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…mehr
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.
1. Classification and General Properties.- 1. History and Classification.- 2. Isolation and Propagation.- 3. Occurrence in Nonhuman Species.- 4. Physicochemical Properties.- 5. Hemagglutination.- 6. Virion Structure and Morphology.- References.- 2. The Genome of Group B Coxsackieviruses.- 1. Introduction.- 2. General Remarks on the CVB Genome.- 3. The 5' Nontranslated Region.- 4. The P1 Region.- 5. The P2 Region.- 6. The P3 Region.- 7. The 3' Nontranslated Region.- 8. Summary.- References.- 3. Replication.- 1. Introduction.- 2. Virus Growth, Purification, and Assay.- 3. Viral Replication.- 4. Concluding Remarks.- References.- 4. Perspectives on Cellular Receptors as Determinants of Viral Tropism.- 1. Introduction.- 2. Pathogenesis of Coxsackievirus Infections.- 3. Structural Studies Identifying the Virion Attachment Site.- 4. Specific Cellular Receptors for Coxsackieviruses.- 5. Future Directions.- References.- 5. The Role of Interferon in Picornavirus Infections.- 1. The Interferon System.- 2. The Interferon in Picornavirus Infections.- 3. Conclusions.- References.- 6. Interactions with the Immune System.- 1. Introduction.- 2. Nonspecific Mechanisms of Resistance to Coxsackieviruses.- 3. Antibody Response to Coxsackieviruses.- 4. Cell-Mediated Immune Response to Coxsackieviruses.- 5. Coxsackievirus Replication in Immunocompetent Cells.- 6. Immunodepression by Coxsackieviruses.- 7. Histopathology of Lymphoid Organs in Coxsackievirus-Infected Hosts.- 8. Mechanisms and Significance of Damage to the Immune System.- 9. Concluding Remarks.- References.- 7. The Role of Immune Mechanisms in Pathogenesis.- 1. Introduction.- 2. Role of Virus in Disease Pathogenesis.- 3. Evidence for Immune Pathogenesis in Picornavirus Infections.- 4. Mechanisms of Pathogenesis.- 5. Hypothetical Model for Picornavirus-Induced Autoimmunity in Myocarditis.- References.- 8. Application of Monoclonal Antibodies to the Study of Coxsackieviruses.- 1. Introduction.- 2. Generation and Characterization of Monoclonal Antibodies.- 3. Antigenic Variants among Naturally Occurring Clinical Isolates.- 4. Selection of Antigenic Variants.- 5. Characterization of Antigenic Variants.- 6. Demonstration of Conserved and Nonconserved Epitopes on CVB4.- 7. Neutralization Epitope Diversity among Laboratory Isolates.- 8. Selection of Antigenic Variants with Changes in Their Biologic Properties.- 9. Characterization of Viral Polypeptides.- 10. Anti-idiotypic Antibodies to Anti-CVB4 Monoclonal Antibodies.- 11. Molecular Mimicry and Autoimmunity.- 12. Perspective.- References.- 9. Host Conditions Affecting the Course of Coxsackievirus Infections.- 1. Introduction.- 2. Infection: Route, Dose, Site of Virus Localization.- 3. Temperature.- 4. Effect of Age and Aging on Coxsackievirus Infection.- 5. Fetal and Neonatal Infections.- 6. Genetics.- 7. Nutrition.- 8. Effect of Hormones on Infection.- 9. Other Agents.- 10. Summary.- References.- 10. The Possible Role of Viral Variants in Pathogenesis.- 1. Introduction.- 2. Origin of Variants.- 3. Types of Coxsackievirus Group B Variants.- 4. Coxsackievirus Group B Variants and Animal Models of Diseases.- 5. Coxsackievirus Group A Variants.- 6. Unaccounted-for Coxsackievirus Variants.- 7. Future Goals.- References.- 11. Persistent Infections.- 1. Introduction.- 2. In Vitro Persistent Infections.- 3. In Vivo Persistent Infections.- 4. Consequences of Persistent Infection.- 5. Discussion.- 6. Conclusion.- References.- 12. New Approaches to Laboratory Diagnosis.- 1. Introduction.- 2. Improvements of Established Techniques.- 3. New Technical Approaches.- 4. Concluding Remarks.- References.- 13. General Pathogenicity and Epidemiology.- 1. General Pathogenicity of Coxsackieviruses.- 2. Epidemiologic Observations.- 3. Role of Coxsackieviruses in Various Disease Syndromes.- 4. Conclusions.- References.- 14. Coxsackievirus Infection in Children under Three Months of Age.- 1. Introduction.- 2. Mild Coxsackie B Infection Acquired from a Sick Househ
