In recent years, enterovirus D68 (EV-D68) has advanced from a rarely detected respiratory virus to a widespread pathogen responsible for increasing rates of severe respiratory illness and acute flaccid myelitis (AFM) in children worldwide. In this review, we discuss the accumulating data on the molecular features of EV-D68 and place these into the context of enterovirus biology in general. We highlight similarities and differences with other enteroviruses and genetic divergence from own historical prototype strains of EV-D68. These include changes in capsid antigens, host cell receptor usage, and viral RNA metabolism collectively leading to increased virulence. Furthermore, we discuss the impact of EV-D68 infection on the biology of its host cells, and how these changes are hypothesized to contribute to motor neuron toxicity in AFM. We highlight areas in need of further research, including the identification of its primary receptor and an understanding of the pathogenic cascade leading to motor neuron injury in AFM. Finally, we discuss the epidemiology of the EV-D68 and potential therapeutic approaches.
【저자키워드】 Adaptive immunity, Innate immunity, COVID-19, Coronavirus disease 2019, virus replication, enterovirus, acute flaccid myelitis, AFM, acute flaccid myelitis, CDC, US Centers for Disease Control and Prevention, eIF4, eukaryotic initiation factor 4, EMG, electromyography study, EV-A71, enterovirus A71, EV-D68, enterovirus D68, GI, gastrointestinal, hnRNP, heterogenous nuclear ribonucleoprotein, ICAM, intercellular adhesion molecule, iPS, induced pluripotent stem cell, IRES, internal ribosome entry site, IVIG, intravenous immunoglobulin, MDA, melanoma differentiation–associated protein, NCS, nerve conduction study, RIG, retinoic acid–inducible gene, TLR, Toll-like receptor, 【초록키워드】 Epidemiology, children, Genetic, Infection, Toxicity, metabolism, pathogen, respiratory virus, Research, antigens, Viral RNA, receptor, virulence, severe respiratory illness, change, Injury, strain, AFM, similarity, host cells, therapeutic approaches, host cell receptor, pathogenic, cascade, motor neuron, widespread, Enterovirus D68, highlight, responsible, include, changes in, contribute, accumulating, molecular feature, 【제목키워드】 Pathogenesis, molecular, cellular,