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Infection à coxsackievirus B4, inflammation et persistance

Abstract : Group B coxsackieviruses (CVB) are small RNA viruses belonging to Enterovirus genus and to the Picornaviridae family. In humans, CVB can cause numerous mild and severe acute infections. They are also thought to be involved in the development of chronic diseases such as type 1 diabetes (T1D). Several epidemiological and clinical data support a link between enteroviruses, especially CVB and T1D. Two main mechanisms have been described to explain this enteroviral pathogenesis of T1D including a “bystander activation” of an inflammatory environment and viral persistence. These mechanisms contribute to initiation of the autoimmune process. Our studies aimed to understand the features and outcomes of CVB infection that could explain their involvement in these mechanisms. The results suggest that CVB4 (used as CVB model) is an inflammatory virus. CVB4 induces in vitro the production by peripheral blood mononuclear cells (PBMCs) of high amounts of IFNα. However this induction is only possible when CVB4 infection is enhanced by non-neutralizing antibodies, resulting in increased viral entry in cells. We also reported detection of IFNα in plasma of T1D patients, commonly associated with enteroviral RNA. In addition, monocytes have been identified as major targets of enteroviruses among PBMCs. Besides IFNα, CVB4 can induce the synthesis of other proinflammatory cytokines, mainly IL-6 and TNFα. Interestingly, infection is not needed, since inactivated viral particles can induce these proinflammatory cytokines. In addition, the enhancing of CVB4 infection in PBMCs results in increased production of these cytokines. We have shown that macrophages that are known as major innate immunity effectors can produce IFNα and other proinflammatory cytokines upon infection with CVB4. Macrophages derived from PBMCs in presence of M-CSF (but not GM-CSF) can be infected by CVB4, and the virus can persist in these cells. CVB4 can also establish a productive, carrier-sate persistent infection in pancreatic ductal-like cells. The virus can be completely cleared from chronically-infected cells using fluoxetine. This molecule already used in the treatment of depression and other mental disorders, has displayed antiviral activity against many enteroviruses, and can completely clear CVB4 from chronically-infected cells within few weeks. Cellular changes have been observed during chronic infection including a reduced expression of PDX-1, a resistant profile to lysis upon superinfection with CVB4, and an important decrease of CAR expression. These changes can linger even after the clearance of CVB4. In addition the miRNA profile in chronically-infected ductal-like cells was clearly different from that of mock-infected cells. Some phenotypic and genotypic changes were also observed in the virus derived from chronic infection. Altogether, these findings show the features of CVB4 infection are compatible with mechanisms reported in the enteroviral pathogenesis of T1D, and support the hypothesis of involvement of CVB in this disease.
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Enagnon Kazali Alidjinou. Infection à coxsackievirus B4, inflammation et persistance. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2016. Français. ⟨NNT : 2016LIL2S022⟩. ⟨tel-01926082⟩



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