1. Classification and General Properties.- 1. History and Classification.- 2. Isolation and Propagation.- 3. Occurrence in Nonhuman Species.- 4. Physicochemical Properties.- 5. Hemagglutination.- 6. Virion Structure and Morphology.- References.- 2. The Genome of Group B Coxsackieviruses.- 1. Introduction.- 2. General Remarks on the CVB Genome.- 3. The 5' Nontranslated Region.- 4. The P1 Region.- 5. The P2 Region.- 6. The P3 Region.- 7. The 3' Nontranslated Region.- 8. Summary.- References.- 3. Replication.- 1. Introduction.- 2. Virus Growth, Purification, and Assay.- 3. Viral Replication.- 4. Concluding Remarks.- References.- 4. Perspectives on Cellular Receptors as Determinants of Viral Tropism.- 1. Introduction.- 2. Pathogenesis of Coxsackievirus Infections.- 3. Structural Studies Identifying the Virion Attachment Site.- 4. Specific Cellular Receptors for Coxsackieviruses.- 5. Future Directions.- References.- 5. The Role of Interferon in Picornavirus Infections.- 1. The Interferon System.- 2. The Interferon in Picornavirus Infections.- 3. Conclusions.- References.- 6. Interactions with the Immune System.- 1. Introduction.- 2. Nonspecific Mechanisms of Resistance to Coxsackieviruses.- 3. Antibody Response to Coxsackieviruses.- 4. Cell-Mediated Immune Response to Coxsackieviruses.- 5. Coxsackievirus Replication in Immunocompetent Cells.- 6. Immunodepression by Coxsackieviruses.- 7. Histopathology of Lymphoid Organs in Coxsackievirus-Infected Hosts.- 8. Mechanisms and Significance of Damage to the Immune System.- 9. Concluding Remarks.- References.- 7. The Role of Immune Mechanisms in Pathogenesis.- 1. Introduction.- 2. Role of Virus in Disease Pathogenesis.- 3. Evidence for Immune Pathogenesis in Picornavirus Infections.- 4. Mechanisms of Pathogenesis.- 5. Hypothetical Model for Picornavirus-Induced Autoimmunity in Myocarditis.- References.- 8. Application of Monoclonal Antibodies to the Study of Coxsackieviruses.- 1. Introduction.- 2. Generation and Characterization of Monoclonal Antibodies.- 3. Antigenic Variants among Naturally Occurring Clinical Isolates.- 4. Selection of Antigenic Variants.- 5. Characterization of Antigenic Variants.- 6. Demonstration of Conserved and Nonconserved Epitopes on CVB4.- 7. Neutralization Epitope Diversity among Laboratory Isolates.- 8. Selection of Antigenic Variants with Changes in Their Biologic Properties.- 9. Characterization of Viral Polypeptides.- 10. Anti-idiotypic Antibodies to Anti-CVB4 Monoclonal Antibodies.- 11. Molecular Mimicry and Autoimmunity.- 12. Perspective.- References.- 9. Host Conditions Affecting the Course of Coxsackievirus Infections.- 1. Introduction.- 2. Infection: Route, Dose, Site of Virus Localization.- 3. Temperature.- 4. Effect of Age and Aging on Coxsackievirus Infection.- 5. Fetal and Neonatal Infections.- 6. Genetics.- 7. Nutrition.- 8. Effect of Hormones on Infection.- 9. Other Agents.- 10. Summary.- References.- 10. The Possible Role of Viral Variants in Pathogenesis.- 1. Introduction.- 2. Origin of Variants.- 3. Types of Coxsackievirus Group B Variants.- 4. Coxsackievirus Group B Variants and Animal Models of Diseases.- 5. Coxsackievirus Group A Variants.- 6. Unaccounted-for Coxsackievirus Variants.- 7. Future Goals.- References.- 11. Persistent Infections.- 1. Introduction.- 2. In Vitro Persistent Infections.- 3. In Vivo Persistent Infections.- 4. Consequences of Persistent Infection.- 5. Discussion.- 6. Conclusion.- References.- 12. New Approaches to Laboratory Diagnosis.- 1. Introduction.- 2. Improvements of Established Techniques.- 3. New Technical Approaches.- 4. Concluding Remarks.- References.- 13. General Pathogenicity and Epidemiology.- 1. General Pathogenicity of Coxsackieviruses.- 2. Epidemiologic Observations.- 3. Role of Coxsackieviruses in Various Disease Syndromes.- 4. Conclusions.- References.- 14. Coxsackievirus Infection in Children under Three Months of Age.- 1. Introduction.- 2. Mild Coxsackie B Infection Acquired from a Sick Househ
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