Enhancing and neutralizing anti-coxsackievirus activities in serum samples from patients prior to development of type 1 diabetes

Abstract Studies in prospective cohorts have suggested that enterovirus infections are associated with the appearance of islet autoantibodies that precede later appearance of type 1 diabetes (T1D). It was shown that in addition to an antibody-mediated anti-coxsackievirus (CV)-B neutralizing activity of serum from patients with T1D, there was also enhancing anti-CV-B activity in vitro. In this study the patterns of enhancing and neutralizing anti-CV activities were analyzed from consecutive serum samples collected from children who were followed from birth until they developed T1D in the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) study and compared to those in non-diabetic control children. The titers of serum neutralizing activity were analyzed against those CVs which were detected in the stools in these children (CV-B3, CV-B5 or CV-A4) using plaque assay. The enhancing activity of these serum samples was analysed by measuring interferon-alpha (INF-α) production in cultures of peripheral blood mononuclear cells (PBMC) inoculated with a mixture of these viruses and diluted serum. A sustained anti-CV enhancing activity was observed in consecutive serum samples in patients with T1D. The pattern of responses differed between children who developed T1D and control children. In patients, the anti-CV enhancing activity was predominant or even exclusive over the neutralizing activity, whereas in controls the enhancing and neutralizing activities were more balanced or the neutralizing activity was largely predominant. In conclusion, evaluating the anti-enterovirus neutralizing and enhancing activity of serum samples can be useful to investigate further the relationship between enteroviruses and the development of T1D. This article is protected by copyright. All rights reserved.Peer reviewe

Enhancing and neutralizing anti-coxsackievirus activities in serum samples from patients prior to development of type 1 diabetes

Abstract Studies in prospective cohorts have suggested that enterovirus infections are associated with the appearance of islet autoantibodies that precede later appearance of type 1 diabetes (T1D). It was shown that in addition to an antibody-mediated anti-coxsackievirus (CV)-B neutralizing activity of serum from patients with T1D, there was also enhancing anti-CV-B activity in vitro. In this study the patterns of enhancing and neutralizing anti-CV activities were analyzed from consecutive serum samples collected from children who were followed from birth until they developed T1D in the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) study and compared to those in non-diabetic control children. The titers of serum neutralizing activity were analyzed against those CVs which were detected in the stools in these children (CV-B3, CV-B5 or CV-A4) using plaque assay. The enhancing activity of these serum samples was analysed by measuring interferon-alpha (INF-α) production in cultures of peripheral blood mononuclear cells (PBMC) inoculated with a mixture of these viruses and diluted serum. A sustained anti-CV enhancing activity was observed in consecutive serum samples in patients with T1D. The pattern of responses differed between children who developed T1D and control children. In patients, the anti-CV enhancing activity was predominant or even exclusive over the neutralizing activity, whereas in controls the enhancing and neutralizing activities were more balanced or the neutralizing activity was largely predominant. In conclusion, evaluating the anti-enterovirus neutralizing and enhancing activity of serum samples can be useful to investigate further the relationship between enteroviruses and the development of T1D. This article is protected by copyright. All rights reserved.Peer reviewe

Effect of Coxsackievirus B4 Infection on the Thymus: Elucidating Its Role in the Pathogenesis of Type 1 Diabetes

peer reviewedThe thymus gland is a primary lymphoid organ for T-cell development. Various viral infections can result in disturbance of thymic functions. Medullary thymic epithelial cells (mTECs) are important for the negative selection of self-reactive T-cells to ensure central tolerance. Insulin-like growth factor 2 (IGF2) is the dominant self-peptide of the insulin family expressed in mTECs and plays a crucial role in the intra-thymic programing of central tolerance to insulin-secreting islet β-cells. Coxsackievirus B4 (CVB4) can infect and persist in the thymus of humans and mice, thus hampering the T-cell maturation and differentiation process. The modulation of IGF2 expression and protein synthesis during a CVB4 infection has been observed in vitro and in vivo in mouse models. The effect of CVB4 infections on human and mouse fetal thymus has been studied in vitro. Moreover, following the inoculation of CVB4 in pregnant mice, the thymic function in the fetus and offspring was disturbed. A defect in the intra-thymic expression of self-peptides by mTECs may be triggered by CVB4. The effects of viral infections, especially CVB4 infection, on thymic cells and functions and their possible role in the pathogenesis of type 1 diabetes (T1D) are presented

Vemurafenib Inhibits Acute and Chronic Enterovirus Infection by Affecting Cellular Kinase Phosphatidylinositol 4-Kinase Type IIIb

