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development and evaluation of a paramagnetic nanoparticle based immunochromatographic strip for specific detection of 2009 h1n1 influenza virus.influenza a/h1n1 virus spreads worldwide and has been a threat to human health and the poultry industry. although h1n1 lateral-flow immunoassay strips are available for the detection of 2009/a/h1n1 antigens, the specificity and sensitivity of these strips are limited. because of the monodispersity, the strong magnetic signal and the stable brown color of superparamagnetic nanoparticles, which were employed in this study as label instead of commonly used colloidal gold particles. two different mo ...201323755574
the frequency and seasonality of influenza and other respiratory viruses in tennessee: two influenza seasons of surveillance data, 2010-2012.in 2010, the tennessee department of health, in collaboration with the centers for disease control and prevention (cdc), expanded influenza surveillance in tennessee to include other respiratory viruses.201323962104
prevalence and correlates of influenza-a in piggery workers and pigs in two communities in lagos, nigeria.worldwide, three influenza-a virus subtypes (h1n1, h1n2 and h3n2) in swine are major public health issues. in nigeria, the existence of these subtypes in pigs has not been well studied. this study aimed at determining the prevalence and correlates of influenza-a viruses circulating in piggery workers and pigs in oke-aro and goshen communities in lagos, nigeria.201324711881
[development and validation of the real-time pcr assay for the identification of viral agents causing acute respiratory infections in humans].the real time pcr assay targeting influenza a and b virus, 5 subtypes of influenza a virus (seasonal h1n1, pandemic h1n1 (2009), seasonal h3n2, pathogenic for human subtypes of avian influenza h5 and h7), respiratory syncytial virus, and adenovirus was developed. the analytical sensitivity of the developed assay was 1 x 10(3) genome equivalents per ml. the diagnostic sensitivity of the method was 1 x l0(3)-10(4) viral particles per ml. experiments with human dna/cdna and viral cdna showed a mark ...201324645276
replication characteristics of swine influenza viruses in precision-cut lung slices reflect the virulence properties of the viruses.precision-cut lung slices of pigs were infected with five swine influenza a viruses of different subtypes (a/sw/potsdam/15/1981 h1n1, a/sw/bad griesbach/idt5604/2006 h1n1, a/sw/bakum/1832/2000 h1n2, a/sw/damme/idt5673/2006 h3n2, a/sw/herford/idt5932/2007 h3n2). the viruses were able to infect ciliated and mucus-producing cells. the infection of well-differentiated respiratory epithelial cells by swine influenza a viruses was analyzed with respect to the kinetics of virus release into the superna ...201324225030
kinetics of influenza a virus nucleoprotein antibody (igm, iga, and igg) in serum and oral fluid specimens from pigs infected under experimental conditions.indirect influenza a virus (iav) nucleoprotein (np) antibody elisas were used to compare the kinetics of the np igm, iga, and igg responses in serum and pen-based oral fluid samples collected from 82 pigs followed for 42 days post inoculation (dpi). treatment categories included vaccination (0, 1) and inoculation (0, 1) with contemporary h1n1 or h3n2 isolates. antibody ontogeny was markedly affected by vaccination status, but no significant differences were detected between h1n1 and h3n2 inocula ...201324200976
phase i/ii trial of a replication-deficient trivalent influenza virus vaccine lacking ns1.the non-structural protein ns1 of the influenza virus counteracts the interferon-mediated immune response of the host. we investigated the safety and immunogenicity of a trivalent formulation containing influenza h1n1, h3n2 and b strains lacking ns1 (delns1-trivalent).201324183981
serum antibody response to influenza virus vaccination during chemotherapy treatment in adult patients with solid tumours.higher rates of hospitalization and mortality are described in oncology patients with influenza virus infection compared to the general population. yearly influenza vaccination is recommended for patients treated with chemotherapy. the optimal moment to administer the vaccine during a treatment cycle has not been studied extensively.201324176495
the anti-influenza virus effect of phellinus igniarius extract.herbal medicine has been used in the orient for thousands of years to treat large and small ailments, including microbial infections. although there are treatments for influenza virus infection, there is no treatment for drug-resistant viruses. it is time that we explored and exploited the multi-component nature of herbal extracts as multi-drug combination therapies. here, we present data on the anti-influenza virus effect of a medicinal mushroom, phellinus igniarius. the p. igniarius water extr ...201324173646
genome sequence of a circulating human-like swine-origin influenza a virus h3n2 strain.the full-genome sequence of a/swine/henan/1/2010, a strain of influenza a virus isolated in central china, was determined. phylogenetic analyses show that its eight genomic segments are human-like, and some of its segments have appeared in swine h1n2, swine h1n1, and human h1n2 influenza viruses.201324233586
signal-processing-based bioinformatics approach for the identification of influenza a virus subtypes in neuraminidase genes.neuraminidase (na) genes of influenza a virus is a highly potential candidate for antiviral drug development that can only be realized through true identification of its sub-types. in this paper, in order to accurately detect the sub-types, a hybrid predictive model is therefore developed and tested over proteins obtained from the four subtypes of the influenza a virus, namely, h1n1, h2n2, h3n2 and h5n1 that caused major pandemics in the twentieth century. the predictive model is built by the fo ...201324110375
standard trivalent influenza virus protein vaccination does not prime antibody-dependent cellular cytotoxicity in macaques.yearly vaccination with the trivalent inactivated influenza vaccine (tiv) is recommended, since current vaccines induce little cross neutralization to divergent influenza strains. whether the tiv can induce antibody-dependent cellular cytotoxicity (adcc) responses that can cross-recognize divergent influenza virus strains is unknown. we immunized 6 influenza-naive pigtail macaques twice with the 2011-2012 season tiv and then challenged the macaques, along with 12 control macaques, serially with ...201324109221
[meta analysis on the immunogenicity of domestic influenza virus vaccines].to evaluate the immunogenicity of domestic influenza virus vaccines.201324011163
bioluminescence-based neuraminidase inhibition assay for monitoring influenza virus drug susceptibility in clinical specimens.the qflu prototype bioluminescence-based neuraminidase (na) inhibition (ni) assay kit was designed to detect na inhibitor (nai)-resistant influenza viruses at point of care. here, we evaluated its suitability for drug susceptibility assessment at a surveillance laboratory. a comprehensive panel of reference viruses (n = 14) and a set of 90 seasonal influenza virus a and b isolates were included for testing with oseltamivir and/or zanamivir in the qflu assay using the manufacturer-recommended pro ...201323917311
