在感染后9~12 d檢測到中和抗體[14]。另有研究顯示,補(bǔ)體可使中和試驗(yàn)提高一個滴度[12,15]。但是即使采用改良的病毒中和試驗(yàn),感染后42 d中和抗體滴度依然很低,僅為1:32~1:64。歐洲株和美洲株產(chǎn)生的中和抗體,都可在感染28 d后檢測到。

有報(bào)道顯示 M、GP2a、GP3、GP4 和 GP5 上都有病毒的中和表位[5,16-20]。但在誘導(dǎo)中和抗體產(chǎn)生方面GP5更加重要。用PRRSV GP5接種免疫豬后可誘導(dǎo)產(chǎn)生中等水平的中和抗體,盡管如此,當(dāng)用同種(或同源)毒株攻毒時,豬可被保護(hù),僅表現(xiàn)輕微發(fā)熱,用MARC-145細(xì)胞只能從肺和縱膈淋巴結(jié)回收到病毒,攻毒 2 周后,中和抗體滴度增加到1:128[21-22]。

無論是母豬還是仔豬,中和抗體在血清中的滴度與對豬抗PRRSV感染的免疫保護(hù)作用呈正相關(guān)。向懷孕母豬體內(nèi)輸入1:8或更高滴度的抗體,可阻止仔豬病毒血癥的出現(xiàn);輸入1:16滴度的抗體,可保護(hù)母豬免于繁殖障礙和胎盤感染;當(dāng)?shù)味冗_(dá)到1:32時,則可清除病毒感染[23]。這些結(jié)果表明,如果疫苗能夠誘導(dǎo)產(chǎn)生1:32的抗體滴度,則能有效地預(yù)防疾病,并且可在清除PRRSV中成為有力的手段。

1.2 細(xì)胞免疫 細(xì)胞免疫對于預(yù)防PRRSV感染具有十分重要的作用。Mo1itor等(1997)報(bào)道,PRRSV感染后不僅產(chǎn)生針對病毒多肽的以各種特異性抗體為特征的體液疫,而且還產(chǎn)生CD4+細(xì)胞增殖和遲發(fā)型變態(tài)反應(yīng)為特征的細(xì)胞免疫[24]。一般在外周血循環(huán)中CD4+T細(xì)胞的百分比與感染豬發(fā)病的嚴(yán)重程度有直接關(guān)系,CD4+比例愈小,感染豬越有可能發(fā)生嚴(yán)重癥狀。由此看出,豬感染疾病的臨床診斷在一定程度上建立于CD4+水平上。

PRRSV感染后第4周左右出現(xiàn)抗原特異性淋巴細(xì)胞的增生,第7周左右達(dá)到高峰,第11周左右開始下降,最多可以持續(xù)3個月[25]。此增殖性反應(yīng)可被由抗CD4+和MHC-Ⅱ類抗原產(chǎn)生的抗體所抑制,說明這種反應(yīng)是依賴CD4+和T淋巴細(xì)胞的[26]。

在自然感染PRRSV的豬體內(nèi)淋巴細(xì)胞亞群會發(fā)生變化,外周血中的CD4+/CD8+細(xì)胞的比例會顯著降低。但是PRRSV并非總是誘導(dǎo)這樣的變化,由于毒株的來源及毒力的差異,有的甚至?xí)a(chǎn)生相反的結(jié)果[27]。Bruin等(2000)通過淋巴細(xì)胞增生試驗(yàn)和病毒特異性干擾素產(chǎn)生的細(xì)胞試驗(yàn)比較了PRRSV野毒接種豬、偽狂犬病病毒 (PRV)疫苗接種豬及PRRSV疫苗接種豬的細(xì)胞免疫反應(yīng)情況,結(jié)果發(fā)現(xiàn),PRRSV野毒接種豬可產(chǎn)生長期而強(qiáng)烈的細(xì)胞免疫反應(yīng),與PRV疫苗接種豬的細(xì)胞免疫反應(yīng)相當(dāng)。而PRRSV減毒活疫苗接種豬的細(xì)胞免疫反應(yīng)與保護(hù)性極好的PRV疫苗誘導(dǎo)的細(xì)胞免疫反應(yīng)效果相差甚遠(yuǎn)[28]。

