Characterization of nonpolio enteroviruses recovered from patients with aseptic meningitis in Korea.

OBJECTIVES: We attempted to characterize nonpolio enteroviruses recovered from Korean patients with aseptic meningitis. METHODS: We performed RT-PCR on the 5'-nontranslated region using clinical specimens. Infectious clinical isolates were amplified by infecting Vero cells with RT-PCR-positive clinical specimens. We then investigated the direct effect in primary neuronal cells or cardiomyocytes following virus infection. RESULTS: Total 12 clinical isolates were subtypically analyzed by both RT-PCR/sequencing comparison of the VP-1 region and neutralization assay. 43-2, 43-2S, 57 and 58 were found to be coxsackievirus B1 (CVB1), 312 to be CVB5, 14-2S and 327 to be echovirus 6, 165 to be echovirus 9, 337 to be echovirus 11, and 270 to be echovirus 30. All the clinical isolates tested showed profound cytotoxicity to various degrees in the primary neuronal cells within 24 h postinfection at 10 MOI. By contrast, a significant cytopathic effect was observed in the primary cardiomyocytes at 3-5 days postinfection at 50 MOI. CONCLUSIONS: The present study suggests that the clinical isolates recovered from Korean patients belonged to different CVB or echovirus serotypes and that these viruses showed diversities in their virulence in primary neuronal cells and cardiomyocytes.

All CVB serotypes and clinical isolates induce irreversible cytopathic effects in primary cardiomyocytes.

Coxsackievirus B3 (CVB3) has been identified as a major causative agent of acute and chronic myocarditis, but the involvement of other CVB serotypes in myocarditis has not been investigated. To dissect the pathological properties of different CVB serotypes toward primary cardiomyocytes, we tested their effects on primary cardiomyocyte cultures from neonatal rats. Morphological abnormalities were examined by both light and fluorescence microscopy after Hoechst 33342 staining, and loss of cell viability was estimated by MTT assay. All six CVB serotypes showed a similar degree of severe toxicity toward primary cardiomyocytes. CVB clinical isolates had cytopathic effects (CPEs) similar to those of their respective CVB reference strains. Within 1-2 days of infection with multiplicities of infection MOI 50, the cells began to experience morphological changes including cell shrinkage, rounding-up, and slight nuclear condensation. The irreversible loss of cell viability was readily observed within 3-5 days following virus infection. These results suggest that all six CVB serotypes induce direct, irreversible toxicity towards cardiomyocytes, which eventually leads to the death of infected cells. These findings indicate that the variations in CVB serotype are not the limiting factor determining the susceptibility of cardiomyocytes to CVB infection.

Characteristics of apoptotic cell death induced by coxsackievirus B in permissive Vero cells.

Coxsackievirus B (CVB) causes a wide spectrum of human diseases which are closely associated with direct destruction of infected cells. We investigated the morphological and biochemical characteristics of CPEs in permissive Vero cells caused by different CVB serotypes. Regardless of serotype, the infected cells experienced similar degrees of CPEs within 24 h postinfection (p.i.). Using both Hoechst 33342 staining and transmission electron microscopy, we consistently observed morphological properties of apoptosis, heavily condensed nuclei and subsequent chromatin condensation into the periphery of the nuclei within 12 h p.i. Moreover, we noticed typical oligonucleosomal DNA fragmentation, while productive CVB multiplication was accomplished within 6 h p.i. prior to an apoptotic signal. Caspase inhibitor significantly prohibited nuclear changes due to apoptosis with no influence on virus production and cell death, demonstrating that all the CVBs induced more than one type of pathological effect, including apoptotic alteration in permissive Vero cells.