Wu Jia-Mei, Wang Cheng-Si, Yu Xi-Wen
School of Basic Medicine, Baicheng Medical College, Baicheng, China.
College of Mathematical Sciences, Shanghai Jiaotong University, Shanghai, China.
Medicine (Baltimore). 2025 Apr 11;104(15):e42183. doi: 10.1097/MD.0000000000042183.
This study examines the intricate interactions between enterovirus 71 (EV71) and various programmed cell death pathways, specifically apoptosis, necroptosis, and pyroptosis, which collectively shape the pathogenesis and severity of EV71 infections. Primarily affecting children under 5 years of age, EV71 is a leading cause of hand, foot, and mouth disease and has been linked to severe neurological and systemic complications. This paper highlights how EV71 leverages distinct cell death mechanisms to enhance viral replication and amplify disease pathology. Apoptosis, for example, may restrict viral dissemination by systematically eliminating infected cells; however, EV71's activation of necroptosis and pyroptosis induces robust inflammatory responses, potentially resulting in extensive tissue damage and adverse health outcomes. Additionally, this study also summarizes recent advancements in the field, with an emphasis on experimental studies and clinical trials focused on vaccine and antiviral therapy development. Despite substantial progress, challenges persist, notably in achieving reliable vaccine efficacy and formulating safe treatment options specifically for pediatric populations. Moving forward, the review suggests that future research should delve further into understanding EV71-related complications, developing broad-spectrum antiviral agents, and investigating host genetic factors that may influence disease progression and outcomes. Ultimately, this research is essential for the development of targeted interventions capable of reducing severe symptoms without compromising the immune response, underscoring the importance of these efforts for public health and the management of infectious diseases.
本研究探讨了肠道病毒71型(EV71)与各种程序性细胞死亡途径之间的复杂相互作用,特别是凋亡、坏死性凋亡和焦亡,这些途径共同塑造了EV71感染的发病机制和严重程度。EV71主要影响5岁以下儿童,是手足口病的主要病因,并与严重的神经和全身并发症有关。本文强调了EV71如何利用不同的细胞死亡机制来增强病毒复制并扩大疾病病理。例如,凋亡可能通过系统地清除受感染细胞来限制病毒传播;然而,EV71激活坏死性凋亡和焦亡会引发强烈的炎症反应,可能导致广泛的组织损伤和不良健康后果。此外,本研究还总结了该领域的最新进展,重点是专注于疫苗和抗病毒治疗开发的实验研究和临床试验。尽管取得了重大进展,但挑战依然存在,特别是在实现可靠的疫苗效力以及制定专门针对儿科人群的安全治疗方案方面。展望未来,该综述表明,未来的研究应进一步深入了解与EV71相关的并发症,开发广谱抗病毒药物,并研究可能影响疾病进展和结果的宿主遗传因素。最终,这项研究对于开发能够减轻严重症状而不损害免疫反应的靶向干预措施至关重要,凸显了这些努力对公共卫生和传染病管理的重要性。