Abstract
Coxsackievirus B1 (CVB1) is a leading causative agent of severe infectious diseases in humans and has been reported to be associated with outbreaks of aseptic meningitis, myocarditis, and the development of chronic diseases such as type 1 diabetes mellitus (T1DM). There is no approved vaccine or effective antiviral therapy to treat CBV1 infection. And animal models to assess the effects of antiviral agents and vaccine remain limited. In this study, we established a neonatal mouse model of CVB1 using a clinically isolated strain to characterize the pathological manifestations of virus infection and to promote the development of vaccines and antiviral drugs against CVB1. One-day-old BALB/c mice were susceptible to CVB1 infection by intraperitoneal injection. Mice challenged with CVB1 at a low dose [10 median tissue culture infective dose (TCID50)] exhibited a series of clinical symptoms, such as inactivity, emaciation, limb weakness, hair thinning, hunching and even death. Pathological examination and tissue viral load analysis showed that positive signals of CVB1 were detected in the heart, spinal cord, limb muscle and kidney without pathological damage. Particularly, CVB1 had a strong tropism towards the pancreas, causing severe cellular necrosis with inflammatory infiltration, and was spread by viraemia. Notably, the monoclonal antibody (mAb) 6H5 and antisera elicited from CVB1-vaccinated mice effectively protected the mice from CVB1 infection in the mouse model. In summary, the established neonatal mouse model is an effective tool for evaluating the efficacy of CVB1 antiviral reagents and vaccines.





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Callen J, Paes BA (2007) A case report of a premature infant with coxsackie b1 meningitis. Adv Neonatal Care 7:238–247
Cao L, Mao F, Pang Z, Yi Y, Qiu F, Tian R, Meng Q, Jia Z, Bi S (2015) Protective effect of enterovirus-71 (ev71) virus-like particle vaccine against lethal ev71 infection in a neonatal mouse model. Mol Med Rep 12:2473–2480
CDC (2008) Increased detections and severe neonatal disease associated with coxsackievirus b1 infection–united states, 2007. MMWR 57:553–556
CDC (2010) Nonpolio enterovirus and human parechovirus surveillance—united states, 2006–2008. MMWR 59:1577–1580
Chen W, Weng YW, Zhang YJ, He WX, Zhu Y, Yu TT, Xie JF, Zheng KC, Yan YS, Zhang WC (2019) Molecular epidemiology of coxsackievirus b1–5 associated with hfmd in fujian province, china, 2011–2016. Biomed Environ Sci 32:633–638
Goren A, Kaplan M, Glaser J, Isacsohn M (1989) Chronic neonatal coxsackie myocarditis. Arch Dis Child 64:404–406
Hankaniemi MM, Laitinen OH, Stone VM, Sioofy-Khojine A, Määttä JAE, Larsson PG, Marjomäki V, Hyöty H, Flodström-Tullberg M, Hytönen VP (2017) Optimized production and purification of coxsackievirus b1 vaccine and its preclinical evaluation in a mouse model. Vaccine 35:3718–3725
Hankaniemi MM, Stone VM, Sioofy-Khojine AB, Heinimäki S, Marjomäki V, Hyöty H, Blazevic V, Laitinen OH, Flodström-Tullberg M, Hytönen VP (2019b) A comparative study of the effect of uv and formalin inactivation on the stability and immunogenicity of a coxsackievirus b1 vaccine. Vaccine 37:5962–5971
Hankaniemi MM, Stone VM, Andrejeff T, Heinimäki S, Sioofy-Khojine AB, Marjomäki V, Hyöty H, Blazevic V, Flodström-Tullberg M, Hytönen VP, Laitinen OH (2019) Formalin treatment increases the stability and immunogenicity of coxsackievirus b1 vlp vaccine. Antivir Res 171:104595
Heinimäki S, Hankaniemi MM, Sioofy-Khojine AB, Laitinen OH, Hyöty H, Hytönen VP, Vesikari T, Blazevic V (2019) Combination of three virus-derived nanoparticles as a vaccine against enteric pathogens; enterovirus, norovirus and rotavirus. Vaccine 37:7509–7518
