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Insight into the Life Cycle of Enterovirus-A71
Open accessAbstract
Human enterovirus 71 (EV-A71), a member of the Picornaviridae family, is predominantly associated with hand, foot, and mouth disease in infants and young children. Additionally, EV-A71 can cause severe neurological complications, including aseptic meningitis, brainstem encephalitis, and fatalities. The molecular mechanisms underlying these symptoms are complex and involve the viral tissue tropism, evasion from the host immune responses, induction of the programmed cell death, and cytokine storms. This review article delves into the EV-A71 life cycle, with a particular emphasis on recent advancements in understanding the virion structure, tissue tropism, and the interplay between the virus and host regulatory networks during replication. The comprehensive review is expected to contribute to our understanding of EV-A71 pathogenesis and inform the development of antiviral therapies and vaccines.
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![Figure 2 Schematics of the EV-A71 genome, translation, and polyprotein processing. (A) The EV-A71 genome and secondary structure loops (SLs) are depicted as a black line and circles, respectively. The 5′-UTR of EV-A71 encompasses SLs I–VI (black line), with SLs II–VI constituting the type I IRES. The viral major open reading frame (mORF) encodes a polyprotein precursor, which is proteolytically processed into four structural proteins (indicated with blue blocks) and seven non-structural proteins (2A–2C indicated with green, 3A–3D in yellow, respectively). Additionally, a small upstream open reading frame (uORF) is indicated by a purple block, initiated from the first in-frame AUG codon (AUG1). The 3′-UTR of EV-A71 contains domains designated as -X, -Y, and -Z, which are implicated in genome RNA replication. (B) A schematic illustration of the translation and processing of the EV-A71 polyprotein is presented, highlighting the primary roles of 2Apro and 3Cpro proteases in these processes. (C) Four types of classical viral IRES. IRESs are generally categorized into four types based on their essential eIFs and ITAFs, secondary structure, and other biological properties. Some well-known ITAFs binding to the domain are shown. Notable domains within the IRES are color-coded: C-rich regions are in brown, representing areas with a high cytosine content; GNRA motifs are in blue, where G is for guanine, N for undefined nucleotides, R for purine (adenine or guanine), and A for adenine; Yn regions are in green, indicating pyrimidine-rich sequences approximately 8 to 10 nucleotides in length. Thin line junctions denote known pseudoknot structures within the IRES (adapted from references [21,68]).](/paper-figures/3e2ba383c391414ba2f85fd77a7bfcf7/insight-into-the-life-cycle-of-enterovirus-a71-figure-2.jpg)

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“By traveling within nerve axons, the virus can effectively bypass the bloodstream and the meningeal immune surveillance, reaching the CNS without triggering an early, widespread meningeal inflammation (21, 22).”
From Pathogen detection in acellular cerebrospinal fluid: diagnostic insights from a pediatric cohort in Colombia (2026) · cites this paper as [22]
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Patiño Patiño, J. J., Osorio-Rodríguez, E., García Toscano, Y. P., Filott Tamara, M., De-Ávila-Arias, M., Rodríguez Sanjuán, A., Villarreal-Camacho, J. L., Martínez De la Rosa, W., Bilbao Ramírez, J., Coronell-Rodríguez, W., et al. (2026) · Microbiology Spectrum · doi:10.1128/spectrum.02122-25
Metadata
- Authors
- Liu, Q., & Long, J.-E.
- Affiliations
- Shanghai Medical College of Fudan University (CN)
- Corresponding author
- Long, Jian-Er
- ORCID
- Long, Jian-Er
- Venue
- Viruses
- Publisher
- MDPI AG
- Published
- 2025-01-27
- Volume
- 17
- Issue
- 2
- Pages
- 181
- ISSN
- 1999-4915 (ISSN-L)
- PMC
- PMC11861800
- OpenAlex
- W4406844396
- Cited by
- 11
- References
- 4
- Citations by year
- 2026: 6 · 2025: 5
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Viruses (publishedVersion, cc-by)
- Preprints.org (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Natural Science Foundation of China (32070184, 32470144)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- enterovirus 71, viral life cycle, hand, foot and mouth disease, neurological complications, aseptic meningitis, brainstem encephalitis, virion structure, tissue tropism, immune evasion, programmed cell death, cytokine storm, host-virus interaction, viral replication, antiviral therapy, vaccine development
- MeSH terms
- Animals, Enterovirus Infections, Hand, Foot and Mouth Disease, Humans, Life Cycle Stages, Virus Replication, Enterovirus A, Human, Host-Pathogen Interactions, Viral Tropism
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