Enteroviruses are one of the most abundant viruses causing mild to serious acute infections in humans and also contributing to chronic diseases like type 1 diabetes. Presently, there are no approved antiviral drugs against enteroviruses. Here, we studied the potency of vemurafenib, an FDA-Approved RAF kinase inhibitor for treating BRAFV600E mutant-related melanoma, as an antiviral against enteroviruses. We showed that vemurafenib prevented enterovirus translation and replication at low micromolar dosage in an RAF/MEK/ERK-independent manner. Vemurafenib was effective against group A, B, and C enteroviruses, as well as rhinovirus, but not parechovirus or more remote viruses such as Semliki Forest virus, adenovirus, and respiratory syncytial virus. The inhibitory effect was related to a cellular phosphatidylinositol 4-kinase type IIIb (PI4KB), which has been shown to be important in the formation of enteroviral replication organelles. Vemurafenib prevented infection efficiently in acute cell models, eradicated infection in a chronic cell model, and lowered virus amounts in pancreas and heart in an acute mouse model. Altogether, instead of acting through the RAF/MEK/ERK pathway, vemurafenib affects the cellular PI4KB and, hence, enterovirus replication, opening new possibilities to evaluate further the potential of vemurafenib as a repurposed drug in clinical care. IMPORTANCE Despite the prevalence and medical threat of enteroviruses, presently, there are no antivirals against them. Here, we show that vemurafenib, an FDA-Approved RAF kinase inhibitor for treating BRAFV600E mutant-related melanoma, prevents enterovirus translation and replication. Vemurafenib shows efficacy against group A, B, and C enteroviruses, as well as rhinovirus, but not parechovirus or more remote viruses such as Semliki Forest virus, adenovirus, and respiratory syncytial virus. The inhibitory effect acts through cellular phosphatidylinositol 4-kinase type IIIb (PI4KB), which has been shown to be important in the formation of enteroviral replication organelles. Vemurafenib prevents infection efficiently in acute cell models, eradicates infection in a chronic cell model, and lowers virus amounts in pancreas and heart in an acute mouse model. Our findings open new possibilities to develop drugs against enteroviruses and give hope for repurposing vemurafenib as an antiviral drug against enteroviruses

Antiviral Properties of Chemical Inhibitors of Cellular Anti-Apoptotic Bcl-2 Proteins

Viral diseases remain serious threats to public health because of the shortage of effective means of control. To combat the surge of viral diseases, new treatments are urgently needed. Here we show that small-molecules, which inhibit cellular anti-apoptotic Bcl-2 proteins (Bcl-2i), induced the premature death of cells infected with different RNA or DNA viruses, whereas, at the same concentrations, no toxicity was observed in mock-infected cells. Moreover, these compounds limited viral replication and spread. Surprisingly, Bcl-2i also induced the premature apoptosis of cells transfected with viral RNA or plasmid DNA but not of mock-transfected cells. These results suggest that Bcl-2i sensitizes cells containing foreign RNA or DNA to apoptosis. A comparison of the toxicity, antiviral activity, and side effects of six Bcl-2i allowed us to select A-1155463 as an antiviral lead candidate. Thus, our results pave the way for the further development of Bcl-2i for the prevention and treatment of viral diseases.Peer reviewe

Antiviral properties of chemical inhibitors of cellular anti-apoptotic Bcl-2 proteins

Viral diseases remain serious threats to public health because of the shortage of effective means of control. To combat the surge of viral diseases, new treatments are urgently needed. Here we show that small-molecules, which inhibit cellular anti-apoptotic Bcl-2 proteins (Bcl-2i), induced the premature death of cells infected with different RNA or DNA viruses, whereas, at the same concentrations, no toxicity was observed in mock-infected cells. Moreover, these compounds limited viral replication and spread. Surprisingly, Bcl-2i also induced the premature apoptosis of cells transfected with viral RNA or plasmid DNA but not of mock-transfected cells. These results suggest that Bcl-2i sensitizes cells containing foreign RNA or DNA to apoptosis. A comparison of the toxicity, antiviral activity, and side effects of six Bcl-2i allowed us to select A-1155463 as an antiviral lead candidate. Thus, our results pave the way for the further development of Bcl-2i for the prevention and treatment of viral diseases.</p

