Decoding the complex receptor landscape of enterovirus D68

Mengyang Zhao1,2, Leiliang Zhang1,2

  • 1Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.

Plos Pathogens
|May 26, 2026
PubMed

Insights

Enterovirus D68 (EV-D68) uses multiple receptors, including MFSD6, sialic acid, and ICAM-5, for infection. Understanding these viral entry mechanisms is key to developing new antiviral therapies against EV-D68.

Area of Science:

  • Virology
  • Molecular Biology
  • Immunology

Background:

  • Enterovirus D68 (EV-D68) is an emerging viral pathogen causing severe respiratory and neurological diseases.
  • Viral entry mechanisms are crucial for understanding EV-D68 pathogenesis and developing treatments.

Purpose of the Study:

  • To elucidate the roles of specific glycan and protein receptors in EV-D68 infection.
  • To correlate receptor distribution with EV-D68 tissue tropism and pathogenicity.
  • To explore therapeutic strategies targeting EV-D68-receptor interactions.

Main Methods:

  • Review and synthesis of existing literature on EV-D68 receptors.
  • Analysis of the functional roles of sialic acid, ICAM-5, and MFSD6 in viral entry.
  • Correlation of receptor expression patterns with clinical manifestations and disease severity.

Main Results:

  • MFSD6 acts as a primary receptor for EV-D68 due to its broad tissue distribution.
  • Sialic acid and ICAM-5 exhibit synergistic roles, facilitating viral invasion across diverse tissues.
  • The complex interplay of these receptors enhances EV-D68 pathogenicity and adaptability.

Conclusions:

  • EV-D68 employs a sophisticated receptor system, including MFSD6, sialic acid, and ICAM-5, to achieve multi-tissue invasion and adaptation.
  • Understanding receptor-virus interactions is critical for predicting disease severity and developing targeted antiviral interventions.
  • Targeting these specific receptors offers a promising avenue for novel therapeutic strategies against EV-D68 infections.