title: Coxsackievirus B heart infections and their putative contribution to sudden unexpected death: An 8-year review of patients and victims in the coastal region of Tunisia.
abstract: Coxsackieviruses B (CV B) are known as the most common viral cause of human heart infections. Cardiac inflammations contribute to sudden unexpected death (SUD) significantly. The diagnosis remains difficult with the traditional diagnostic tests and must be substantially improved. This has prompted health professionals to seek new diagnostic procedures which may provide important clues regarding underlying etiology. The present study is based on patients with infectious heart diseases and SUD victims with no relevant pathologies. They were investigated for possible CV-B infection. Patients with coronary artery diseases and unnatural road and domestic accident victims served as controls. The samples were studied for CV-B applying PCR. Histopathology for inflammatory markers, immunohistochemistry (IHC) for immune inflammatory cells and the enteroviral VP1-capsid protein were performed. Overall, 102 patients and 87 SUD victims were studied. As controls, 100 patients and 54 SUD unnatural accident victims were enrolled. CV-B were detected in 28 patients and 15 SUD victims. The control group samples were completely virus negative. Compared to controls, IHC revealed a significant presence of T and B lymphocytes within the myocardium. Furthermore, enteroviral VP1-capsid protein were detected from samples by IHC. Applying a comprehensive combination of methods, our results demonstrate the involvement of CV-B in cases of heart infection suggesting they play a significant role in SUD. Our results emphasize the importance of opting for a combination of methods.
authors.affiliation: Laboratory of Transmissible Diseases LR99-ES27, Faculty of Pharmacy, Avenue Avicenne 5000, Monastir, Tunisia; University of Vermont, Department of Pathology, Division of Experimental Pathology, Burlington, USA; University of Vermont, DNA Microarray Facility, 305 Health Science Research Facility, Burlington, USA; University of Vermont, Department of Pathology, 208 South Park Drive, Suite #2, Colchester, VT 05446, USA. Electronic address: chbeli_imed@yahoo.fr.
authors.forename: Imed
authors.initials: I
authors.lastname: Gaaloul
authors.affiliation: Laboratory of Transmissible Diseases LR99-ES27, Faculty of Pharmacy, Avenue Avicenne 5000, Monastir, Tunisia.
authors.forename: Samira
authors.initials: S
authors.lastname: Riabi
authors.affiliation: University of Vermont, Department of Pathology, Division of Experimental Pathology, Burlington, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Evans
authors.affiliation: University of Vermont, DNA Microarray Facility, 305 Health Science Research Facility, Burlington, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Hunter
authors.affiliation: University of Vermont, Department of Pathology, 208 South Park Drive, Suite #2, Colchester, VT 05446, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Huber
authors.affiliation: Laboratory of Transmissible Diseases LR99-ES27, Faculty of Pharmacy, Avenue Avicenne 5000, Monastir, Tunisia.
authors.forename: Mahjoub
authors.initials: M
authors.lastname: Aouni
mesh_terms: D000293:Adolescent; D000328:Adult; D001402:B-Lymphocytes / Q000473:pathology; D036022:Capsid Proteins / Q000235:genetics; D016022:Case-Control Studies; D003384:Coxsackievirus Infections / Q000175:diagnosis*; D003645:Death, Sudden / Q000209:etiology*; D029822:Enterovirus B, Human / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008875:Middle Aged; D009205:Myocarditis / Q000821:virology*; D009206:Myocardium / Q000473:pathology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral; D013601:T-Lymphocytes / Q000473:pathology; D014416:Tunisia; D055815:Young Adult
chemical_list: D036022:Capsid Proteins; D012367:RNA, Viral
keywords: Cardiotropic coxsackievirus B; Combination of methods; Human heart infections; Sudden; and unexpected deaths