PRRSV 的 GP2a、GP3、GP4、GP5、M、N 蛋白都能刺激T淋巴細(xì)胞的增生[29]。但是,N蛋白的作用最弱,M蛋白的作用最強(qiáng)。各種蛋白的誘導(dǎo)作用和該蛋白的濃度呈正相關(guān)。這表明M蛋白在細(xì)胞免疫中居主要地位。

2 PRRSV的免疫調(diào)節(jié)與免疫逃避

2.1 干擾素 PRRSV可以引起繼發(fā)感染,通過阻斷一種抗病毒蛋白的激活或抑制豬體內(nèi)α干擾素(IFN-α)的活性是PRRSV免疫逃避的防御機(jī)制之一。A1bina等(1998)發(fā)現(xiàn)PRRSV在肺泡巨噬細(xì)胞中復(fù)制,而巨噬細(xì)胞和PBMC都不產(chǎn)生IFN-α[30]。Góm ez-Laguna等(2010)發(fā)現(xiàn)PRRSV可誘導(dǎo)產(chǎn)生少量IFN-α,但它在血清中的出現(xiàn)較晚,與病毒血癥的消退相吻合[31]。PRRSV感染可能干擾維甲酸誘導(dǎo)基因-Ⅰ(RIG-Ⅰ)、To11樣受體 3(TLR3)和 IPS-1(IFN-β啟動刺激因子1)信號轉(zhuǎn)導(dǎo)來抑制IFN-β啟動子活性及IFN-β產(chǎn)生,減少IFN-α表達(dá)量,從而減弱固有免疫應(yīng)答,繼而影響獲得性免疫應(yīng)答(包括延緩產(chǎn)生IFN-γ和中和抗體),并最終引起病毒血癥和持續(xù)性感染[32-34]。

另有體外的研究結(jié)果表明IFN-α和IFN-β在凈化PRRSV中起重要作用。重組豬IFN-α(rpIFN-α)可以抑制PRRSV在巨噬細(xì)胞中的復(fù)制并誘導(dǎo)其他抗 PRRSV 介質(zhì)因子的轉(zhuǎn)錄[30,34-35]。用含有豬IFN-β(swIFN-β)表達(dá)的細(xì)胞上清液孵育M arc-145細(xì)胞后再接種PRRSV,結(jié)果未出現(xiàn)細(xì)胞病變。而用不含swIFN-β的細(xì)胞培養(yǎng)液孵育M arc-145細(xì)胞,則在病毒感染后出現(xiàn)細(xì)胞病變。此外用swIFN-β培養(yǎng)液孵育分離于PRRSV陰性豬的支氣管肺泡灌肺泡巨噬細(xì)胞后再接種PRRSV,用Rea1time RT-PCR測定發(fā)現(xiàn)病毒RNA載量顯著減少;這些研究結(jié)果充分表明,Ⅰ型IFN在干預(yù)PRRSV感染方面有很大潛力。

2.2 細(xì)胞因子 IFN-γ是Th1類細(xì)胞因子的典型代表,并且是促進(jìn)細(xì)胞免疫應(yīng)答的效應(yīng)因子,可抑制PRRSV在巨噬細(xì)胞中的復(fù)制,其作用機(jī)制是能阻斷病毒蛋白的正常合成,還能增強(qiáng)巨噬細(xì)胞產(chǎn)生超氧負(fù)離子的能力。提示IFN-γ可以抑制PRRSV對巨噬細(xì)胞的感染。但是,低水平的IFN-γ不能消除PRRSV[36],且在病毒感染期間影響機(jī)體免疫系統(tǒng)[37],可以說,PRRSV持續(xù)性感染與機(jī)體有效細(xì)胞免疫應(yīng)答低下有關(guān)。

IL-1是致炎性細(xì)胞因子,參與免疫防御抗感染。Van Reeth等(2000)研究發(fā)現(xiàn)接種PRRSV后第3~10 d,感染豬肺臟產(chǎn)生高水平的 IL-1[38]。Góm ez-Laguna等(2010)發(fā)現(xiàn)感染PRRSV后,豬肺臟損傷程度、巨噬細(xì)胞數(shù)量與IL-1α表達(dá)量顯著相關(guān)[31]。Labarque等(2003)發(fā)現(xiàn)在感染后第9 d IL-1產(chǎn)量達(dá)到峰值,而未感染PRRSV的細(xì)胞凋亡數(shù)量急劇上升[39]。因此,IL-1可能介導(dǎo)PRRSV感染后的病理發(fā)生。

