Similar cytokine profiles in response to infection with respiratory syncytial virus type a and type B in the upper respiratory tract in infants

Human respiratory syncytial virus (RSV) is the leading viral cause of severe respiratory illness in infants and young children worldwide. RSV isolates can be divided into 2 subgroups, type A and type B. Here, we compare for the first time the nasal profiles of 27 immune mediators in response to both viral subtypes in 14 children infected with RSV/A, 8 children infected with RSV/B, 11 children coinfected with RSV/A plus other respiratory viruses, and finally, 27 control children, all <2 years old. Our results evidence that children's infection with both RSV subtypes induces very similar profiles of immune mediators in the upper respiratory tract, characterized by the elevation of Th1 and Th2 cytokines, chemokines and growth factors. Interestingly, no major differences in the profiles of the immune mediators were found between the children infected exclusively with RSV/A and those infected with RSV/A plus other respiratory viruses.     

直接免疫荧光法对多种呼吸道病毒检测的临床意义

目的为临床提供一种快速诊断呼吸道病毒感染的方法。方法采用直接荧光免疫法检测呼吸道分泌物的合胞病毒、腺病毒、流感病毒A、流感病毒B及副流感病毒1、2、3型。结果对195例呼吸道感染者的鼻咽分泌物标本采用直接荧光免疫法进行病毒原检测，结果显示本地区病毒感染率为57．94％，病毒原以呼吸道合胞病毒为主，副流感病毒1、3型次之，感染以冬季好发。结论该法具有快速、简便、特异性高等优点，对确定临床呼吸道病毒感染是一种非常好的方法。直接荧光免疫法操作简便，费用较低，适合基层医院推广使用。     

儿童急性下呼吸道感染病毒感染的检测与分析

目的研究分析儿童急性下呼吸道感染病毒病原的构成特点。方法收集临床162例确诊急性下呼吸道感染病例的肺泡灌洗液,用试剂盒法进行病毒核酸提取和检测。结果162例急性下呼吸道感染病例中病毒感染阳性病例119例,阳性率73．5％。119例阳性病例中检出：流行性感冒病毒（IFV）3例、呼吸道合胞病毒（RSV）22例、腺病毒（ADV）4例、副流感病毒（PIV）46例、偏肺病毒（hMPV）17例、冠状病毒（COV）6例、博卡病毒（HBoV）20例。其中混合性感染47例,占29％,两种病毒混合感染38例,三种病毒混合感染8例,四种病毒混合感染1例。结论病毒是儿童急性下呼吸道感染的重要感染原因,患儿感染呈混合性感染趋势,两种病毒感染情况最多见。     

Enzyme immunoassay for respiratory syncytial virus: Rapid detection in nasopharyngeal secretions and evaluation of isolates representing different RSV subgroups

The presence of respiratory syncytial virus (RSV) was investigated by immunofluorescent antibody (IFA) technique and by an enzyme immunoassay (EIA) in 169 samples of nasopharyngeal secretions of infants and children with acute respiratory infections. Of 31 samples positive by EIA, 25 were positive by IFA. In 24 samples from a retrospective study, RSV positive by IFA and/or tissue culture isolation (TCI), 22 were also positive by EIA. The EIA was also evaluated with 111 RSV isolates in Hep2 cell cultures representing different RSV subgroups. All were positive by EIA. © 1993 Wiley-Liss, Inc.     

Interleukin-11: stimulation in vivo and in vitro by respiratory viruses and induction of airways hyperresponsiveness.

To address the role of IL-11 in viral airways dysfunction, we determined whether infectious agents that exacerbate asthma stimulate stromal cell IL-11 production, determined whether IL-11 could be detected at sites of viral infection and evaluated the effects of IL-11 on airway physiology. Respiratory syncytial virus (RSV), parainfluenza virus type 3 (PIV3), and rhinovirus (RV) 14 were potent stimulators while cytomegalovirus and adenovirus only weakly stimulated and herpes simplex virus type 2 and bacteria did not stimulate IL-11 elaboration. IL-11 was not detected or barely detected in nasal aspirates from children without, but was detected in aspirates from children with viral upper respiratory tract infections. The levels of IL-11 were highest in patients with clinically detectable wheezing. IL-11 also caused nonspecific airways hyperresponsiveness in BALB/c mice. These studies demonstrate that three major causes of viral-induced asthma, RSV, RV, and PIV, in contrast to other viruses and bacteria, share the ability to induce stromal cell IL-11 production. They also demonstrate that IL-11 can be detected in vivo during viral respiratory infections, that the presence of IL-11 correlates with clinical bronchospasm and that IL-11 is a potent inducer of airways hyperresponsiveness. IL-11 may be an important mediator in viral airways disorders.     