Infection à Coxsackievirus B4 et prévention

Type 1 diabetes (T1D) is a chronic multifactorial disease. Enteroviral infections, especially those with group B coxsackieviruses, and in particular the B4 serotype (CVB4), mainly transmitted by the fecal-oral route, are among the environmental factors most able to be involved in the pathogenesis of the disease. Several pathophysiological mechanisms have been proposed to explain this relationship between CVB4 and T1D. Among these mechanisms, the preferential tropism of CVB4 for islets and pancreatic &#946; cells and the resulted inflammation; virus persistence in infected cells which can constitute an important factor in the process leading to endocrine cells alteration; the possible worsening of the infection by enhancing antibodies or molecular mimicry between self-antigens and viral antigens. Moreover, some studies have demonstrated that &#946;-cell depletion in mice infected with the diabetogenic strain CVB4E2 is due to lack of regeneration rather than direct destruction of these cells by the virus. Enteroviral constituents have been detected in pancreatic ductal cells of T1D patients. Type 1 diabetes is a final expression of a long process usually occurring in young children. Therefore, the hypothesis that the pancreatic tissue of young subjects is more permissive to CVB4 infection can not be excluded. Prevention of viral infections is the best way to protect people against diseases they cause. Thus, identification and characterization of broad-spectrum antiviral inhibitors are of particular interest. A lower risk of T1D is associated with breastfeeding, however, the support of the breast milk protective effect has not been clarified, and the neutralizing activity of breast milk in vitro against CVB4 has not been studied so far.Le diabète de type 1 (DT1) est une maladie chronique multifactorielle. Les infections entérovirales, en particulier à Coxsackievirus du groupe B (CVB), et notamment CVB4, transmises par voie digestive, constituent le facteur de risque le plus souvent évoqué dans la littérature. Plusieurs mécanismes physiopathologiques sont proposés pour expliquer cette relation entre CVB4 et diabète de type 1. Il s’agit, entre autres, du tropisme préférentiel de CVB4 pour les ilots et les cellules &#946; pancréatiques et l’inflammation qui s’ensuit, de la persistance du virus au niveau des cellules infectées qui pourrait constituer un facteur déterminant dans le processus d’altération des cellules endocrines, de l’exacerbation possible de l’infection par des d’anticorps facilitateurs ou encore du mimétisme moléculaire entre les auto-antigènes et les antigènes viraux. Par ailleurs des auteurs ont montré que la cause de la déplétion des cellules &#946; chez des souris infectées par la souche diabétogénique CVB4E2 est un défaut de régénération plutôt qu’une destruction directe de ces cellules par le virus. La présence de constituants entéroviraux dans les cellules ductales du pancréas de patients diabétiques a été observée. Le diabète de type 1, qui serait l’expression finale d’un long processus, survient généralement chez des sujets jeunes, c’est pourquoi l’hypothèse que le tissu pancréatique jeune serait plus permissif aux infections à CVB4 n’est pas exclue. La prévention des infections virales reste le meilleur moyen de protéger les individus contre les maladies qu’elles provoquent. Un intérêt particulier est aujourd’hui accordé à la mise en évidences et à la caractérisation d’inhibiteurs antiviraux à large spectre. L’absence d’allaitement maternel est associé à un risque plus élevé de diabète de type 1, mais la nature du ou des facteurs du lait conférant une protection est mal connue, et l’activité anti-CVB4 du lait maternel n’a pas été étudiée jusqu’à présent. Objectifs : Nous avons émis l’hypothèse que CVB4 pouvait infecter des cellules humaines précurseurs de cellules endocrines, impliquées dans la régénération des îlots. L’infection de ces cellules par CVB4E2 et ses conséquences ont été étudiées ; nous avons utilisé des cellules humaines précurseurs canalaires primitives et la lignée continue de cellules Panc-1, dont la différenciation in vitro est possible. La permissivité au CVB4 du tissu pancréatique selon l’âge a été étudiée ex vivo chez le rat et l’existence d’inhibiteurs antiviraux à large spectre est notamment explorée dans l’intestin de souris. L’activité anti-CVB4 du lait maternel susceptible de protéger, à un âge critique, le jeune enfant vis-à-vis d’un virus diabétogène a été étudiée in vitro et l’hypothèse que le lait humain pourrait prévenir le déclenchement du DT1 chez la souris NOD a également été évaluée in vivo

