First seroepidemiological investigation of human enterovirus 71 in Iran

Javadi, Mahsa; Nejati, Ahmad; Yousefi, Maryam; Mahmoodi, Mahmood; Shoja, Zabihollah; Shahmahmoodi, Shohreh

doi:10.18502/ijm.v13i4.6975

Cited by 2 publications

(2 citation statements)

References 28 publications

(48 reference statements)

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“…Subsequently, the literature was screened independently with reference to pre-established inclusion and exclusion criteria, and valid data were extracted and verified. After excluding invalid and duplicate studies, 71 eligible studies were included in the meta-analysis [ 6 , 8 , 9 , 59 – 73 ]. These 71 studies included a total of 55,176 samples, 23,297 of which were positive for EV-A71 neutralizing antibody.…”

Section: Resultsmentioning

confidence: 99%

Seroprevalence of coxsackievirus A6 and enterovirus A71 infection in humans: a systematic review and meta-analysis

et al. 2023

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Hand, foot, and mouth disease (HFMD) is a common infectious disease in children. Enterovirus A71 (EV-A71) is one of the main pathogens, and coxsackievirus A6 (CVA6) has gradually become the dominant pathogen of HFMD in recent years. This study was conducted mainly to assess the serological prevalence of EV-A71 and CVA6 antibodies in people of different ages, sexes, and regions through a systematic review and meta-analysis. A comprehensive study was performed based on the EV-A71 and CVA6 serological literature published before May 2022. Heterogeneity analysis (Cochrane's Q test and the I 2 statistic) and random effect models were adopted. Subgroup and meta-regression analyses were used to identify potential sources of heterogeneity in the data, and all analysis was performed using STATA version 16.0. This study included 71 studies involving 55,176 people from 13 countries that met the inclusion criteria. The serological prevalence of EV-A71 antibody in different studies was 4.31-88.8%, and that of CVA6 antibody was 40.8-80.9%. Meta-analysis results showed that the serum positive rate for EV-A71 antibody was 45.9% (95% CI: 37.6-54.1%). The rate in the Chinese population was 47.8% (95% CI: 42.4-53.2%), and in the other countries, it was 38% (95% CI: 23-55%). The serum positive rate for CVA6 antibody was 58.3% (95% CI: 46.5-70.2%). The rate in the Chinese population was 49.1% (95% CI: 38.3-59.9%), and in the other countries, it was 68% (95% CI: 51-83%). Subgroup analysis was also conducted. The seroprevalence of EV-A71 and CVA6 antibodies is related to age rather than gender or region. The rates of EV-A71 and CVA6 seropositivity are considerably lower in children younger than five years of age. However, the rates gradually increase with age. The findings of this study suggest that children under five years of age may be susceptible to EV-A71 and CVA6. Thus, safety education and vaccination should be strengthened accordingly. This study provides a basis for understanding the risk factors for EV-A71 and CVA6 infection in China and for deciding how to formulate standard preventive measures to prevent the spread of the virus. Supplementary Information The online version contains supplementary material available at 10.1007/s00705-022-05642-0.

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Section: Resultsmentioning

confidence: 99%

Seroprevalence of coxsackievirus A6 and enterovirus A71 infection in humans: a systematic review and meta-analysis

et al. 2023

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“…However, the seroprevalence of EV-A71 in endemic areas indicates that the majority of infections are asymptomatic 15,16 . Importantly, even those asymptomatically infected can shed virus for several weeks in feces 17 .…”

Section: Introductionmentioning

confidence: 99%

Mechanical force sensing drives extrusion of Enterovirus A71-infected cells from colonic epithelial organoids

Moshiri

Craven

Mixon

et al. 2022

Preprint

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Enterovirus A71 (EV-A71) causes severe disease upon systemic infection, sometimes leading to life-threatening neurological dysfunction. In most cases, infection is limited to the gastrointestinal tract, where virus is amplified for transmission. We used three-dimensional epithelial organoids generated from crypt stem cells of healthy patient colon tissue (colonoids) to investigate viral spread. Surprisingly, many infected cells were extruded from the apical surface of colonoids, leading to their removal from the epithelium. EV-A71 infected extruding cells were not frequently apoptotic and could propagate infection to uninfected monolayers and colonoids. Cell extrusion in healthy gastrointestinal epithelium is mediated either by apoptosis or cell-crowding forces sensed via the mechanosensitive ion channel Piezo-1. Treatment of infected colonoids with mechanosensitive ion-channel inhibitor GsMTx4 significantly reduced the infected cell extrusion. Instead, increased abundance of cell-free virus in media was observed. These results suggest a novel mechanism for extrusion of live, virus-infected cells through mechanical compression forces. In the gastrointestinal tract, apically extruded cells are released into the gut lumen and excreted in feces; therefore, extruded infected cells likely contribute to virus spread.

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First seroepidemiological investigation of human enterovirus 71 in Iran

Cited by 2 publications

References 28 publications

Seroprevalence of coxsackievirus A6 and enterovirus A71 infection in humans: a systematic review and meta-analysis

Seroprevalence of coxsackievirus A6 and enterovirus A71 infection in humans: a systematic review and meta-analysis

Mechanical force sensing drives extrusion of Enterovirus A71-infected cells from colonic epithelial organoids

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