national surveillance for influenza and influenza-like illness in vietnam, 2006-2010.influenza virus infections result in considerable morbidity and mortality both in the temperate and tropical world. influenza surveillance over multiple years is important to determine the impact and epidemiology of influenza and to develop a national vaccine policy, especially in countries developing influenza vaccine manufacturing capacity, such as vietnam. we conducted surveillance of influenza and influenza-like illness in vietnam through the national influenza surveillance system during 200 ...201323911781
probability of detecting influenza a virus subtypes h1n1 and h3n2 in individual pig nasal swabs and pen-based oral fluid specimens over time.the probability of detecting influenza a virus (iav) by virus isolation (vi), point-of-care (poc) antigen detection, and real-time reverse-transcription polymerase chain reaction (rrt-pcr) was estimated for pen-based oral fluid (of) and individual pig nasal swab (ns) specimens. piglets (n=82) were isolated for 30 days and confirmed negative for porcine reproductive and respiratory syndrome virus, mycoplasma hyopneumoniae, and iav infections. a subset (n=28) was vaccinated on day post inoculation ...201323910522
hemagglutinin stalk-based universal vaccine constructs protect against group 2 influenza a viruses.current influenza virus vaccines contain h1n1 (phylogenetic group 1 hemagglutinin), h3n2 (phylogenetic group 2 hemagglutinin), and influenza b virus components. these vaccines induce good protection against closely matched strains by predominantly eliciting antibodies against the membrane distal globular head domain of their respective viral hemagglutinins. this domain, however, undergoes rapid antigenic drift, allowing the virus to escape neutralizing antibody responses. the membrane proximal s ...201323903831
subtyping clinical specimens of influenza a virus by use of a simple method to amplify rna targets.this work presents the clinical application of a robust and unique approach for rna amplification, called a simple method for amplifying rna targets (smart), for the detection and identification of subtypes of h1n1 pandemic, h1n1 seasonal, and h3n2 seasonal influenza virus. while all the existing amplification techniques rely on the diffusion of two molecules to complex rna structures, the smart achieves fast and efficient amplification via single-molecule diffusion. the smart utilizes amplifiab ...201323903546
caspase-1 deficient mice are more susceptible to influenza a virus infection with pa variation.reassortment within polymerase genes causes changes in the pathogenicity of influenza a viruses. we previously reported that the 2009 ph1n1 pa enhanced the pathogenicity of seasonal h1n1. we examined the effects of the pa gene from the hpai h5n1 following its introduction into currently circulating seasonal influenza viruses.201323901080
epidemiology of pandemic influenza a/h1n1 virus during 2009-2010 in taiwan.outbreak of swine-origin influenza a/h1n1 virus (pdmh1n1) occurred in 2009. taiwanese authorities implemented nationwide vaccinations with pdmh1n1-specific inactivated vaccine as of november 2009. this study evaluates prevalence, ha phylogenetic relationship, and transmission dynamic of influenza a and b viruses in taiwan in 2009-2010. respiratory tract specimens were analyzed for influenza a and b viruses. the pdmh1n1 peaked in november 2009, was predominant from august 2009 to january 2010, th ...201323886669
influenza a/hong kong/156/1997(h5n1) virus ns1 gene mutations f103l and m106i both increase ifn antagonism, virulence and cytoplasmic localization but differ in binding to rig-i and cpsf30.the genetic basis for avian to mammalian host switching in influenza a virus is largely unknown. the human a/hk/156/1997 (h5n1) virus that transmitted from poultry possesses ns1 gene mutations f103l + m106i that are virulence determinants in the mouse model of pneumonia; however their individual roles have not been determined. the emergent a/shanghai/patient1/2013(h7n9)-like viruses also possess these mutations which may contribute to their virulence and ability to switch species.201323886034
influenza virus resistance to antiviral therapy.antiviral drugs for influenza therapy and prophylaxis are either of the adamantane or neuraminidase inhibitor (nai) class. however, the nais are mainly prescribed nowadays, because of widespread adamantane resistance among influenza a viruses and ineffectiveness of adamantanes against influenza b. emergence and spread of nai resistance would further limit our therapeutic options. taking into account the previous spread of oseltamivir-resistant viruses during the 2007/2008 season preceding the la ...201323886002
baicalein, ethyl acetate, and chloroform extracts of scutellaria baicalensis inhibit the neuraminidase activity of pandemic 2009 h1n1 and seasonal influenza a viruses.this study rated antiviral activity of scutellaria baicalensis georgi (s. baicalensis) extracts against influenza a virus subtypes, for example, pandemic 2009 h1n1, seasonal h1n1 and h3n2. ethyl acetate (etoac) and chloroform extracts inhibited in vitro neuraminidase (na) enzymatic activity and viral replication more than methanol (meoh) extract. etoac extract demonstrated na inhibition ic50 values ranging from 73.16 to 487.40 μg/ml and plaque reduction ic50 values ranging from 23.7 to 27.4 μg/m ...201323864896
patients hospitalized with laboratory-confirmed influenza during the 2010-2011 influenza season: exploring disease severity by virus type and subtype.the 2010-2011 influenza season was dominated by influenza a(h3n2) virus, but influenza a(h1n1) pdm09 (ph1n1) and b viruses cocirculated. this provided an opportunity to explore within-season predictors of severity among hospitalized patients, avoiding biases associated with season-to-season differences in strain virulence, population immunity, and healthcare seeking.201323863950
simultaneous and complete genome sequencing of influenza a and b with high coverage by illumina miseq platform.active global surveillance and characterization of influenza viruses are essential for better preparation against possible pandemic events. obtaining comprehensive information about the influenza genome can improve our understanding of the evolution of influenza viruses and emergence of new strains, and improve the accuracy when designing preventive vaccines. this study investigated the use of deep sequencing by the next-generation sequencing (ngs) illumina miseq platform to obtain complete geno ...201323856301
triplet entropy analysis of hemagglutinin and neuraminidase sequences measures influenza virus phylodynamics.the influenza virus has been a challenge to science due to its ability to withstand new environmental conditions. taking into account the development of virus sequence databases, computational approaches can be helpful to understand virus behavior over time. furthermore, they can suggest new directions to deal with influenza. this work presents triplet entropy analysis as a potential phylodynamic tool to quantify nucleotide organization of viral sequences. the application of this measure to segm ...201323850726