Hindersson M, Orn A, Harris RA, Frisk G (2004) Strains of coxsackie virus b4 differed in their ability to induce acute pancreatitis and the responses were negatively correlated to glucose tolerance. Arch Virol 149:1985–2000
Hober D, Alidjinou EK (2018) Diabetes: towards a coxsackievirus b-based vaccine to combat t1dm. Nat Rev Endocrinol 14:131–132
Ji H, Fan H, Lu PX, Zhang XF, Ai J, Shi C, Huo X, Bao CJ, Shan J, Jin Y (2019) Surveillance for severe hand, foot, and mouth disease from 2009 to 2015 in jiangsu province: Epidemiology, etiology, and disease burden. BMC Infect Dis 19:79
Jin Y, Zhang C, Zhang R, Ren J, Chen S, Sui M, Zhou G, Dang D, Zhu J, Feng H, Xi Y, Yang H, Duan G (2017) Pulmonary edema following central nervous system lesions induced by a non- mouse-adapted ev71 strain in neonatal balb/c mice. Virol J 14:243
Kim H, Kang B, Hwang S, Hong J, Chung J, Kim S, Jeong YS, Kim K, Cheon DS (2013) Molecular characteristics of human coxsackievirus b1 infection in korea, 2008–2009. J Med Virol 85:110–115
Larsson PG, Lakshmikanth T, Laitinen OH, Utorova R, Jacobson S, Oikarinen M, Domsgen E, Koivunen MRL, Chaux P, Devard N, Lecouturier V, Almond J, Knip M, Hyöty H, Flodström-Tullberg M (2015) A preclinical study on the efficacy and safety of a new vaccine against coxsackievirus b1 reveals no risk for accelerated diabetes development in mouse models. Diabetologia 58:346–354
Li S, Zhao H, Yang L, Hou W, Xu L, Wu Y, Wang W, Chen C, Wan J, Ye X, Liang Z, Mao Q, Cheng T, Xia N (2017) A neonatal mouse model of coxsackievirus a10 infection for anti-viral evaluation. Antivir Res 144:247–255
Lu JC, Koay KW, Ramers CB, Milazzo AS (2005) Neonate with coxsackie b1 infection, cardiomyopathy and arrhythmias. J Natl Med Assoc 97:1028–1030
Mao Q, Wang Y, Gao R, Shao J, Yao X, Lang S, Wang C, Mao P, Liang Z, Wang J (2012) A neonatal mouse model of coxsackievirus a16 for vaccine evaluation. J Virol 86:11967–11976
Oikarinen S, Tauriainen S, Hober D, Lucas B, Vazeou A, Sioofy-Khojine A, Bozas E, Muir P, Honkanen H, Ilonen J, Knip M, Keskinen P, Saha M-T, Huhtala H, Stanway G, Bartsocas C, Ludvigsson J, Taylor K, Hyöty H (2014) Virus antibody survey in different european populations indicates risk association between coxsackievirus b1 and type 1 diabetes. Diabetes 63:655–662
Op de Beeck A, Eizirik DL (2016) Viral infections in type 1 diabetes mellitus–why the β cells? Nat Rev Endocrinol 12:263–273
Reed LJ, Hugo M (1938) A simple method of estimating fifty per cent endpoints. Am J Hyg 27:493–497
Sioofy-Khojine AB, Lehtonen J, Nurminen N, Laitinen OH, Oikarinen S, Huhtala H, Pakkanen O, Ruokoranta T, Hankaniemi MM, Toppari J, Vähä-Mäkilä M, Ilonen J, Veijola R, Knip M, Hyöty H (2018) Coxsackievirus b1 infections are associated with the initiation of insulin-driven autoimmunity that progresses to type 1 diabetes. Diabetologia 61:1193–1202
Stene LC, Oikarinen S, Hyöty H, Barriga KJ, Norris JM, Klingensmith G, Hutton JC, Erlich HA, Eisenbarth GS, Rewers M (2010) Enterovirus infection and progression from islet autoimmunity to type 1 diabetes: the diabetes and autoimmunity study in the young (daisy). Diabetes 59:3174–3180
Stone VM, Hankaniemi MM, Svedin E, Sioofy-Khojine A, Oikarinen S, Hyöty H, Laitinen OH, Hytönen VP, Flodström-Tullberg M (2018) A coxsackievirus b vaccine protects against virus-induced diabetes in an experimental mouse model of type 1 diabetes. Diabetologia 61:476–481
Stone VM, Hankaniemi MM, Laitinen OH, Sioofy-Khojine AB, Lin A, Diaz Lozano IM, Mazur MA, Marjomäki V, Loré K, Hyöty H, Hytönen VP, Flodström-Tullberg M (2020) A hexavalent coxsackievirus b vaccine is highly immunogenic and has a strong protective capacity in mice and nonhuman primates. Sci Adv 6:eaaz2433