Evidence for a causal relationship between respiratory syncytial virus infection and asthma

Respiratory syncytial virus (RSV) infects all children early in life, is the most common cause of infant lower respiratory tract infections, and causes disease exacerbations in children with asthma. Episodes of lower respiratory tract infection in early life are associated with asthma development. Whether RSV infection early in life directly causes asthma or simply identifies infants who are genetically predisposed to develop subsequent wheezing is debatable. Recent studies suggest that these two explanations are not mutually exclusive, and are likely both important in asthma development. An open-label study of RSV immunoprophylaxis administered to preterm infants reduced recurrent wheezing by 50%. Clinical trials of infant RSV prevention, delay or severity reduction on the outcome of childhood asthma would confirm the causal relationship between RSV infection and asthma, and offer a primary prevention strategy.     

海岛地区婴幼儿呼吸道感染的病原学研究

目的 探讨海岛地区婴幼儿急性呼吸道感染的病毒病原.方法 采取211例急性呼吸道感染患儿的痰液做病毒检测.结果 病毒感染35例,其中呼吸道合胞病毒(RSV)感染20例(9.5%),流感病毒感染6例(2.8%),腺病毒9例(4-3%),副流感病毒Ⅲ型4例(1.9%),副流感病毒Ⅰ、Ⅱ型各2例(1%).结论 RSV感染仍是海岛婴幼儿急性呼吸道病毒感染最常见的病原,病毒病原的诊断可为临床诊断和治疗提供可靠的依据.     

Evidence for a causal relationship between respiratory syncytial virus infection and asthma

Respiratory syncytial virus (RSV) infects all children early in life, is the most common cause of infant lower respiratory tract infections, and causes disease exacerbations in children with asthma. Episodes of lower respiratory tract infection in early life are associated with asthma development. Whether RSV infection early in life directly causes asthma or simply identifies infants who are genetically predisposed to develop subsequent wheezing is debatable. Recent studies suggest that these two explanations are not mutually exclusive, and are likely both important in asthma development. An open-label study of RSV immunoprophylaxis administered to preterm infants reduced recurrent wheezing by 50%. Clinical trials of infant RSV prevention, delay or severity reduction on the outcome of childhood asthma would confirm the causal relationship between RSV infection and asthma, and offer a primary prevention strategy.     

A review of respiratory syncytial virus infection in infants and children

By the age of 2, nearly every child becomes infected with the respiratory syncytial virus (RSV), the most common cause of lower respiratory tract infections (RTIs) in infants and children. Yearly epidemics occur from October to May. Most infections are mild, producing nothing more than a cold, and can be managed at home. Some cases, however, are more severe, leading to bronchiolitis, pneumonitis, pneumonia, and even death.     

RFI-641, a potent respiratory syncytial virus inhibitor

Human respiratory syncytial virus (RSV), a paramyxovirus, is a major cause of acute upper and lower respiratory tract infections in infants, young children, and adults. RFI-641 is a novel anti-RSV agent with potent in vitro and in vivo activity. RFI-641 is active against both RSV type A and B strains. The viral specificity and the large therapeutic window of RFI-641 (>100-fold) indicate that the antiviral activity of the compound is not due to adverse effects on normal cells. The potent in vitro activity of RFI-641 can be translated to efficacy in vivo: RFI-641 is efficacious when administered prophylactically by the intranasal route in mice, cotton rats, and African green monkeys. RFI-641 is also efficacious when administered therapeutically (24 h postinfection) in the monkey model. Mechanism of action studies indicate that RFI-641 blocks viral F protein-mediated fusion and cell syncytium formation.     