an eight-segment swine influenza virus harboring h1 and h3 hemagglutinins is attenuated and protective against h1n1 and h3n2 subtypes in pigs.swine influenza virus (siv) infections continue to cause production losses in the agricultural industry in addition to being a human public health concern. the primary method of controlling siv is through vaccination. the killed siv vaccines currently in use must be closely matched to the challenge virus, and their protective efficacy is limited. live attenuated influenza vaccines (laiv) provide strong, long-lived cell-mediated and humoral immunity against different influenza virus subtypes with ...201323843633
characterization of porcine p58ipk gene and its up-regulation after h1n1 or h3n2 influenza virus infection.the 58-kda inhibitor of the interferon-induced double-stranded rna-activated protein kinase (p58ipk) is a cellular protein that is activated during influenza virus infection. although the function of human p58ipk has been studied for a long time, porcine p58ipk (pp58ipk) has little been studied except for its cloning.201323827789
expanded cocirculation of stable subtypes, emerging lineages, and new sporadic reassortants of porcine influenza viruses in swine populations in northwest germany.the emergence of the human 2009 pandemic h1n1 (h1n1pdm) virus from swine populations refocused public and scientific attention on swine as an important source of influenza a viruses bearing zoonotic potential. widespread and year-round circulation of at least four stable lineages of porcine influenza viruses between 2009 and 2012 in a region of germany with a high-density swine population is documented here. european avian influenza virus-derived h1n1 (h1n1av) viruses dominated the epidemiology, ...201323824819
human infections with influenza a(h3n2) variant virus in the united states, 2011-2012.background. during august 2011-april 2012, 13 human infections with influenza a(h3n2) variant (h3n2v) virus were identified in the united states; 8 occurred in the prior 2 years. this virus differs from previous variant influenza viruses in that it contains the matrix (m) gene from the influenza a(h1n1)pdm09 pandemic influenza virus. methods. a case was defined as a person with laboratory-confirmed h3n2v virus infection. cases and contacts were interviewed to determine exposure to swine and othe ...201323794729
multiple contributory factors to the age distribution of disease cases: a modeling study in the context of influenza a(h3n2v).in late 2011 and early 2012, 13 cases of human influenza resulted from infection with a novel triple reassortant swine-origin influenza virus, influenza a (h3n2) variant. this variant was notable for its inclusion of the matrix gene from the 2009 influenza a(h1n1) pandemic virus. while most of these confirmed cases were among children, the transmission potential and likely age-dependent susceptibility to the virus was unknown. preliminary serologic studies indicated that very young children have ...201323794728
estimates of the number of human infections with influenza a(h3n2) variant virus, united states, august 2011-april 2012.thirteen human infections with an influenza a(h3n2) variant (h3n2v) virus containing a combination of gene segments not previously associated with human illness were identified in the united states from august 2011 to april 2012. because laboratory confirmation of influenza virus infection is only performed for a minority of ill persons and routine clinical tests may not identify h3n2v virus, the count of laboratory-confirmed h3n2v virus infections underestimates the true burden of illness.201323794726
role of the viral hemagglutinin in the anti-influenza virus activity of newly synthesized polycyclic amine compounds.we here report on the synthesis of new series of polycyclic amines initially designed as ring-rearranged analogs of amantadine and featuring pentacyclo, hexacyclo, and octacyclo rings. a secondary amine, 3-azahexacyclo[7.6.0.0¹,⁵.0⁵,¹².0⁶,¹⁰.0¹¹,¹⁵]pentadeca-7,13-diene, 3, effectively inhibited a/m2 proton channel function, and, moreover, possessed dual activity against an a/h3n2 virus carrying a wild-type a/m2 proton channel, as well as an amantadine-resistant a/h1n1 virus. among the polycyclic ...201323800838
neuraminidase inhibitor susceptibility profile of pandemic and seasonal influenza viruses during the 2009-2010 and 2010-2011 influenza seasons in japan.two new influenza virus neuraminidase inhibitors (nais), peramivir and laninamivir, were approved in 2010 which resulted to four nais that were used during the 2010-2011 influenza season in japan. this study aims to monitor the susceptibility of influenza virus isolates in 2009-2010 and 2010-2011 influenza seasons in japan to the four nais using the fluorescence-based 50% inhibitory concentration (ic₅₀) method. outliers were identified using box-and-whisker plot analysis and full na gene sequenc ...201323791870
the use of the probiotic lactobacillus rhamnosus gg and viral findings in the nasopharynx of children attending day care.limited data are available on the effects of probiotics on the nasopharyngeal presence of respiratory viruses in children attending day care. in this substudy of a randomized, double-blinded, placebo-controlled 28-week intervention study, nasopharyngeal swab samples were collected, on visits to a physician due to symptoms of infection, from children receiving control milk (n = 97) and children receiving the same milk supplemented with probiotic lactobacillus rhamnosus gg (n = 97). the presence o ...201323794458
influenza virus utilizes n-linked sialoglycans as receptors in a549 cells.influenza viruses (ifvs) recognize sialoglycans expressed on the host cell surface. to understand the mechanisms underlying tissue and host tropisms of ifv, it is essential to elucidate the molecular interaction of the virus with the host sialoglycan receptor. we established and applied a new monoclonal antibody, clone hyb4, which specifically recognizes the neu5acα2-3 determinant at the non-reducing terminal gal residue of both glycoproteins and gangliosides to investigate the biochemical prope ...201323747419
distribution of influenza and other acute respiratory viruses during the first year after the 2009-2010 influenza pandemic in the english- and dutch-speaking caribbean countries.limited specimen collection and testing for influenza occurred in the english and dutch-speaking caribbean countries prior to the 2009/2010 influenza pandemic. caribbean epidemiology centre (carec) member countries rapidly mobilized to collect specimens during the pandemic and a vast majority of confirmed cases during the pandemic period were influenza a(h1n1)pdm09.201323745666
genetic characterization of thai swine influenza viruses after the introduction of pandemic h1n1 2009.pandemic h1n1 2009 (ph1n1), influenza virus containing triple reassortant internal genes (trig) from avian, human, and swine influenza viruses emerged in 2009 as a highly infectious virus that was able to be transmitted from humans to pigs. during june 2010-may 2012, influenza virus surveillance was conducted in thai pig population. twenty-three samples (1.75%) were successfully isolated from total of 1,335 samples. interestingly, ph1n1 (7 isolates, 30.34%), reassortant ph1n1 (rh1n1) (1 isolate, ...201323740270