Coxsackievieus B4 : infection and prevention

Le diabète de type 1 (DT1) est une maladie chronique multifactorielle. Les infections entérovirales, en particulier à Coxsackievirus du groupe B (CVB), et notamment CVB4, transmises par voie digestive, constituent le facteur de risque le plus souvent évoqué dans la littérature. Plusieurs mécanismes physiopathologiques sont proposés pour expliquer cette relation entre CVB4 et diabète de type 1. Il s’agit, entre autres, du tropisme préférentiel de CVB4 pour les ilots et les cellules &#946; pancréatiques et l’inflammation qui s’ensuit, de la persistance du virus au niveau des cellules infectées qui pourrait constituer un facteur déterminant dans le processus d’altération des cellules endocrines, de l’exacerbation possible de l’infection par des d’anticorps facilitateurs ou encore du mimétisme moléculaire entre les auto-antigènes et les antigènes viraux. Par ailleurs des auteurs ont montré que la cause de la déplétion des cellules &#946; chez des souris infectées par la souche diabétogénique CVB4E2 est un défaut de régénération plutôt qu’une destruction directe de ces cellules par le virus. La présence de constituants entéroviraux dans les cellules ductales du pancréas de patients diabétiques a été observée. Le diabète de type 1, qui serait l’expression finale d’un long processus, survient généralement chez des sujets jeunes, c’est pourquoi l’hypothèse que le tissu pancréatique jeune serait plus permissif aux infections à CVB4 n’est pas exclue. La prévention des infections virales reste le meilleur moyen de protéger les individus contre les maladies qu’elles provoquent. Un intérêt particulier est aujourd’hui accordé à la mise en évidences et à la caractérisation d’inhibiteurs antiviraux à large spectre. L’absence d’allaitement maternel est associé à un risque plus élevé de diabète de type 1, mais la nature du ou des facteurs du lait conférant une protection est mal connue, et l’activité anti-CVB4 du lait maternel n’a pas été étudiée jusqu’à présent. Objectifs : Nous avons émis l’hypothèse que CVB4 pouvait infecter des cellules humaines précurseurs de cellules endocrines, impliquées dans la régénération des îlots. L’infection de ces cellules par CVB4E2 et ses conséquences ont été étudiées ; nous avons utilisé des cellules humaines précurseurs canalaires primitives et la lignée continue de cellules Panc-1, dont la différenciation in vitro est possible. La permissivité au CVB4 du tissu pancréatique selon l’âge a été étudiée ex vivo chez le rat et l’existence d’inhibiteurs antiviraux à large spectre est notamment explorée dans l’intestin de souris. L’activité anti-CVB4 du lait maternel susceptible de protéger, à un âge critique, le jeune enfant vis-à-vis d’un virus diabétogène a été étudiée in vitro et l’hypothèse que le lait humain pourrait prévenir le déclenchement du DT1 chez la souris NOD a également été évaluée in vivo.Type 1 diabetes (T1D) is a chronic multifactorial disease. Enteroviral infections, especially those with group B coxsackieviruses, and in particular the B4 serotype (CVB4), mainly transmitted by the fecal-oral route, are among the environmental factors most able to be involved in the pathogenesis of the disease. Several pathophysiological mechanisms have been proposed to explain this relationship between CVB4 and T1D. Among these mechanisms, the preferential tropism of CVB4 for islets and pancreatic &#946; cells and the resulted inflammation; virus persistence in infected cells which can constitute an important factor in the process leading to endocrine cells alteration; the possible worsening of the infection by enhancing antibodies or molecular mimicry between self-antigens and viral antigens. Moreover, some studies have demonstrated that &#946;-cell depletion in mice infected with the diabetogenic strain CVB4E2 is due to lack of regeneration rather than direct destruction of these cells by the virus. Enteroviral constituents have been detected in pancreatic ductal cells of T1D patients. Type 1 diabetes is a final expression of a long process usually occurring in young children. Therefore, the hypothesis that the pancreatic tissue of young subjects is more permissive to CVB4 infection can not be excluded. Prevention of viral infections is the best way to protect people against diseases they cause. Thus, identification and characterization of broad-spectrum antiviral inhibitors are of particular interest. A lower risk of T1D is associated with breastfeeding, however, the support of the breast milk protective effect has not been clarified, and the neutralizing activity of breast milk in vitro against CVB4 has not been studied so far

Exposure of Piglets to Enteroviruses Investigated by an Immunoassay Based on the EV-G1 VP4 Peptide

International audienceObjective: The aim of this study was to investigate the exposure of piglets to enteroviruses-G (EV-G) through the presence of antibodies in their serum. Methods: Serum samples were obtained from the vena cava of 10 piglets at 9 weeks of age and again 39 days later (day 39). They were tested using an immunoassay based on the EV-G1 VP4 peptide, since VP4 is highly conserved among the four Enterovirus capsid proteins, and by using a seroneutralization assay. Results: For each serum collected on day 39 the optical density was high compared to the value obtained in serum collected earlier (p = 0.002). However, the titers of anti-EV-G1 serum neutralizing activity were not different in paired samples (p > 0.999). The sequence alignment of the EV-G1 VP4 peptide, encompassing 50 amino acids, used in the immunoassay showed 88% homology with EV-G, suggesting that antibodies directed toward other EV-G than EV-G1 may be detected. Conclusion: An immunoassay based on EV-G1 VP4 can detect an increased level of EV-G antibodies in piglet serum samples. Further studies are needed to determine whether this immunoassay may be useful for diagnosis and/or epidemiological studies and to monitor EV-G infection in pigs to evaluate strategies aimed to prevent enterovirus infections. (C) 2016 S. Karger AG, Base