个旧市儿童呼吸道感染常见病毒检测及分析

目的检测并分析个旧市儿童呼吸道病毒感染流行情况。方法采用直接免疫荧光法对2384例患儿进行RSV、FLUA、FLUB、PIV1、PIV2、PIV3、ADV病毒抗原检测,并分析结果。结果2384例呼吸道感染患儿中呼吸道病毒阳性353例,阳性率为14.81%。不同季度患儿的呼吸道病毒合计阳性率有显著差异(P<0.05),一季度和四季度的阳性率高于其他季度。不同季度患儿的RSV、FLUA、FLUB、PIV3阳性率有显著差异(P<0.05)。结论儿童RSV感染的阳性率最高,一季度和四季度是儿童呼吸道病毒感染高发期。     

兰州地区儿童呼吸道感染常见病毒和肺炎支原体检测及分析

目的 了解兰州地区儿童呼吸道感染常见病毒、肺炎支原体在不同季节、呼吸道疾病、年龄、性别方面的差异,为临床诊疗提供参考依据.方法 对2010年4月至2011年3月间确诊为急性呼吸道感染的768例住院患儿,采用直接酶联免疫吸附测定(ELISA)法检测7种常见病毒的IgM抗体即:呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感病毒( IFV)、副流感病毒(PIF)、艾柯病毒(ECHO)、柯萨奇病毒(COX)、EB病毒(EBV)又称人类疱疹病毒(HHV-4),并对其中509例进行肺炎支原体(MP) IgM抗体检测.结果 768例标本中阳性检出率44.5％ (342/768),其中RSV占阳性率的48.8％ (167/342),以1～3岁年龄组检出率最高为57.6％ (129/224).21例大叶性肺炎患儿进行MP-IgM抗体检测,其中42.9％ (9/21) MP-IgM抗体阳性.结论 病毒仍是兰州地区儿童呼吸道感染的主要病原,RSV最常见.MP是小儿呼吸道感染的常见病原之一,也是引起大叶性肺炎的主要病原.     

Viral infections of the respiratory tract in patients with cystic fibrosis

The role of viruses and bacteria in the development of respiratory tract infections causing acute deteriorations in lung function in patients with cystic fibrosis (CF) was investigated. Over a period of 30 months, 29 viral respiratory diseases were proven serologically by testing 275 sporadically collected sera from 75 patients with cystic fibrosis. The influenza A virus was the most frequent responsible viral pathogen (11 × ), followed by adenovirus (8 × ), influenza B virus (5 × ), parainfluenza virus type 3 (3 × ), parainfluenza virus type 1 and respiratory syncytial virus (RSV) (each of 1 × ). There was no serological evidence for infections with parainfluenza virus type 2, Mycoplasma pneumoniae or Coxiella burnetii. Deterioration of the clinical condition was found in 78% of the viral infections leading in 70% to hospital admission. Patients with cystic fibrosis and viral respiratory illnesses showed significantly more admissions to the hospital (3·2 ± 2·7) with a longer stay (90·6 ± 99·6 days). Nearly all viral episodes (93%) were accompanied or followed by a significant change of the microbial flora in the sputum especially by colonisation with Pseudomonas aeruginosa, Staphylococcus aureus and Haemophilus influenzae. Seventy-two per cent of the viral infections occurred at home and 28% seemed to be hospital acquired. Our study emphasises the importance of improving antibacterial therapy at home to reduce the number of hospital admissions. Efforts for prophylaxis by vaccination or the use of chemotherapeutic agents should be made for the patients with cystic fibrosis.     

Respiratory syncytial virus: disease, development and treatment

Respiratory syncytial virus (RSV) is spread by droplets and causes infections of the upper and lower respiratory tract. It is most common in infants, children under the age of five years and the elderly. Due to the nature of the transmission, infections with RSV are contagious but usually short lived. Pharmacological treatment involves the use of antiviral medication. Nurses caring for older people, infants or young children should be aware of the risk of transmission of RSV, pathogenesis and treatment options available to effectively manage the care of patients.     

Generation and Characterization of ALX-0171, a Potent Novel Therapeutic Nanobody for the Treatment of Respiratory Syncytial Virus Infection

Respiratory syncytial virus (RSV) is an important causative agent of lower respiratory tract infections in infants and elderly individuals. Its fusion (F) protein is critical for virus infection. It is targeted by several investigational antivirals and by palivizumab, a humanized monoclonal antibody used prophylactically in infants considered at high risk of severe RSV disease. ALX-0171 is a trimeric Nanobody that binds the antigenic site II of RSV F protein with subnanomolar affinity. ALX-0171 demonstrated in vitro neutralization superior to that of palivizumab against prototypic RSV subtype A and B strains. Moreover, ALX-0171 completely blocked replication to below the limit of detection for 87% of the viruses tested, whereas palivizumab did so for 18% of the viruses tested at a fixed concentration. Importantly, ALX-0171 was highly effective in reducing both nasal and lung RSV titers when delivered prophylactically or therapeutically directly to the lungs of cotton rats. ALX-0171 represents a potent novel antiviral compound with significant potential to treat RSV-mediated disease.     