active surveillance for influenza a virus among swine, midwestern united states, 2009-2011.veterinary diagnostic laboratories identify and characterize influenza a viruses primarily through passive surveillance. however, additional surveillance programs are needed. to meet this need, an active surveillance program was conducted at pig farms throughout the midwestern united states. from june 2009 through december 2011, nasal swab samples were collected monthly from among 540 groups of growing pigs and tested for influenza a virus by real-time reverse transcription pcr. of 16,170 sample ...201323735740
cross-protective effect of antisense oligonucleotide developed against the common 3' ncr of influenza a virus genome.the influenza a virus (iav) has eight segmented single-stranded rna genome containing a common and evolutionarily conserved non-coding region (ncrs) at 5' and 3' ends that are important for the virus replication. in this study, we designed an antisense oligonucleotide against the 3' ncr of vital segments of the iav genome to inhibit its replication. the results demonstrated that the co-transfection of madine darby canine kidney (mdck) cells with the antisense oligonucleotide and the plasmids enc ...201323729285
effect of double dose oseltamivir on clinical and virological outcomes in children and adults admitted to hospital with severe influenza: double blind randomised controlled trial.to investigate the validity of recommendations in treatment guidelines to use higher than approved doses of oseltamivir in patients with severe influenza.201323723457
glycosylations in the globular head of the hemagglutinin protein modulate the virulence and antigenic properties of the h1n1 influenza viruses.with the global spread of the 2009 pandemic h1n1 (ph1n1) influenza virus, there are increasing worries about evolution through antigenic drift. one way previous seasonal h1n1 and h3n2 influenza strains have evolved over time is by acquiring additional glycosylations in the globular head of their hemagglutinin (ha) proteins; these glycosylations have been believed to shield antigenically relevant regions from antibody immune responses. we added additional ha glycosylation sites to influenza a/net ...201323720581
visual detection of human infection with influenza a (h7n9) virus by subtype-specific reverse transcription loop-mediated isothermal amplification with hydroxynaphthol blue dye.a rapid and sensitive h7 and n9 subtype-specific reverse transcription loop-mediated isothermal amplification assay was developed respectively for visual detection of human-infected influenza a (h7n9) virus. the reaction was performed in one step in a single tube at 63°c for 60 min with the addition of hydroxynaphthol blue dye before amplification. the detection limits of both subtype-specific assays were comparable to those of validated h7 and n9 real-time pcr assays respectively and no cross-d ...201323718218
[a study on the ha amount of ha influenza vaccination on efficacy and safety in infants].we examined the efficacy and safety of inactivated influenza vaccine when the amount of ha influenza vaccination in children was increased to the dose recommended by the who. the purpose of this study was to obtain basic evidence to review the vaccination dose in japanese children. ha influenza vaccine produced by the research foundation for microbial diseases of osaka university (biken) licenced in japan was administered through vaccination at the international dose, and split ha influenza vacc ...201323713330
[design of deoxyribozymes for inhibition of influenza a virus].influenza a viruses take a significant place in human and animal pathology causing epidemics and epizootics. therefore, the development of new antiflu drugs has become more and more urgent. deoxyribozymes can be considered as promising antiviral agents due to their ability to efficiently and highly specifically cleave rna molecules. in this study, a number ofgenomic sequences of the most relevant influenza a virus subtypes, h5n1, h3n2, and h1n1, were analyzed. conservative regions were revealed ...201323705497
genotype patterns of contemporary reassorted h3n2 virus in us swine.to understand the evolution of swine-origin h3n2v influenza viruses that have infected 320 humans in the usa since august 2011, we performed a phylogenetic analysis at a whole genome scale of north american swine influenza viruses (n = 200). all viral isolates evolved from the prototypical north american h3 cluster 4 (c4), with evidence for further diversification into subclusters. at least ten distinct reassorted h3n2/pandemic h1n1 (rh3n2p) genotypes were identified in swine. genotype 1 (g1) wa ...201323695819
deliberate reduction of hemagglutinin and neuraminidase expression of influenza virus leads to an ultraprotective live vaccine in mice.a long-held dogma posits that strong presentation to the immune system of the dominant influenza virus glycoprotein antigens neuraminidase (na) and hemagglutinin (ha) is paramount for inducing protective immunity against influenza virus infection. we have deliberately violated this dogma by constructing a recombinant influenza virus strain of a/pr8/34 (h1n1) in which expression of na and ha genes was suppressed. we down-regulated na and ha expression by recoding the respective genes with subopti ...201323690603
swine, human or avian influenza viruses differentially activates porcine dendritic cells cytokine profile.swine influenza virus (swiv) is considered a zoonosis and the fact that swine may act as an intermediate reservoir for avian influenza virus, potentially infectious for humans, highlights its relevance and the need to understand the interaction of different influenza viruses with the porcine immune system. thus, in vitro porcine bone marrow-derived dendritic cell (pobmdcs) were infected with a circulating swiv a/swine/spain/sf32071/2007(h3n2), 2009 human pandemic influenza virus a/catalonia/63/2 ...201323689011
b cell responses to the 2011/12-influenza vaccine in the aged.antibody and b cell responses to influenza a viruses were measured over a period of 2 months in 30 aged and 15 middle-aged individuals following vaccination with the 2011/12 trivalent inactivated influenza vaccine by micro-neutralization assays, elisas, elispot assays and cell surface staining with lineage-defining antibodies followed by multicolor flow cytometry. both cohorts developed comparable antibody responses to the h3n2 virus of the vaccine while responses to the h1n1 virus were compromi ...201323674565
isolation of influenza a(h3n2)v virus from pigs and characterization of its biological properties in pigs and mice.recently, a novel reassortant virus, influenza a(h3n2)v [a(h3n2)v], was identified as the causative pathogen in 307 human cases of influenza in the united states. a(h3n2)v contains the matrix gene from the 2009 pandemic h1n1 (ph1n1) virus, while its other genes originate from h3n2 viruses with triple-reassorted internal genes. in this study, we isolated three a(h3n2)v viruses from commercial pigs in korea that showed similarities with published human a(h3n2)v viruses in eight segment sequence al ...201323674250
