Coxsackievirus B infections are common in Cystic Fibrosis and experimental evidence supports protection by vaccination

Virginia M Stone; Renata Utorova; Marta Butrym; Amir-Babak Sioofy-Khojine; Minna M Hankaniemi; Emma E Ringqvist; Marfa Blanter; Anirudra Parajuli; Terezia Pincikova; Björn Fischler; Ferenc Karpati; Vesa P Hytönen; Heikki Hyöty; Lena Hjelte; Malin Flodström-Tullberg

doi:10.1016/j.isci.2022.105070

Coxsackievirus B infections are common in Cystic Fibrosis and experimental evidence supports protection by vaccination

iScience. 2022 Sep 5;25(10):105070. doi: 10.1016/j.isci.2022.105070. eCollection 2022 Oct 21.

Authors

Virginia M Stone¹, Renata Utorova¹, Marta Butrym¹, Amir-Babak Sioofy-Khojine², Minna M Hankaniemi², Emma E Ringqvist¹, Marfa Blanter¹, Anirudra Parajuli¹, Terezia Pincikova^{1

3

4}, Björn Fischler⁴, Ferenc Karpati^{3

4}, Vesa P Hytönen^{2

5}, Heikki Hyöty^{2

5}, Lena Hjelte^{3

4}, Malin Flodström-Tullberg¹

Affiliations

¹ Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden.
² Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland.
³ Stockholm CF Center, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
⁴ Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Pediatrics, Karolinska University Hospital, 141 86 Stockholm, Sweden.
⁵ Fimlab Laboratories, 33520 Tampere, Finland.

Abstract

Viral respiratory tract infections exacerbate airway disease and facilitate life-threatening bacterial colonization in cystic fibrosis (CF). Annual influenza vaccination is recommended and vaccines against other common respiratory viruses may further reduce pulmonary morbidity risk. Enteroviruses have been found in nasopharyngeal samples from CF patients experiencing pulmonary exacerbations. Using serology tests, we found that infections by a group of enteroviruses, Coxsackievirus Bs (CVBs), are prevalent in CF. We next showed that a CVB vaccine, currently undergoing clinical development, prevents infection and CVB-instigated lung damage in a murine model of CF. Finally, we demonstrate that individuals with CF have normal vaccine responses to a similar, commonly used enterovirus vaccine (inactivated poliovirus vaccine). Our study demonstrates that CVB infections are common in CF and provides experimental evidence indicating that CVB vaccines could be efficacious in the CF population. The role of CVB infections in contributing to pulmonary exacerbations in CF should be further studied.

Keywords: Virology.