{"doi":"10.3389/fcimb.2026.1774711","title":"Respiratory enterovirus D68: virology, clinical surveillance, host-pathogen interactions, and therapeutic prospects","abstract":"<jats:p>Enterovirus D68 (EV-D68), a unique enterovirus resembling human rhinoviruses, was long considered to cause only sporadic outbreaks of mild, self-limiting respiratory infections mainly in children. However, over the past decade, EV-D68 has exhibited a biennial outbreak pattern across multiple regions worldwide, coinciding with an increased incidence of severe respiratory illnesses and cases of acute flaccid myelitis (AFM) in children. The immune system plays a crucial role in providing rapid and effective defense. Nonetheless, our knowledge of the complex interactions between EV-D68 and the host immune responses is still very limited. Additionally, clinical detection of EV-D68 remains challenging, and there are no FDA-approved vaccines or antiviral treatments available. Therefore, ongoing research should focus on understanding the pathogenic mechanisms of EV-D68, as well as the development of reliable diagnostic methods and therapeutic options to control EV-D68 spread. This review intends to examine the initiatives undertaken for clinical surveillance of EV-D68 outbreaks, the immune responses elicited by EV-D68, and its strategies for immune evasion. Additionally, it explores recent advancements in antiviral drug development, thereby providing a comprehensive overview of current knowledge and identifying prospective directions for future research.</jats:p>","journal":"Frontiers in Cellular and Infection Microbiology","year":2026,"id":647507,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":320661,"name":"Bing Han","orcid":"0000-0002-7299-2753","position":1,"is_corresponding":false},{"id":1687058,"name":"Jialong Wei","orcid":null,"position":2,"is_corresponding":false},{"id":1687059,"name":"Danlei Sun","orcid":null,"position":3,"is_corresponding":false},{"id":1687060,"name":"Laixian Zhou","orcid":null,"position":4,"is_corresponding":false},{"id":1687062,"name":"Shuchen Yuan","orcid":null,"position":5,"is_corresponding":false},{"id":1687063,"name":"Wenzhan Xie","orcid":null,"position":6,"is_corresponding":false},{"id":390278,"name":"Hui Feng","orcid":"0000-0001-6936-1734","position":7,"is_corresponding":false},{"id":1687057,"name":"Yanshan Gui","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Respiratory enterovirus D68: virology, clinical surveillance, host-pathogen interactions, and therapeutic prospects","abstract":"<jats:p>Enterovirus D68 (EV-D68), a unique enterovirus resembling human rhinoviruses, was long considered to cause only sporadic outbreaks of mild, self-limiting respiratory infections mainly in children. However, over the past decade, EV-D68 has exhibited a biennial outbreak pattern across multiple regions worldwide, coinciding with an increased incidence of severe respiratory illnesses and cases of acute flaccid myelitis (AFM) in children. The immune system plays a crucial role in providing rapid and effective defense. Nonetheless, our knowledge of the complex interactions between EV-D68 and the host immune responses is still very limited. Additionally, clinical detection of EV-D68 remains challenging, and there are no FDA-approved vaccines or antiviral treatments available. Therefore, ongoing research should focus on understanding the pathogenic mechanisms of EV-D68, as well as the development of reliable diagnostic methods and therapeutic options to control EV-D68 spread. This review intends to examine the initiatives undertaken for clinical surveillance of EV-D68 outbreaks, the immune responses elicited by EV-D68, and its strategies for immune evasion. Additionally, it explores recent advancements in antiviral drug development, thereby providing a comprehensive overview of current knowledge and identifying prospective directions for future research.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41868141","pmcid":"PMC12999577","openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://public-pages-files-2025.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2026.1774711/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fcimb.2026.1774711/full","host_type":"publisher"},{"url":"https://doaj.org/article/19bbe1debb4f4fceb9a6a772bf0d756b","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12999577/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12999577","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12999577?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":[],"mesh_terms":["Animals","Humans","Enterovirus D, Human","Respiratory Tract Infections","Central Nervous System Viral Diseases","Myelitis","Enterovirus Infections","Neuromuscular Diseases","Antiviral Agents","Disease Outbreaks","Host-Pathogen Interactions","Immune Evasion","Epidemiological Monitoring"],"keywords":["Immune response","Antivirals","Escape","Clinical Surveillance","Neurotropic Enterovirus"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T00:31:36.275077Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}