Enteroviruses Are a Key Target for Disease Prevention

Enteroviruses can cause illnesses ranging from the common cold and hand-foot-mouth disease to serious infections such as myocarditis, meningitis, pancreatitis, and severe systemic infections, especially in newborn infants. They are also associated with chronic conditions including type 1 diabetes and chronic heart disease. Coxsackievirus B (CVB), a common enterovirus, can cause mild flu-like symptoms but also severe conditions like myocarditis, meningitis, encephalitis, and pancreatitis. Particularly concerning are systemic CVB infections in infants, with studies reporting substantial mortality rates. CVB specifically targets pancreatic beta cells via the coxsackievirus and adenovirus receptor (CAR), which is abundant in these cells.

This interaction leads to the infection of beta-cells which induces cell destruction and autoimmune responses, potentially triggering type 1 diabetes. Indeed, enterovirus has been detected in pancreatic cells of approximately 80% of diabetes patients and in the gut of many of these patients. These viruses have also been linked to the development of celiac disease. In both type 1 diabetes and celiac disease, a chronic infection in beta cells or in the intestinal mucosa is considered as the most plausible mechanism. Given their proven safety and efficacy, the development of new enterovirus vaccines represents a promising strategy to prevent these infections and their associated acute and chronic diseases, improving global health outcomes significantly.