E3 PreliminaryPreliminaryPEM not requiredMechanisticPeer-reviewedMachine draft
Eradication of persistent coxsackievirus B infection from a pancreatic cell line with clinically used antiviral drugs.
Honkimaa, Anni, Sioofy-Khojine, Amir-Babak, Oikarinen, Sami et al. · Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2020 · DOI
Quick Summary
This study tested whether common antiviral medications could eliminate persistent coxsackievirus B infections in laboratory pancreatic cells. Researchers found that four drugs—Enviroxime, Fluoxetine, Hizentra (an immune protein), and Pleconaril—successfully cleared the virus from infected cells. The results suggest these medications might be worth testing in patients with chronic enterovirus infections.
Why It Matters
Persistent enterovirus infections have been hypothesized to contribute to ME/CFS pathogenesis in some patients. This study identifies specific antiviral candidates that can eliminate coxsackievirus B from cells in laboratory conditions, providing a foundation for evaluating whether these drugs might benefit ME/CFS patients with evidence of persistent enteroviral infection.
Observed Findings
- Enviroxime successfully eradicated persistent coxsackievirus B1 infection in pancreatic cells.
- Fluoxetine demonstrated antiviral activity capable of clearing persistent coxsackievirus B1 infection.
- Hizentra (concentrated human immunoglobulin) was able to eradicate coxsackievirus B1 infection.
- Pleconaril eradicated persistent coxsackievirus B1 infection with variable effectiveness between viral strains.
- The efficacy of Enviroxime, Hizentra, and Pleconaril varied depending on which coxsackievirus B1 strain was used.
Inferred Conclusions
- Four clinically used or tested antiviral drugs show promise in vitro for eradicating persistent coxsackievirus B infections.
- These identified drugs warrant evaluation in clinical trials for patients with persistent enteroviral infections and enterovirus-associated chronic diseases.
- Viral strain heterogeneity affects drug response and may need to be considered in therapeutic strategies.
Remaining Questions
- Will these antivirals be effective and safe in human clinical trials with ME/CFS or other chronic enterovirus-associated conditions?
- Can drug efficacy observed in this pancreatic cell line be replicated in other tissue types relevant to ME/CFS (immune cells, neural tissue, muscle)?
What This Study Does Not Prove
This laboratory study does not prove that these antivirals will cure ME/CFS or that coxsackievirus B causes ME/CFS in patients. It does not establish that viral eradication in cells will translate to clinical benefit, nor does it demonstrate safety or efficacy in human trials. The study cannot determine whether persistent enterovirus plays a role in any individual patient's illness.
Tags
Biomarker:Blood Biomarker
Phenotype:Infection-Triggered
Method Flag:No ControlsExploratory Only
Metadata
- DOI
- 10.1016/j.jcv.2020.104334
- PMID
- 32450550
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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