2019年湖北省武汉市儿童呼吸道合胞病毒感染临床特征及流行病学分析

目的分析2019年湖北省武汉市呼吸道合胞病毒(RSV)引起儿童急性呼吸道感染(ARTI)的流行病学特征,总结其临床特点。方法收集2019年因ARTI在武汉儿童医院治疗的患儿鼻咽拭子标本。采用直接免疫荧光法检测样本中的RSV,根据临床资料进行流行病学分析。结果 2019年武汉市ARTI患儿中RSV阳性率为8.41%,不同年龄段患儿检出率差异有统计学意义(P<0.05),且RSV的检出率随患儿年龄增加而逐渐降低。男性患儿中的检出率高于女性患儿(P<0.05)。RSV在1-2、12月检出率最高,在5-7月检出率最低。患儿临床表现主要为咳嗽、发热、喘息。部分患儿可出现其他并发症,如肝功能异常、癫痫、心律失常、中耳炎等。RSV与其他呼吸道病毒的混合感染率为2.81%,主要为副流感病毒3型及腺病毒。结论 RSV是武汉市儿童ARTI的常见病原,流行时间为12月至次年2月,患儿年龄越小越容易被感染。RSV易与副流感病毒3型及腺病毒发生混合感染。     

Bench-to-bedside review: Rare and common viral infections in the intensive care unit – linking pathophysiology to clinical presentation

Viral infections are common causes of respiratory tract disease in the outpatient setting but much less common in the intensive care unit. However, a finite number of viral agents cause respiratory tract disease in the intensive care unit. Some viruses, such as influenza, respiratory syncytial virus (RSV), cytomegalovirus (CMV), and varicella-zoster virus (VZV), are relatively common. Others, such as adenovirus, severe acute respiratory syndrome (SARS)-coronavirus, Hantavirus, and the viral hemorrhagic fevers (VHFs), are rare but have an immense public health impact. Recognizing these viral etiologies becomes paramount in treatment, infection control, and public health measures. Therefore, a basic understanding of the pathogenesis of viral entry, replication, and host response is important for clinical diagnosis and initiating therapeutic options. This review discusses the basic pathophysiology leading to clinical presentations in a few common and rare, but important, viruses found in the intensive care unit: influenza, RSV, SARS, VZV, adenovirus, CMV, VHF, and Hantavirus.     

Bench-to-bedside review: rare and common viral infections in the intensive care unit--linking pathophysiology to clinical presentation

Viral infections are common causes of respiratory tract disease in the outpatient setting but much less common in the intensive care unit. However, a finite number of viral agents cause respiratory tract disease in the intensive care unit. Some viruses, such as influenza, respiratory syncytial virus (RSV), cytomegalovirus (CMV), and varicella-zoster virus (VZV), are relatively common. Others, such as adenovirus, severe acute respiratory syndrome (SARS)-coronavirus, Hantavirus, and the viral hemorrhagic fevers (VHFs), are rare but have an immense public health impact. Recognizing these viral etiologies becomes paramount in treatment, infection control, and public health measures. Therefore, a basic understanding of the pathogenesis of viral entry, replication, and host response is important for clinical diagnosis and initiating therapeutic options. This review discusses the basic pathophysiology leading to clinical presentations in a few common and rare, but important, viruses found in the intensive care unit: influenza, RSV, SARS, VZV, adenovirus, CMV, VHF, and Hantavirus.     

Bench-to-bedside review: Rare and common viral infections in the intensive care unit – linking pathophysiology to clinical presentation

Viral infections are common causes of respiratory tract disease in the outpatient setting but much less common in the intensive care unit. However, a finite number of viral agents cause respiratory tract disease in the intensive care unit. Some viruses, such as influenza, respiratory syncytial virus (RSV), cytomegalovirus (CMV), and varicella-zoster virus (VZV), are relatively common. Others, such as adenovirus, severe acute respiratory syndrome (SARS)-coronavirus, Hantavirus, and the viral hemorrhagic fevers (VHFs), are rare but have an immense public health impact. Recognizing these viral etiologies becomes paramount in treatment, infection control, and public health measures. Therefore, a basic understanding of the pathogenesis of viral entry, replication, and host response is important for clinical diagnosis and initiating therapeutic options. This review discusses the basic pathophysiology leading to clinical presentations in a few common and rare, but important, viruses found in the intensive care unit: influenza, RSV, SARS, VZV, adenovirus, CMV, VHF, and Hantavirus.