IL-2是調(diào)節(jié)細(xì)胞介導(dǎo)免疫應(yīng)答的主要細(xì)胞因子之一。Rompato等(2006)用IL-2表達(dá)質(zhì)粒作為PRRSV ORF7DNA疫苗佐劑給豬免疫,經(jīng)過二免后攻毒發(fā)現(xiàn),IL-2能明顯提高T細(xì)胞增殖[40]。Xue等(2004)用IL-2作為PRRSV ORF5和ORF7疫苗的佐劑一起免疫豬,然后用同型PRRSV攻毒,發(fā)現(xiàn)豬血清、PAM和淋巴組織中病毒載量明顯減少[41]??梢?,應(yīng)用IL-2作為PRRSV疫苗佐劑有非常不錯的前景。

IL-6與豬的細(xì)胞免疫可能有關(guān)。Liu等(2009)發(fā)現(xiàn)8周齡的豬感染PRRSV后第7 d,豬肺泡巨噬細(xì)胞產(chǎn)生大量 IL-6[42]。A1bina等(1998)報(bào)道,8 周齡的豬感染PRRSV后第3周,CD8+T細(xì)胞和IgM顯著增多[30]。CD8+T細(xì)胞能殺傷表達(dá)抗原的靶細(xì)胞,它是抗病毒感染的重要效應(yīng)細(xì)胞。IL-6誘導(dǎo)CD8+細(xì)胞大量增殖,對于清除PRRSV感染有潛在作用。

IL-8是病毒急性感染后免疫防御機(jī)制的一部分。Aasted等(2002)發(fā)現(xiàn)經(jīng)子宮感染PRRSV的小母豬在2~6周時,血液中檢測不到IL-8,且巨噬細(xì)胞減少;這可能是由于PRRSV復(fù)制導(dǎo)致巨噬細(xì)胞功能受損,使生成IL-8水平降低。因而血液循環(huán)中的IL-8水平可能反映巨噬細(xì)胞的功能狀態(tài)[43]。Ait-A1i等(2007)研究發(fā)現(xiàn)感染PRRSV 2 h后,長白豬和皮特蘭豬的肺泡巨噬細(xì)胞中IL-8水平急劇升高,隨后IL-8水平穩(wěn)步升高。進(jìn)一步研究發(fā)現(xiàn),累積高水平IL-8能使PRRSV減少或延遲復(fù)制[44]。由此可見,IL-8參與豬機(jī)體抵御PRRSV感染過程。

IL-10對PRRSV的免疫應(yīng)答調(diào)節(jié)起很重要的作用。不論是感染PRRSV歐洲株還是美洲株,豬外周血單核細(xì)胞(PBMCs)中IL-10的mRNA水平均得到了提高,且支氣管肺泡灌洗液中IL-10的濃度也增加了[45]。某些歐洲株能夠在陰性豬的PBMCs中誘導(dǎo)產(chǎn)生強(qiáng)烈的IL-10反應(yīng),表明這是一種非記憶特性的[15]。接種IL-10誘導(dǎo)型毒株的豬,其特異性IFN-γ的分泌頻率要低于接種非IL-10誘導(dǎo)型毒株的豬,這表明IL-10的產(chǎn)生可能是PRRSV感染后體液免疫受到一定抑制的原因之一[46]。給PRRSV血清陰性豬接種PRRSV之前轉(zhuǎn)染IL-10 mRNA,PBMCs內(nèi)IL-10和IL-12 mRNA顯著減少,而IFN-γmRNA升高,TNF-α和IL-4 mRNA沒有變化。這表明外源的IL-10 mRNA可以干擾PRRSV感染后IL-10 mRNA 的表達(dá)[47]。

PRRSV感染后對IL-12表達(dá)的影響,目前相關(guān)文獻(xiàn)的研究結(jié)果并不一致。有研究結(jié)果指出,PRRSV能刺激機(jī)體產(chǎn)生少量IL-12,但表達(dá)水平很弱[48-51]。

