Table Of ContentC oxsackieviruses
A GENERAL UPDATE
INFECTIOUS AGENTS AND PATHOGENESIS
Series Editors: Mauro Bendinelli, University of Pisa
Herman Friedman, University of South Florida
COXSACKIEVIR USES
A General Update
Edited by Mauro Bendinelli and Herman Friedman
MYCOBACTERIUM TUBERCULOSIS
Interactions with the Immune System
Edited by Mauro Bendinelli and Herman Friedman
C oxsackieviruses
A GENERAL UPDATE
Edited by
MAURO BENDINELLI
University of Pisa
Pisa, Italy
and
HERMAN FRIEDMAN
University of South Florida
Tampa, Florida
Plenum Press. New York and London
Library of Congress Cataloging in Publication Data
Coxsackieviruses: a general update.
(Infectious agents and pathogenesis)
Includes bibliographies and index.
1. Coxsackievirus infections. 2. Coxsackieviruses. I. Bendinelli, Mauro. II. Friedman,
Herman, 1931- . III. Series. [DNLM: 1. Coxsackievirus Infections. 2. Coxsackie-
viruses. QW 168.5.P4 C879]
QR201. C65C69 1988 616'.0194 88-4234
ISBN 978-1-4757-0249-1 ISBN 978-1-4757-0247-7 (eBook)
DOl 10.1007/978-1-4757-0247-7
© 1988 Plenum Press, New York
Softcover reprint of the hardcover 18t edition 1988
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Contributors
FAKHRY ASSAADt • Communicable Diseases Division, World
Health Organization, Geneva, Switzerland
FULVIO BASOLO • Department of Pathology, University of Pisa,
1-56100 Pisa, Italy
KIRK W. BEISEL • Department of Pathology and Laboratory
Medicine, Emory University School of Medicine, Atlanta, Georgia
30322
J.
ELEANOR BELL • Enterovirus Reference (Scotland) Laboratory,
Regional Virus Laboratory, Ruchill Hospital, Glasgow G20 9NB,
Scotland
MAURO BENDINELLI • Institute of Epidemiology, Hygiene and
Virology, University of Pisa, 1-56100 Pisa, Italy
MARIA R. CAPOBIANCHI • Institute of Virology, University of
Rome, 00185 Rome, Italy
NAN DO K. CHATTERJEE • Wadsworth Center for Laboratories
and Research, New York State Department of Health, Albany,
New York 12201
PIER GIULIO CONALDI • Institute of Epidemiology, Hygiene and
Virology, University of Pisa, 1-56100 Pisa, Italy
RICHARD L. CROWELL • Department of Microbiology and
Immunology, Hahnemann University School of Medicine,
Philadelphia, Pennsylvania 19102
FERDINANDO DIANZANI • Institute of Virology, University of
Rome, 00185 Rome, Italy
RUDIGER DORRIES • Institute for Virology and Immunobiology,
University of Wiirzburg, D-8700 Wiirzburg, Federal Republic of
Germany
tDeceased.
v
VI CONTRIB UTORS
KARIN ESTEVES • Epidemiology and Management Support
Services, World Health Organization, Geneva, Switzerland
GIOVANNI FEDERICO • Department of Pediatrics, University of
Pisa, 1-56100 Pisa, Italy
CHARLES J. GAUNTT • Department of Microbiology, The
University of Texas Health Science Center at San Antonio, San
Antonio. Texas 78284
NORMAN R. GRIST • Department of Infectious Diseases, University of
Glasgow, Glasgow G12 8QQ, Scotland; Communicable Diseases
Unit, Ruchill Hospital, Glasgow G20 9NB, Scotland
G. HAMMOND • Cadham Provincial Laboratory, Winnipeg,
Manitoba R3C 3Y 1, Canada
KUO-HOM LEE HSU • Department of Microbiology and
Immunology, Hahnemann University School of Medicine,
Philadelphia, Pennsylvania 19102
SALLY ANN HUBER • Department of Pathology, University of
Vermont, Burlington, Vermont 05405
REINHARD KANDOLF • Department of Virology, Max Planck
Institute for Biochemistry, D-8033 Martinsried; Department of
Internal Medicine I, Klinikum Grosshadern, University of
Munich, D-8000 Munich 70, Federal Republic of Germany
MARK H. KAPLAN • Division of Infectious Disease ,md
Immunology, North Shore University Hospital, Manhasset, New
York 11030; Cornell University Medical College, New York, New
York lO021
BURTON J. LANDAU • Department of Microbiology and
Immunology, Hahnemann University School of Medicine,
Philadelphia, Pennsylvania 19102
A. MARTIN LERNER • Wayne State University, Division of
Infectious Diseases, Hutzel Hospital, Detroit, Michigan 48201
ROGER M. LORIA • Departments of Microbiology, Immunology
and Pathology, Virginia Commonwealth University; School of
Basic Health Sciences, Medical College of Virginia, Richmond,
Virginia 23298
BRIAN W. J. MAHY • Animal Virus Research Institute, Pirbright,
Woking, Surrey GU24 ONF, England
DONATELLA MATTEUCCI • Institute of Epidemiology, Hygiene
and Virology, University of Pisa, I-56lO0 Pisa, Italy
T AKASHI ONODERA • Laboratory of Viral Immunology, National
Institute of Animal Health, Tsukuba, Ibaraki 305, Japan
MARK A. P ALLANSCH • Division of Viral Diseases, Center for
Infectious Diseases, Centers for Disease Control, U.S. Public
Health Service, U.S. Department of Health and Human Services,
Atlanta, Georgia 30333
CONTRIBUTORS VII
BELLUR S. PRABHAKAR • Laboratory of Oral Medicine, National
Institute of Dental Research, National Institutes of Health,
Bethesda, Maryland 20892
DANIEL REID • Communicable Diseases Unit, Ruchill Hospital,
Glasgow G20 9NB, Scotland
MILAGROS P. REYES • Wayne State University, Division of
Infectious Diseases, Hutzel Hospital, Detroit, Michigan 48201
GIOVANNI ROCCHI • Infectious Diseases Clinic, Department of
Public Health, Second University of Rome, 00191 Rome, Italy
NOEL R. ROSE • Department of Immunology and Infectious
