PDF(Pubmed)
Abstract：
Hand, foot, and mouth disease (HFMD) is one of the most common class C infectious diseases, posing a serious threat to public health worldwide. Enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16) have been regarded as the major pathogenic agents of HFMD; however, since an outbreak caused by coxsackievirus A6 (CV-A6) in France in 2008, CV-A6 has gradually become the predominant pathogen in many regions. CV-A6 infects not only children but also adults, and causes atypical clinical symptoms such as a more generalized rash, eczema herpeticum, high fever, and onychomadesis, which are different from the symptoms associated with EV-A71 and CV-A16. Importantly, the rate of genetic recombination of CV-A6 is high, which can lead to changes in virulence and the rapid evolution of other characteristics, thus posing a serious threat to public health. To date, no specific vaccines or therapeutics have been approved for CV-A6 prevention or treatment, hence it is essential to fully understand the relationship between recombination and evolution of this virus. Here, we systematically review the genetic recombination events of CV-A6 that have occurred worldwide and explore how these events have promoted virus evolution, thus providing important information regarding future HFMD surveillance and prevention.
摘要：
手,脚,和口蹄疫（HFMD）是最常见的C类传染病之一，对全球公共卫生构成严重威胁。肠道病毒A71(EV-A71)和柯萨奇病毒A16(CV-A16)被认为是手足口病的主要致病原,自2008年柯萨奇病毒A6（CV-A6）在法国爆发以来，CV-A6已逐渐成为许多地区的主要病原体。CV-A6不仅感染儿童，也感染成人，并导致非典型的临床症状，如更广泛的皮疹，疱疹湿疹，高烧,和甲癣,与EV-A71和CV-A16相关的症状不同。重要的是,CV-A6基因重组率高，这可能导致毒力的变化和其他特征的快速进化，从而对公众健康构成严重威胁。迄今为止,尚未批准用于CV-A6预防或治疗的特定疫苗或疗法，因此，充分了解这种病毒的重组和进化之间的关系是至关重要的。这里,我们系统地回顾了在全球范围内发生的CV-A6基因重组事件，并探讨了这些事件如何促进病毒进化，从而提供有关未来手足口病监测和预防的重要信息。