antigenically intact hemagglutinin in circulating avian and swine influenza viruses and potential for h3n2 pandemic.the 2009 swine-origin h1n1 influenza, though antigenically novel to the population at the time, was antigenically similar to the 1918 h1n1 pandemic influenza, and consequently was considered to be "archived" in the swine species before reemerging in humans. given that the h3n2 is another subtype that currently circulates in the human population and is high on who pandemic preparedness list, we assessed the likelihood of reemergence of h3n2 from a non-human host. using ha sequence features releva ...201323661027
epidemiological analysis of respiratory viral etiology for influenza-like illness during 2010 in zhuhai, china.influenza-like illnesses (ili), a subset of acute respiratory infections (ari), are a significant source of morbidity and mortality worldwide. ili can be caused by numerous pathogens, however; there is limited information on the etiology and epidemiology of ili in china.201323651577
the serial intervals of seasonal and pandemic influenza viruses in households in bangkok, thailand.the serial interval (si) of human influenza virus infections is often described by a single distribution. understanding sources of variation in the si could provide valuable information for understanding influenza transmission dynamics. using data from a randomized household study of nonpharmaceutical interventions to prevent influenza transmission in bangkok, thailand, over 34 months between 2008 and 2011, we estimated the influence of influenza virus type/subtype and other characteristics of 2 ...201323629874
swine influenza in sri lanka.to study influenza viruses in pigs in sri lanka, we examined samples from pigs at slaughterhouses. influenza (h3n2) and a(h1n1)pdm09 viruses were prevalent during 2004-2005 and 2009-2012, respectively. genetic and epidemiologic analyses of human and swine influenza viruses indicated 2 events of a(h1n1)pdm09 virus spillover from humans to pigs.201323621918
exploring the molecular epidemiology and evolutionary dynamics of influenza a virus in taiwan.the evolution and population dynamics of human influenza in taiwan is a microcosm of the viruses circulating worldwide, which has not yet been studied in detail. we collected 343 representative full genome sequences of human influenza a viruses isolated in taiwan between 1979 and 2009. phylogenetic and antigenic data analysis revealed that h1n1 and h3n2 viruses consistently co-circulated in taiwan, although they were characterized by different temporal dynamics and degrees of genetic diversity. ...201323613982
antibody responses to trivalent influenza vaccine in iranian adults infected with human immunodeficiency virus.the serious influenza-associated complications among immunodeficient individuals such as those who are infected with human immunodeficiency virus (hiv), highlights the importance of influenza vaccination in these people. therefore, the current study aimed to investigate the antibody responses to influenza vaccine in this group. two hundred subjects were recruited, during autumn 2010 and 2011, to receive, trivalent inactivated influenza vaccine consisting of a (h1n1), a (h3n2), and b strains. hem ...201323605597
[analysis of evolution features of whole genome of influenza virus h3n2 in qingdao between year 2007 and 2011].to investigate the evolution features of whole-genome of influenza virus h3n2 prevalent in qingdao from year 2007 to 2011.201323601520
molecular assays for quantitative and qualitative detection of influenza virus and oseltamivir resistance mutations.sensitive and reproducible molecular assays are essential for influenza virus diagnostics. this manuscript describes the design, validation, and evaluation of a set of real-time rt-pcr assays for quantification and subtyping of human influenza viruses from patient respiratory material. four assays are included for detection of oseltamivir resistance mutations h275y in prepandemic and pandemic influenza a/h1n1 and e119v and r292k in influenza a/h3n2 neuraminidase. the lower limits of detection of ...201323597879
genetic characterization of h1n2 swine influenza virus isolated in china and its pathogenesis and inflammatory responses in mice.in 2009, two h1n2 influenza viruses were isolated from trachea swabs of pigs in hubei in china. we compared these sequences with the other 18 complete genome sequences of swine h1n2 isolates from china during 2004 to 2010 and undertook extensive analysis of their evolutionary patterns. six different genotypes - two reassortants between triple reassortant (tr) h3n2 and classical swine (cs) h1n1 virus, three reassortants between tr h1n2, eurasian avian-like h1n1 swine virus and h9n2 swine virus, a ...201323591972
comparison of influenza virus replication fidelity in vitro using selection pressure with monoclonal antibodies.the replication fidelity of reassortant a/fujian/411/02(h3n2)-like influenza viruses was assessed by in vitro detection of escape mutants developing under selective pressure from monoclonal antibodies. the results showed a/wyoming/3/03(h3n2) possessed lower fidelity relative to the a/california/7/04(h3n2) and a/wisconsin/57/05(h3n2) viruses through the emergence of mutant viruses carrying h156q hemagglutinin mutation which allows antibody escape. using the neutralization assay to compare the fid ...201323588737
neuraminidase inhibitor susceptibility surveillance of influenza viruses circulating worldwide during the 2011 southern hemisphere season.neuraminidase (na) inhibitors (nais) are currently the only antivirals effective against influenza infections due to widespread resistance to m2 inhibitors.201323575174
experimental infection of european starlings (sturnus vulgaris) and house sparrows (passer domesticus) with pandemic 2009 h1n1 and swine h1n1 and h3n2 triple reassortant influenza viruses.european starlings (sturnus vulgaris) and house sparrows (passer domesticus) are common peridomestic passerine birds that are often associated with domestic animal production facilities. this association provides a potential means for pathogen transmission between facilities. we inoculated european starlings and house sparrows with three non-avian influenza virus strains: two swine isolates (h1n1 and h3n2) and one human isolate representing the h1n1 pandemic strain that originated from swine. no ...201323568924
the effect of age and recent influenza vaccination history on the immunogenicity and efficacy of 2009-10 seasonal trivalent inactivated influenza vaccination in children.there is some evidence that annual vaccination of trivalent inactivated influenza vaccine (tiv) may lead to reduced vaccine immunogenicity but evidence is lacking on whether vaccine efficacy is affected by prior vaccination history. the efficacy of one dose of tiv in children 6-8 y of age against influenza b is uncertain. we examined whether immunogenicity and efficacy of influenza vaccination in school-age children varied by age and past vaccination history.201323554974