Diseases, The Johns Hopkins University, School of Hygiene and
Public Health, Baltimore, Maryland 21205
NATHALIE J. SCHMIDT • Viral and Rickettsial Disease Laboratory,
Division of Laboratories, California State Department of Health
Services, Berkeley, California 94704
DAVID P. SCHNURR • Center for Advanced Medical Technology,
San Francisco State University, San Francisco, California 94132;
Viral and Rickettsial Disease Laboratory, Division of Laboratories,
California State Department of Health Services, Berkeley,
California 94704
MAGGIE SCHULTZ • Department of Microbiology and
Immunology, Hahnemann University School of Medicine,
Philadelphia, Pennsylvania 19102
ANTONIO TONIOLO • Institute of Microbiology and Virology,
University of Sassari Medical School, 07100 Sassari, Italy
STEVEN TRACY • Department of Pathology and Microbiology,
University of Nebraska Medical Center, Omaha, Nebraska 68105
ANTONIO VOLPI • Infectious Diseases Clinic, Department of
Public Health, Second University of Rome, 00191 Rome, Italy
Preface to the Series
The mechanisms of disease production by infectious agents are present
ly the focus of an unprecedented flowering of studies. The field has
undoubtedly received impetus from the considerable advances recently
made in the understanding of the structure, biochemistry, and biology
of viruses, bacteria, fungi, and other parasites. Another contributing
factor is our improved knowledge of immune responses and other adap
tive or constitutive mechanisms by which hosts react to infection. Fur
thermore, recombinant DNA technology, monoclonal antibodies, and
other newer methodologies have provided the technical tools for exam
ining questions previously considered too complex to be successfully
tackled. The most important incentive of all is probably the regenerated
idea that infection might be the initiating event in many clinical entities
presently classified as idiopathic or of uncertain origin.
Infectious pathogenesis research holds great promise. As more in
formation is uncovered, it is becoming increasingly apparent that our
present knowledge of the pathogenic potential of infectious agents is
often limited to the most noticeable effects, which sometimes represent
only the tip of the iceberg. For example, it is now well appreciated that
pathologic processes caused by infectious agents may emerge clinically
after an incubation of decades and may result from genetic, immu
nologic, and other indirect routes more than from the infecting agent in
itself. Thus, there is a general expectation that continued investigation
will lead to the isolation of new agents of infection, the identification of
hitherto unsuspected etiologic correlations, and, eventually, more effec
tive approaches to prevention and therapy.
Studies on the mechanisms of disease caused by infectious agents
demand a breadth of understanding across many specialized areas, as
well as much co-operation between clinicians and experimentalists. The
IX
x PREFACE TO THE SERIES
series Infectious Agents and Pathogenesis is intended not only to document
the state of the art in this fascinating and challenging field but also to
help lay bridges among diverse areas and people.
M. Bendinelli
H. Friedman
Preface
It is now just 40 years since coxsackieviruses were first isolated by
Dalldorf and Sickles in the "eponymous" town of Coxsackie, New York.
Yet the overall contribution of coxsackieviruses to clinically evident dis
ease of humans is still largely an open problem. Following their discov
ery, coxsackieviruses were under intense clinical and laboratory scrutiny
for a long time. Because of their relationship to polioviruses, the under
standing of their structure, biochemistry, biology, and epidemiology ad
vanced rapidly as a result of the formidable efforts that eventually led to
the defeat of poliomyelitis. The ability of these viruses to infect mice
permitted dissection of their pathogenicity in an experimental host and
elucidation of conditions that influence its expression. Coxsackieviruses
have been progressively associated with an increasing array of widely
diverse human diseases. However, only some of the suggested causal
correlations have been substantiated with satisfactory certainty. For
others, conclusive evidence has so far resisted investigation. Most impor
tant, among the latter are chronic maladies, such as dilated car
diomyopathy and juvenile diabetes, that demand consideration.
In recent times, there has been a partial eclipse of the subject of
coxsackieviruses in the medical literature. In addition to the difficulties
encountered in pinpointing their pathogenic potential, possible reasons
include the general decline of interest in enteroviruses, which ensued
after the conquest of poliomyelitis, and the continuous appearance in
the limelight of new, more esoteric, and therefore more "appealing"
viruses. An additional factor was probably the realization that all distinc
tions within the Enterovirus genus of Picornaviridae are arbitrary and the
consequent naming of newly identified serotypes as enterovirus (fol
lowed by a number). Although taxonomically correct, this decision has
Xl