體外研究結(jié)果也發(fā)現(xiàn),不論在mRNA還是在蛋白水平,PBMCs感染PRRSV后表達(dá)的IL-12量也非常少[52]。但PRRSV感染豬的樹突狀細(xì)胞(DCs)中IL-12水平增高[53],感染PRRSV后第48 h,豬DCs中IL-12的濃度大約是紫外線滅活PRRSV處理的DCs中IL-12濃度的2.7倍,提示PRRSV對不同組織細(xì)胞內(nèi)的IL-12的影響不同。

IL-18能在免疫活性細(xì)胞中誘導(dǎo)IFN-γ、GMCSF、TNF-α和IL-1等細(xì)胞因子,其中以刺激產(chǎn)生IFN-γ的能力最為顯著,它和IL-12共同協(xié)調(diào)刺激釋放IFN-γ。近來的研究結(jié)果發(fā)現(xiàn),IL-18有潛在促進(jìn)PRRSV免疫的作用。Shen等(2007)給小豬接種rFPV-IL-18后攻擊PRRSV,接種rFPV-IL-18的小豬產(chǎn)生的中和抗體水平、IFN-γ量和T淋巴細(xì)胞免疫增殖反應(yīng)高于對照組,這表明IL-18在某種程度上能有效提高機(jī)體產(chǎn)生PRRSV特異的體液免疫和細(xì)胞免疫[54];但目前沒有內(nèi)源性IL-18參與PRRS免疫調(diào)節(jié)的研究結(jié)論。

GM-CSF可促進(jìn)DCs、中性白細(xì)胞和巨噬細(xì)胞成熟,活化成熟粒細(xì)胞和單核吞噬細(xì)胞,調(diào)節(jié)單核細(xì)胞衍生的DCs、郎格罕氏細(xì)胞和抗原遞呈細(xì)胞。Wang等(2009)構(gòu)建出融合表達(dá)PRRSV GP3及GP5與GM-CSF的重組腺病毒,給豬免疫rAd-GF35(含 GM-CSF)后所產(chǎn)生的 PRRSV GP3/GP5 的特異抗體水平明顯高于無GM-CSF組對照豬,PBMCs中PRRSV增殖指數(shù)明顯高于對照組[48]。提示GM-CSF能明顯增強(qiáng)豬體針對PRRSV的體液免疫和細(xì)胞免疫。

TNF-α是活化的巨噬細(xì)胞、DC和T細(xì)胞早期分泌產(chǎn)生的細(xì)胞因子,可協(xié)同IFN-γ抵抗病毒感染細(xì)胞,但它在PRRSV感染后處于受抑制狀態(tài)。Murtaugh等(2002)發(fā)現(xiàn)感染PRRSV后,豬肺臟中TNF-α表達(dá)受抑制或表達(dá)量明顯減少,并且抑制病毒復(fù)制的能力減弱,導(dǎo)致宿主針對PRRSV的免疫應(yīng)答減弱,使呼吸道出現(xiàn)PRRS亞臨床癥狀,還能引起機(jī)體持續(xù)感染 PRRSV[33]。Subramaniam 等(2010)研究發(fā)現(xiàn),在體外感染PRRSV后,PBMCs的TNF-α轉(zhuǎn)錄被抑制,細(xì)胞內(nèi)也未測到TNF-α蛋白[55]。TNF-α的表達(dá)與病毒復(fù)制呈明顯的負(fù)相關(guān),感染后12h病毒復(fù)制達(dá)到高峰,而TNF-α水平最低。TNF-α表達(dá)水平低可能是PRRSV逃逸宿主免疫應(yīng)答的機(jī)制之一[31],因此,促進(jìn)內(nèi)源性TNF-α的表達(dá)有助于豬體抗PRRSV感染。