combined administration of mf59-adjuvanted a/h5n1 prepandemic and seasonal influenza vaccines: long-term antibody persistence and robust booster responses 1 year after a one-dose priming schedule.having previously demonstrated the feasibility of administering a/h5n1 and seasonal influenza vaccine antigens in an mf59-adjuvanted tetravalent formulation, we now report on long-term antibody persistence and responses to a booster dose of a combined seasonal-pandemic, tetravalent influenza vaccine in adults. the primary objective was the evaluation of responses to a booster dose of tetravalent influenza vaccine containing seasonal (a/h1n1, a/h3n2, and b) and avian (a/h5n1, clade 2) influenza v ...201323536690
synthesis and anti-influenza virus activities of a novel class of gastrodin derivatives.a series of substituted aryl glycoside analogues of gastrodin have been identified as potential anti-influenza agents. the most potent inhibitor 1a exhibited moderate inhibitory activity against the a/hanfang/359/95(h3n2) and a/fm/1/47(h1n1) strains of the influenza a virus (ic(50) values of 44.40 and 34.45 μm, respectively) and the oseltamivir-null b/jifang/13/97 strain of influenza b (ic(50) value of 33.01 μm). in this article, multiple doses of compound 1a (80 mg/kg/day, oral administration) ...201323531598
reassortment between avian h5n1 and human influenza viruses is mainly restricted to the matrix and neuraminidase gene segments.highly pathogenic avian influenza h5n1 viruses have devastated the poultry industry in many countries of the eastern hemisphere. occasionally h5n1 viruses cross the species barrier and infect humans, sometimes with a severe clinical outcome. when this happens, there is a chance of reassortment between h5n1 and human influenza viruses. to assess the potential of h5n1 viruses to reassort with contemporary human influenza viruses (h1n1, h3n2 and pandemic h1n1), we used an in vitro selection method ...201323527283
crystallization and x-ray crystallographic analysis of the cap-binding domain of influenza a virus h1n1 polymerase subunit pb2.pb2 is one of the subunits of the influenza virus heterotrimeric polymerase. by its cap-binding domain (pb2cap), pb2 captures the 5' cap of the host pre-mrna to generate a capped 5' oligonucleotide primer for virus transcription. the crystal structure of influenza a virus h3n2 pb2cap with bound cap analogue m7gtp has been reported previously. to show the substrate-free structural details of pb2cap and clarify whether obvious conformational changes exist between the substrate-free and substrate-b ...201323519804
application of three duplex real-time pcr assays for simultaneous detection of human seasonal and avian influenza viruses.this study was performed to develop real-time pcr (qpcr) for detection of human seasonal and avian influenza viruses in duplex format. first duplex qpcr detects haemagglutinin (ha) gene of influenza virus a(h1n1)pdm09 and ha gene of influenza virus a(h3n2), the second reaction detects neuraminidase (na) gene of influenza virus a(h3n2) and na gene of influenza virus a(h1n1)pdm09 and a(h5n1), and the third reaction detects ha gene of influenza a(h5n1) and nonstructural protein gene of influenza b ...201323515874
intradermally-administered influenza virus vaccine is safe and immunogenic in healthy adults 18-64 years of age.to increase vaccine acceptance, intradermal (id) influenza vaccine (fluzone(®) intradermal, sanofi pasteur inc.) may be an attractive alternative to intramuscular (im) vaccination due to smaller needle and volume injected.201323499604
a polyvalent influenza a dna vaccine induces heterologous immunity and protects pigs against pandemic a(h1n1)pdm09 virus infection.the composition of current influenza protein vaccines has to be reconsidered every season to match the circulating influenza viruses, continuously changing antigenicity. thus, influenza vaccines inducing a broad cross-reactive immune response would be a great advantage for protection against both seasonal and emerging influenza viruses. we have developed an alternative influenza vaccine based on dna expressing selected influenza proteins of pandemic and seasonal origin. in the current study, we ...201323499598
high resolution melting analysis as a tool to detect molecular markers of antiviral resistance in influenza a viruses.a real-time pcr followed by high resolution melting analysis (hrma) was developed, for rapid detection of antiviral resistance markers in influenza a viruses, of both h1n1 and h3n2 subtypes. the targets of these assays were the nucleotide substitution g806a (s31n mutation) in the m gene as marker of resistance to adamatanes in influenza viruses a(h3n2), the substitution a356t (e119v mutation) in the n2 gene of influenza viruses a(h3n2) and the substitution c823t (h274y mutation) in the n1 gene o ...201323499313
potency under pressure: the impact of hydrostatic pressure on antigenic properties of influenza virus hemagglutinin.influenza vaccines are effective in protecting against illness and death caused by this seasonal pathogen. the potency of influenza vaccines is measured by single radial immunodiffusion (srid) assay that quantifies antigenic forms of hemagglutinin (ha). hydrostatic pressure results in loss of binding of influenza virus to red blood cells, but it is not known whether this infers loss of potency.201323496824
influenza virus-like particle containing two different subtypes of hemagglutinin confers protection in mice against lethal challenge with a/pr8 (h1n1) and a/hk (h3n2) viruses.preventing the seasonal or pandemic outbreak of influenza can be powerful and cost-effective.201323487492
evidence of cross-reactive immunity to 2009 pandemic influenza a virus in workers seropositive to swine h1n1 influenza viruses circulating in italy.pigs play a key epidemiologic role in the ecology of influenza a viruses (iavs) emerging from animal hosts and transmitted to humans. between 2008 and 2010, we investigated the health risk of occupational exposure to swine influenza viruses (sivs) in italy, during the emergence and spread of the 2009 h1n1 pandemic (h1n1pdm) virus.201323469029
structure-based discovery of the novel antiviral properties of naproxen against the nucleoprotein of influenza a virus.the nucleoprotein (np) binds the viral rna genome and associates with the polymerase in a ribonucleoprotein complex (rnp) required for transcription and replication of influenza a virus. np has no cellular counterpart, and the np sequence is highly conserved, which led to considering np a hot target in the search for antivirals. we report here that monomeric nucleoprotein can be inhibited by a small molecule binding in its rna binding groove, resulting in a novel antiviral against influenza a vi ...201323459490
impact of influenza a(h1n1)pdm09 virus on circulation dynamics of seasonal influenza strains in kenya.we describe virus variations from patients with influenza-like illness before and after the appearance of influenza a(h1n1)pdm09 in kenya during january 2008-july 2011. a total of 11,592 nasopharyngeal swabs were collected from consenting patients. seasonal influenza b, a/h1n1, a/h3n2, a/h5n1, and influenza a(h1n1)pdm09 viruses were detected by real-time reverse transcription-polymerase chain reaction. of patients enrolled, 2073 (17.9%) had influenza. a total of 1,524 (73.4%) of 2,073 samples we ...201323458953
