Coxsackie B virus

Coxsackie B (also written coxsackievirus B) is a type of enterovirus. There are several different serotypes of Coxsackie B known to infect humans.

Immune system

In a mouse model of myocarditis, Coxsackievirus infection was found to upregulate Toll-like receptor 4 on mast cells and macrophages immediately following infection. It also increased numbers of mast cells.

In human disease

Myalgic Encephalomyelitis

Research has shown that many patients with ME have persistently elevated levels of Coxsackie B IgM or IgG antibodies as well as circulating immune complexes containing viral antigen, indicating the possible presence of a persistent infection. Elevated Coxsackie B antibodies have been found in patients in at least two ME outbreaks. In a retrospective cohort study by Melvin Ramsay and Elizabeth Dowsett, 31% of the patients were found to have elevated enteroviral IgM antibody levels. Sixteen of these patients were retested annually over three years and all showed persistently elevated Coxsackie B neutralizing antibody levels and intermittently positive enteroviral IgM, suggesting a persistent infection was present.

Type 1 diabetes

A study of patients with Type 1 Diabetes found that Coxsackie B4 was found to infect β cells and cause inflammation mediated by natural killer cells.

Testing

In the United States, ARUP Laboratories offers a serum microneutralization assay that is designed to measure the concentration of serum antibodies to six serotypes of the virus; B1 through B6. This specific assay has been shown to be sensitive for detection of chronic infections in ME patients. A persistent fourfold or greater rise in antibody titer is often found in these patients, which is not often found in healthy controls.

A complement fixation assay for Coxsackie B serotypes is available in the United States from LabCorp and Quest Diagnostics, however this specific type of assay has not been found to be sensitive for the chronic infections found in ME patients.

Treatment

There are no approved vaccines or antivirals for Coxsackie viruses. However, preliminary research (often in animal models or in vitro) have been shown various compounds to have potential antiviral effects.

Potential coxsackie antivirals
Serotype	Pharmaceuticals	Herbs	Supplements	Other
B1	Fluoxetine	ursolic acid, Bupleurum kaoi	Glycine max	*
B2	Fluoxetine	simalikalactone D	*	*
B3	Ampligen,Fluoxetine, Interferon, ribvarin, arbidol, amiloride, itraconazole, oseltamivir, valsartan, olmesartan, lovastatin, mycophenolate, arsenic trioxide	shuang huang lian, garlic, curcumin, baicalein, Paris polyphylla, raoulic acid, Dodonaea viscosa, Spatholobus suberectus, Terminalia chebula, Trichosanthes root, Rhodiola rosea, emodin, Astragalus membranaceus, acemannan, Sophora flavescens, Isatis tinctoria, cinnamaldehyde, Rheum palmatum		chlorogenic acid, fatty acid synthase inhibitors
B4	Fluoxetine, oseltamivir	Yakammaoto, raoulic acid, emodin, Epimedium, Azadirachta indica	Dihydroquercetin(Taxifolin)	DHEA, 5-androstenediol
B5	arbidol	Spatholobus suberectus, Terminalia chebula, Epimedium, hyaluronic acid	sodium selenite	chlorogenic acid, clinoptilolite
B6	*	Azadirachta indica	*	*
Note: Many of the elements in this table were reproduced from a post on Phoenix Rising. See that post for full citations and/or help us fully cite this table.

See also

• Enterovirus
• Coxsackie A
• Echovirus

mouse model The use of special strains of mice to study a human disease or condition, and how to prevent and treat it

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

antibodies Antibody/immunoglobulin refers to any of a large number of specific proteins produced by B cells that act against an antigen in an immune response.

antibodies Antibody/immunoglobulin refers to any of a large number of specific proteins produced by B cells that act against an antigen in an immune response.

enterovirus A genus of RNA viruses which typically enter the body through the respiratory or gastrointestinal systems and sometimes spread to the central nervous system or other parts of the body, causing neurological, cardiac, and other damage. Since the first reports of myalgic encephalomyelitis (ME), enteroviruses have been suspected as a cause of ME. Enteroviruses have also been implicated as the cause of Type I diabetes, congestive heart failure, and other conditions. Enteroviruses include poliovirus, coxsackieviruses, and many others. New enteroviruses and new strains of existing enteroviruses are continuously being discovered. (Learn more: viralzone.expasy.org)

antibodies Antibody/immunoglobulin refers to any of a large number of specific proteins produced by B cells that act against an antigen in an immune response.

β β / Β. Greek letter beta (a symbol used in science), equivalent to "b".

serum The clear yellowish fluid that remains from blood plasma after clotting factors have been removed by clot formation. (Blood plasma is simply blood that has had its blood cells removed.)

assay 1. (verb) analysis (as of an ore or drug) to determine the presence, absence, or quantity of one or more components. 2. (noun) In biochemistry, any laboratory protocol used to test a sample for one or more qualities.