TNF-β的表達(dá)水平可能與PRRSV致病力有一定相關(guān)性。有報(bào)道指出,豬接種PRRSV美洲株2周后PBMCs中TNF-β和IL-10基因表達(dá)提高[52],而豬感染PRRSV歐洲株后,PBMC中TNF-β水平無顯著變化,但是IL-10水平提高[12]。同樣,在感染PRRSV歐洲株的DCs中未能檢測到TNF-β,而感染美洲株的DCs中TNF-βmRNA表達(dá)提高[56]。由于美洲型PRRSV株的致病力一般高于歐洲型毒株,上述2個研究小組的發(fā)現(xiàn),提示TNF-β與PRRSV病理發(fā)生有一定的相關(guān)性,PRRSV的致病力對TNF-β的影響仍待進(jìn)一步深入研究。

2.3 抗原提呈 PRRSV可能會干擾正確的抗原提呈和T淋巴細(xì)胞的活化。PRRSV能下調(diào)樹突細(xì)胞(DCs)中主要組織相容性復(fù)合體MHC-Ⅰ的表達(dá),不過這與混合型白細(xì)胞反應(yīng)中增值反應(yīng)的減弱無關(guān)[35]。當(dāng)PRRSV感染激活單核細(xì)胞衍生的樹突細(xì)胞時,CD11b/c、CD14、CD80/86、MHC-Ⅰ、MHC-Ⅱ的表達(dá)均下調(diào)[57-58],用滅活的PRRSV時則沒有下調(diào)。同時,當(dāng)受感染的樹突細(xì)胞與同源的或同種異體的淋巴細(xì)胞配套使用時,增值反應(yīng)減弱,由此表明受感染的樹突細(xì)胞抗原提呈能力下降[58]。PRRSV能夠通過改變樹突狀細(xì)胞和巨噬細(xì)胞的細(xì)胞因子類型,以及通過改變參與抗原提呈的分子的表達(dá),從而減弱獲得性免疫應(yīng)答。

2.4 GP5的誘騙表位和糖基化位點(diǎn) GP5蛋白胞外結(jié)構(gòu)域氨基端高度糖基化,并與M蛋白形成異原二聚體[59-60],用反向免疫法和其他涉及重疊蛋白的研究證實(shí)GP5主要中和位點(diǎn)與中和抗體的活動相關(guān),這個位點(diǎn)的最小抗原區(qū)域在33~47位氨基酸,已被確認(rèn)是中和表位的核心區(qū)域[13,61-63],這個核心區(qū)域被稱做B位點(diǎn),此中和位點(diǎn)在糖基化位點(diǎn)的側(cè)面。GP5的另一個優(yōu)勢顯性表位A位點(diǎn),位于GP5氨基末端的胞外域(第27~31位氨基酸處),具有誘騙表位的特性,與人HIV-1中的Decoy相似[13]。Decoy位點(diǎn)是導(dǎo)致中和位點(diǎn)免疫反應(yīng)性降低的毗鄰于中和位點(diǎn)的位點(diǎn)??刮稽c(diǎn)A的抗體在PRRSV感染早期被誘導(dǎo)產(chǎn)生,而在感染后前30 d不能檢測到抗 B 位點(diǎn)的抗體[63-64]。

因此,認(rèn)為A位點(diǎn)與中和B位點(diǎn)的同時出現(xiàn)將抑制對中和位點(diǎn)B的反應(yīng)??怪泻臀稽c(diǎn)B的抗體的延遲產(chǎn)生可以解釋早期研究者所描述的無中和抗體產(chǎn)生的原因,因此,中和抗體延緩產(chǎn)生是PRRSV逃逸免疫監(jiān)視的主要機(jī)制,也是PRRSV感染的主要特征。

但是,誘騙表位不是PRRSV逃避體液免疫的唯一方式。GP5蛋白含有4個糖基化位點(diǎn),這些位點(diǎn)位于或靠近中和位點(diǎn)內(nèi)。在受感染豬中,上游高變區(qū)缺失糖基化位點(diǎn)的美洲分離株與下游N-44位缺失糖基化位點(diǎn)的毒株相比,產(chǎn)生中和抗體的能力快速而且強(qiáng)烈[65]。西班牙分離株在1991-2005年的進(jìn)化過程中呈現(xiàn)出一個趨勢,即N-46(相當(dāng)于美洲株的N-44位置)糖基化位點(diǎn)逐漸消失,而在側(cè)面(N-37和N-53)保持或獲得新的糖基化位點(diǎn),這與誘導(dǎo)較弱的中和抗體毒株是一致的[66]。

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