antiviral resistance among highly pathogenic influenza a (h5n1) viruses isolated worldwide in 2002-2012 shows need for continued monitoring.highly pathogenic (hp) h5n1 influenza viruses are evolving pathogens with the potential to cause sustained human-to-human transmission and pandemic virus spread. specific antiviral drugs can play an important role in the early stages of a pandemic, but the emergence of drug-resistant variants can limit control options. the available data on the susceptibility of hp h5n1 influenza viruses to neuraminidase (na) inhibitors and adamantanes is scarce, and there is no extensive analysis. here, we syst ...201323458714
simultaneous detection of oseltamivir- and amantadine-resistant influenza by oligonucleotide microarray visualization.presently, the resistance of influenza a virus isolates causes great difficulty for the prevention and treatment of influenza a virus infection. it is important to establish a drug-resistance detection method for epidemiological study and personalized medicine in the clinical setting. consequently, a cost-effective oligonucleotide microarray visualization method, which was based on quantum dot-catalyzed silver deposition, was developed and evaluated for the simultaneous detection of neuraminidas ...201323451169
antigenic variation of h1n1, h1n2 and h3n2 swine influenza viruses in japan and vietnam.the antigenicity of the influenza a virus hemagglutinin is responsible for vaccine efficacy in protecting pigs against swine influenza virus (siv) infection. however, the antigenicity of siv strains currently circulating in japan and vietnam has not been well characterized. we examined the antigenicity of classical h1 sivs, pandemic a(h1n1)2009 (a(h1n1)pdm09) viruses, and seasonal human-lineage sivs isolated in japan and vietnam. a hemagglutination inhibition (hi) assay was used to determine ant ...201323435952
efficient synthesis of 3h,3'h-spiro[benzofuran-2,1'-isobenzofuran]-3,3'-dione as novel skeletons specifically for influenza virus type b inhibition.an efficient and novel two step synthetic procedure to prepare various substituted 3h,3'h-spiro[benzofuran-2,1'-isobenzofuran]-3,3'-diones a, was established from very simple and easily available starting materials. the developed method is a robust and general approach for the synthesis of these structures. the prepared compounds were tested against influenza virus type a viz., a/taiwan/1/86 (h1n1), a/hong kong/8/68 (h3n2) and type b viz., b/panama/45/90, b/taiwan/2/62, b/lee/40, b/brisbane/60/2 ...201323419738
cross-protective immunity against multiple influenza virus subtypes by a novel modified vaccinia ankara (mva) vectored vaccine in mice.development of an influenza vaccine that provides cross-protective immunity remains a challenge. candidate vaccines based on a recombinant modified vaccinia ankara (mva) viral vector expressing antigens from influenza (mva/flu) viruses were constructed. a vaccine candidate, designated mva/ha1/c13l/np, that expresses the hemagglutinin from pandemic h1n1 (a/california/04/09) and the nucleoprotein (np) from highly pathogenic h5n1 (a/vietnam/1203/04) fused to a secretory signal sequence from vaccini ...201323376279
validation of the modified hemagglutination inhibition assay (mhai), a robust and sensitive serological test for analysis of influenza virus-specific immune response.the hemagglutination inhibition assay (hai) is universally regarded as the gold standard in influenza virus serology. nevertheless, difficulties in titre readouts are common and interlaboratory variations are frequently reported.201323375739
guidance for clinical and public health laboratories testing for influenza virus antiviral drug susceptibility in europe.two classes of antiviral drugs are licensed in europe for treatment and prophylaxis of influenza; the m2 ion-channel blockers amantadine and rimantadine acting against type a influenza viruses only and the neuraminidase enzyme inhibitors zanamivir and oseltamivir acting against type a and type b influenza viruses. this guidance document was developed for but not limited to the european union (eu) and other european economic area (eea) countries on how and when to test for influenza virus antivir ...201323375738
infection of the upper respiratory tract with seasonal influenza a(h3n2) virus induces protective immunity in ferrets against infection with a(h1n1)pdm09 virus after intranasal, but not intratracheal, inoculation.the clinical symptoms caused by infection with influenza a virus vary widely and depend on the strain causing the infection, the dose and route of inoculation, and the presence of preexisting immunity. in most cases, seasonal influenza a viruses cause relatively mild upper respiratory tract disease, while sometimes patients develop an acute severe pneumonia. heterosubtypic immunity induced by previous infections with influenza a viruses may dampen the development of clinical symptoms caused by i ...201323365444
comparison of a multiplex real-time pcr assay with a multiplex luminex assay for influenza virus detection.we describe the development of a multiplex reverse transcription-pcr (rt-pcr) with luminex microarray hybridization for detection of influenza virus subtypes (flulum). performance of flulum was evaluated by comparing it to our real-time rt-pcr influenza virus assay on samples collected during two influenza seasons. both assays targeted the matrix genes of influenza virus a (flua m) and influenza virus b (flub m) and the hemagglutinin genes of seasonal h3n2 (h3) and h1n1 (h1) and 2009 pandemic h1 ...201323345299
host microrna molecular signatures associated with human h1n1 and h3n2 influenza a viruses reveal an unanticipated antiviral activity for mir-146a.while post-transcriptional regulation of gene expression by micrornas (mirnas) has been shown to be involved in influenza virus replication cycle, only a few studies have further investigated this aspect in a human cellular model infected with human influenza viruses. in this study, we performed mirna global profiling in human lung epithelial cells (a549) infected by two different subtypes of human influenza a viruses (h1n1 and h3n2). we identified a common mirna signature in response to infecti ...201323343627
cross-reactive influenza-specific antibody-dependent cellular cytotoxicity antibodies in the absence of neutralizing antibodies.a better understanding of immunity to influenza virus is needed to generate cross-protective vaccines. engagement of ab-dependent cellular cytotoxicity (adcc) abs by nk cells leads to killing of virus-infected cells and secretion of antiviral cytokines and chemokines. adcc abs may target more conserved influenza virus ags compared with neutralizing abs. there has been minimal interest in influenza-specific adcc in recent decades. in this study, we developed novel assays to assess the specificity ...201323319732
in vivo selection of h1n2 influenza virus reassortants in the ferret model.although the ferret model has been extensively used to study pathogenesis and transmission of influenza viruses, little has been done to determine whether ferrets are a good surrogate animal model to study influenza virus reassortment. it has been previously shown that the pandemic 2009 h1n1 (h1n1pdm) virus was able to transmit efficiently in ferrets. in coinfection studies with either seasonal h1n1 or h3n2 strains (h1n1s or h3n2s, respectively), the h1n1pdm virus was able to outcompete these st ...201323302886
