Key result
Specific capsid mutations reduce EV-D68 replication and protein expression in spinal cord organoids.
Why the study?
EV-D68-associated acute flaccid myelitis cases waned after 2018 for unknown reasons, and the phenotypes of VP1 and VP3 point mutations in a human multicellular CNS model were unknown.
Specific mutations in EV-D68 structural proteins VP1 and VP3 attenuate neurovirulence in human spinal cord organoids, potentially explaining the recent wane in acute flaccid myelitis cases.
EV-D68 VP1/VP3 mutations may attenuate neurovirulence in human CNS models; leaves open their contribution to post-2018 AFM decline.
Enterovirus D68 (EV-D68) is a non-polio enterovirus that can cause a polio-like paralysis condition, acute flaccid myelitis (AFM). EV-D68 associated AFM cases waned in the US after 2018 and the reasons for this are unknown. It has recently been demonstrated that EV-D68 containing point mutations in viral structural proteins VP1 and VP3 resulted in decreased paralysis in different neonatal mouse models. However, phenotypes of these mutations in a human multicellular central nervous system (CNS) model are unknown. We hypothesized that mutations in VP1 and VP3 will similarly direct neurotropism in human spinal cord organoids (hSCO). To investigate this, we recreated viruses with mutations in VP3 (I88V) or VP1 (L1I/N2D/T98A/E283K or L1P/V148A/K282R) and infected hSCOs. We found that VP3 I88V and VP1 L1I/N2D/T98A/E283K resulted in decreased titer and viral protein staining, consistent with attenuated neurovirulence in previously published murine models. When these mutations were combined, their effects on neurotropism were not additive. Sequence analysis of recently circulating EV-D68 strains reveals that VP3 I88 and VP1 E283 have remained the dominant amino acid residues since 2014, whereas VP1 sites 1, 2, and 98 have higher population diversity, indicating that these residues may be contributing to newly reduced neurovirulence after 2018.
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Packard et al. (2026) studied Enterovirus D68 infection / Acute flaccid myelitis. EV-D68 with VP3 (I88V) or VP1 (L1I/N2D/T98A/E283K) mutations vs. EV-D68 18952 (reference strain) was evaluated on Viral titer and VP1 protein staining in human spinal cord organoids. EV-D68 containing mutations in VP3 (I88V) and VP1 (L1I/N2D/T98A/E283K) demonstrated decreased viral titer and protein staining in human spinal cord organoids compared to the reference strain.
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