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Coxsackieviruses

Introduction

The Coxsackieviruses are RNA viruses of the Picornaviridae family, Enterovirus genus. Infections are often asymptomatic. Enteroviruses are among the most common and important human pathogens, and ordinarily, these viruses are transmitted by the oral-oral or fecal-oral route.

Coxsackieviruses are divided into group A and group B viruses. At least 23 serotypes of group A and six serotypes of group B are recognized. Coxsackievirus infections can result in a wide variety of disease syndromes. Subtypes of group A and B can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease and more severe symptoms, including meningitis (inflammation of the spinal cord and brain).

  • Coxsackievirus A usually affects skin and mucous membranes, causing herpangina and hand, foot, and mouth disease (HFMD). The most common causes of HFMD are Coxsackievirus A16 (CA16) along with the closely related enterovirus 71 (EV71).
  • Coxsackievirus B usually affects the heart, lungs, pancreas and liver, leading to Bornholm disease, hepatitis, myocarditis and pericarditis.

Virus Structure

Coxsackieviruses contain a single plus-strand of RNA protected by an icosahedral capsid exclusively constituted of proteins. The viral particle contains no enzyme and no envelope. Its size is 22-30 nm. The coding part of the coxsackieviral genome is divided into three blocks: P1, P2 and P3. The P1 genome codes for 4 capsid proteins, VP4, VP1, VP2, and VP3 that form an icosahedral capsid. VP4 is located on the internal side of the capsid. P2 is responsible for coding 2A, 2B and 2C. Protein 2A and 3C are viral proteinases which is responsible for the cleavage of the polyprotein encoded by the genome. 3D is the RNA-dependent RNA polymerase (RdRP). 2B, 2C, and 3A are core viral proteins.

Structure and genome of group B coxsackieviruses. Fig.1 Structure and genome of group B coxsackieviruses. (Liu, 2021)

Pathogenesis

Coxsackieviruses are transmitted primarily via the fecal-oral route and respiratory aerosols although transmission via fomites is possible. Initially, the viruses replicate in buccal and ileal mucosa. After the initial infection, the virus can be detected in the respiratory tract. The viruses replicate in the submucosal lymph nodes and disseminate to the reticuloendothelial system. Further dissemination to target organs occurs following a secondary viremia. Viremic spread of virions to target tissues depends on the tissue specificity (tropism) of the virus. Such secondary spread of virus to the CNS can result in aseptic meningitis or, rarely, encephalitis or paralysis. Other tissue-specific infections can result in pleurodynia or myocarditis.

Enterovirus pathogenesis. Fig.2 Enterovirus pathogenesis. (Tahmina, 2017)

Prevention and Treatment

The remarkable distribution of coxsackieviruses infections can be appreciated by the high seroprevalence in many countries around the world. There can be significant geographic and temporal variation in prevalence of individual serotypes. But there's no specific treatment or vaccine for coxsackievirus infections. These diseases tend to be self-limiting, although there are occasional case reports of adult fatalities. A vaccine for Coxsackievirus A16 has not yet been successful. The coxsackieviruses are contagious person to person. Therefore the preventive measures are aimed against transmission of the infectious agents.

What Can We offer

Recently, anti-viral antibody generation technology is undergoing rapid development. Creative Biolabs is an emerging biotherapeutics company that is fully engaged in developing the antibody. Comprehensive custom ViroAntibody production services including monoclonal and polyclonal antibody production services with industry-leading turnaround times. For instance, antibodies targeting coxsackievirus including coxsackievirus A9, A16, A24, B1, B3, B4 and B6, are available. Key requirements for successful antibody services also include ViroAntibody discovery, engineering, customized and neutralization assays services. Please feel free to contact us for further information.

References

  1. Liu, H.; Luo, H. Development of Group B Coxsackievirus as an Oncolytic Virus: Opportunities and Challenges. Viruses. 2021, 13(6): 1082.
  2. Tahmina, A. MenObamacare and the legacy of population health improvement. JOJ Pub Health. 2017, 1(4): 555566.

All products and services are intended for Research Use Only, and NOT to be used in diagnostic or therapeutic procedures.

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