surveillance of influenza viruses in the post-pandemic era (2010-2012) in northern italy.the activity and circulation of influenza viruses in lombardy - northern italy - (a region with nearly 10 out of the 60 million inhabitants of italy) were investigated during two consecutive seasons (2010-2011 and 2011-2012), as part of the italian influenza surveillance network. the molecular characteristics of the hemagglutinin (ha) sequence of circulating viruses were analyzed to investigate the emergence of influenza viral variants. in the surveyed area, the influenza activity of these two p ...201323302775
double dose vs. standard dose influenza vaccination in patients with heart failure: a pilot study.influenza infection leads to increased morbidity and mortality in those with heart failure, and individuals with heart failure exhibit reduced antibody responses to influenza vaccine. we hypothesized that patients with heart failure randomized to double dose (dd) influenza vaccine will mount more vigorous humoral immune responses compared with those given standard dose (sd) vaccine.201323291729
consequences of resistance: in vitro fitness, in vivo infectivity, and transmissibility of oseltamivir-resistant influenza a viruses.the development of drug resistance is a major drawback to any antiviral therapy, and the specific anti-influenza drugs, the neuraminidase (na) inhibitors (nais), are not excluded from this rule. the impact of drug resistance depends on the degree of reduction in fitness of the particular drug-resistant virus. if the resistance mutations lead to only a modest biological fitness cost and the virus remains highly transmissible, the effectiveness of antiviral use is likely to be reduced. this review ...201323279897
assays for monitoring susceptibility of influenza viruses to neuraminidase inhibitors.close monitoring of drug susceptibility among human influenza viruses was necessitated by widespread resistance to m2 inhibitors in influenza h1n1 (pre-pandemic and 2009 pandemic) and h3n2 viruses, and of oseltamivir resistance in pre-pandemic h1n1 viruses. the fda-approved neuraminidase (na) inhibitors (nais), oseltamivir and zanamivir, as well as investigational nais, peramivir and laninamivir, are currently the principal treatment options for managing influenza infection. however, there are c ...201323279896
influenza neuraminidase inhibitors: antiviral action and mechanisms of resistance.there are two major classes of antivirals available for the treatment and prevention of influenza, the m2 inhibitors and the neuraminidase inhibitors (nais). the m2 inhibitors are cheap, but they are only effective against influenza a viruses, and resistance arises rapidly. the current influenza a h3n2 and pandemic a(h1n1)pdm09 viruses are already resistant to the m2 inhibitors as are many h5n1 viruses. there are four nais licensed in some parts of the world, zanamivir, oseltamivir, peramivir, a ...201323279894
severity of the two post-pandemic influenza seasons 2010-11 and 2011-12 in northern greece.since the pandemic in 2009, the two following post pandemic influenza seasons have been associated with increased morbidity and mortality rates in northern greece. the scope of this short report is to provide relevant epidemiological information, an evaluation of the efficacy of the seasonal vaccine and antiviral drugs. molecular analysis revealed the close match of a(h1n1) 2009 pandemic and post-pandemic 2010-11 viruses with the vaccine virus. however, a proportion of the influenza a(h3n2) and ...201324376321
tmprss2 is essential for influenza h1n1 virus pathogenesis in mice.annual influenza epidemics and occasional pandemics pose a severe threat to human health. host cell factors required for viral spread but not for cellular survival are attractive targets for novel approaches to antiviral intervention. the cleavage activation of the influenza virus hemagglutinin (ha) by host cell proteases is essential for viral infectivity. however, it is unknown which proteases activate influenza viruses in mammals. several candidates have been identified in cell culture studie ...201324348248
different evolutionary trends of swine h1n2 influenza viruses in italy compared to european viruses.european h1n2 swine influenza viruses (eu h1n2sivs) arose from multiple reassortment events among human h1n1, human h3n2, and avian influenza viruses. we investigated the evolutionary dynamics of 53 italian h1n2 strains by comparing them with eu h1n2 sivs. hemagglutinin (ha) phylogeny revealed italian strains fell into four groups: group a and b (41 strains) had a human h1 similar to eu h1n2sivs, which probably originated in 1986. however group b (38 strains) formed a subgroup that had a two-ami ...201324289094
development and evaluation of a sybr green-based real time rt-pcr assay for detection of the emerging avian influenza a (h7n9) virus.most recently a novel avian-origin influenza a (h7n9) virus emerged in china and has been associated with lots of human infection and fatal cases. genetic analysis of the viral genome revealed that this reassortant virus might be better adapted to humans than other avian influenza viruses. molecular diagnostic methods are thus urgently needed in public health laboratories. in this study, a sybr green-based one-step real time reverse transcription-pcr (rt-pcr) was developed to detect the novel h7 ...201324278234
population dynamics of cocirculating swine influenza a viruses in the united states from 2009 to 2012.understanding the ecology and evolution of influenza a viruses (iav) in mammalian hosts is critical to reduce disease burden in production animals and lower zoonotic infection risk in humans. recent advances in influenza surveillance in us swine populations allow for timely epidemiological, phylogenetic, and virological analyses that monitor emergence of novel viruses and assess changes in viral population dynamics.201324224819
swine influenza virus vaccine serologic cross-reactivity to contemporary us swine h3n2 and efficacy in pigs infected with an h3n2 similar to 2011-2012 h3n2v.swine influenza a virus (iav) reassortment with 2009 h1n1 pandemic (h1n1pdm09) virus has been documented, and new genotypes and subclusters of h3n2 have since expanded in the us swine population. an h3n2 variant (h3n2v) virus with the h1n1pdm09 matrix gene and the remaining genes of swine triple reassortant h3n2 caused outbreaks at agricultural fairs in 2011-2012.201324224818
anti-influenza activity of alchemilla mollis extract: possible virucidal activity against influenza virus particles.influenza virus infection is a major public health problem that leads to significant morbidity and mortality. the emergence of resistance to the currently available anti-influenza agents has necessitated the development of new drugs with novel targets. studying known ethno-medicinal plants is a promising approach for the discovery of new antiviral compounds. alchemilla mollis is used in traditional medicine in europe for different indications, including minimizing the symptoms of a sore throat. ...201324270383
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