Abstract
ObjectiveTo evaluate the association of enterovirus 71 (EV71) susceptibility and clinical severity with polymorphisms in EV71 receptors, including human scavenger receptor class B member 2 (SCARB2), P-selectin glycoprotein ligand-1 (PSGL-1), and annexin II (ANXA2).MethodsWe enrolled laboratory-confirmed EV71 cases and healthy age- and gender-matched controls in Taiwan from 2000 to 2012. We detected genetic polymorphisms in SCARB2, PSGL-1, and ANXA2 and correlated the results with EV71 susceptibility and severity.ResultsWe collected 599 EV71 cases and 98 controls. Among EV71 patients, the male to female ratio was 1.61, and the mean age was 2.99±2.47 years. For clinical severity, 117 (19.6%) had severe central nervous system involvement with or without cardiopulmonary failure. For outcomes, 46 (7.7%) had sequelae, and 14 (2.3%) died. SCARB2 polymorphisms (rs6824953 and rs11097262) were associated with susceptibility to EV71 infection (OR 1.60, 95% CI 1.07–2.39; and OR 1.64, 95% CI 1.09–2.47, respectively). PSGL-1 polymorphisms (rs7137098 and rs8179137) were significantly associated with severe EV71 infection (OR 1.46, 95% CI 1.1–1.96; and OR 1.47, 95% CI 1.07–2.03, respectively).ConclusionsSCARB2 polymorphisms (rs6824953 and rs11097262) might be associated with EV71 susceptibility. PSGL-1 polymorphisms (rs7137098 and rs8179137) were associated with severe EV71 infection.
Highlights
Enterovirus 71 (EV71) belongs to human enterovirus species A of the family Picornaviridae and has been regarded as the most important neurotropic enterovirus after the near eradication of the polioviruses by vaccine
scavenger receptor class B member 2 (SCARB2) polymorphisms were associated with susceptibility to EV71 infection
P-selectin glycoprotein ligand-1 (PSGL-1) polymorphisms were significantly associated with severe EV71 infection
Summary
Enterovirus 71 (EV71) belongs to human enterovirus species A of the family Picornaviridae and has been regarded as the most important neurotropic enterovirus after the near eradication of the polioviruses by vaccine. In Taiwan, EV71 has become one of the most important endemic diseases in children with an interval of three to five years after the first documented large outbreak in 1998 [2,3,4,5,6]. Patients with EV71 infection display very diverse clinical symptoms, ranging from asymptomatic or mild hand-foot-and-mouth disease (HFMD) and herpangina (HA) to severe neurological and cardiopulmonary disease, and even fatal disease [7,8,9,10]. Whether this is related to host, social, behavioral or environmental factors remains unanswered. It is very important to delineate host susceptible genes that contribute to EV71 infection, which would assist in predicting individual and population risk, as well as help clarify the pathogenesis and provide further therapeutic strategies for EV71 infection
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