Tracy S, Höfling K, Pirruccello S, Lane PH, Reyna SM, Gauntt CJ (2000) Group b coxsackievirus myocarditis and pancreatitis: connection between viral virulence phenotypes in mice. J Med Virol 62:70–81
Wikswo ME, Khetsuriani N, Fowlkes AL, Zheng X, Peñaranda S, Verma N, Shulman ST, Sircar K, Robinson CC, Schmidt T, Schnurr D, Oberste MS (2009) Increased activity of coxsackievirus b1 strains associated with severe disease among young infants in the united states, 2007–2008. Clin Infect Dis 49:e44–e51
Yanagawa B, Spiller OB, Proctor DG, Choy J, Luo H, Zhang HM, Suarez A, Yang D, McManus BM (2004) Soluble recombinant coxsackievirus and adenovirus receptor abrogates coxsackievirus b3-mediated pancreatitis and myocarditis in mice. J Infect Dis 189:1431–1439
Zeng QX, Wang HQ, Wei W, Guo TT, Yu L, Wang YX, Li YH, Song DQ (2020) Synthesis and biological evaluation of berberine derivatives as a new class of broad-spectrum antiviral agents against coxsackievirus b. Bioorg Chem 95:103490
Zhang Z, Dong Z, Wei Q, Carr MJ, Li J, Ding S, Tong Y, Li D, Shi W (2017) A neonatal murine model of coxsackievirus a6 infection for evaluation of antiviral and vaccine efficacy. J Virol 91:e02450–e02416
Zhang C, Zhang X, Dai W, Liu Q, Xiong P, Wang S, Geng L, Gong S, Huang Z (2018) A mouse model of enterovirus d68 infection for assessment of the efficacy of inactivated vaccine. Viruses 10:58
Zhang L, Yan J, Ojcius DM, Lv H, Miao Z, Chen Y, Zhang Y, Yan J (2013) Novel and predominant pathogen responsible for the enterovirus-associated encephalitis in eastern china. PloS One 8:e85023
Zhong Z, Li X, Zhao W, Tong L, Liu J, Wu S, Lin L, Zhang Z, Tian Y, Zhang F (2008) Mutations at nucleotides 573 and 579 within 5’-untranslated region augment the virulence of coxsackievirus b1. Virus Res 135:255–259
Acknowledgements
This research was supported by grants from the National Natural Science Foundation of China (No. 82072282 and 81801646), the National Science and Technology Major Project of Infectious Diseases (No. 2017ZX10304402-002-003) and the National Science and Technology Major Projects for Major New Drugs Innovation and Development (No. 2018ZX09711003-005-003). The sponsors had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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NX, TC and YW conceived the experiments. ZY, RZ and LX wrote the manuscript. ZY and YW performed the majority of the laboratory work. YL and HY prepared of plasmids. WF, QH and DZ checked and finalized the manuscript. JW and WW prepared Coxsackievirus B1 for this study. All authors read and approved the final manuscript.
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All of the animal experiments in this study were approved by the Institutional Animal Care and Use Committee at Xiamen University and conducted in accordance with animal ethics guidelines and approved protocols.
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Supplementary Fig. 1
CVB1 Conn-5 strain infection in mice resulted in dose-dependent mortality. One-day-old BALB/c mice were inoculated i.p. with CVB1 Conn-5 strain at a dose ranging from 100 to 102 TCID50/ mouse (10-fold serially diluted). The control mice were mock-infected with an equal volume of medium via the same route. CVB1, Coxsackievirus B1; TCID50, median tissue culture infective dose; i.p., intraperitoneally. (PDF 204 KB)
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Yin, Z., Wu, Y., Zhu, R. et al. Development of A Neonatal Mouse Model for Coxsackievirus B1 Antiviral Evaluation. Virol. Sin. 36, 1575–1584 (2021). https://doi.org/10.1007/s12250-021-00444-1
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DOI: https://doi.org/10.1007/s12250-021-00444-1