Receptor for the group B coxsackieviruses and adenoviruses: CAR

Considerable progress towards the characterisation of the long-sought receptor, CAR (coxsackievirus and adenovirus receptor), shared by group B coxsackieviruses (CVB) and most adenoviruses (Ad) has been made since it was isolated and cloned in 1997. The primary sequence of CAR shows that it is a member of the immunoglobulin superfamily of proteins, containing two Ig superfamily domains: an amino-terminal V-like module and a C2-like module. The CAR cytoplasmic domain, representing nearly one-third of the protein, is separated from the C2-like module by a single membrane-spanning sequence. The structure of the CAR V-like module complexed with the Ad fibre knob has been determined using recombinant proteins, and reveals three CAR modules associated with a single knob. Although recombinant CAR expressed in mammalian cells confers permissivity to CVB infection, details of the interaction between CAR and CVB remain to be elucidated. The expression of CAR appears to be highly regulated with respect to both cell type and developmental age. In rodents, CAR is expressed at high levels just before birth, and declines thereafter. Expressed levels have been found to increase in regenerating muscle and in response to immunological mediators or inflammation, and in RD cells and umbilical vein endothelial cells in response to high cell density. These studies indicate that CAR expression is highly regulated, but the mechanisms and molecules that mediate the expression remain to be discovered. The physiological function of CAR and its natural ligand also remain to be discovered. In addition, while CAR expression generally correlates with viral tropism, the relationship between the physiological function of CAR and the pathologies of CVB and Ad infections remain to be described.