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Bonnin FA, Talarico LB, Ferolla FM, Acosta PL, Phung E, Kumar A, Toledano A, Caratozzolo A, Neira P, Mascardi N, Satragno D, Contrini MM, Graham BS, Ruckwardt TJ, López EL. Antibody levels against respiratory syncytial virus fusion protein conformations and lack of association with life-threatening infection in previously healthy infants. Vaccine 2024; 42:126119. [PMID: 39003106 PMCID: PMC11401757 DOI: 10.1016/j.vaccine.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/13/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Humoral immune response against the pre-fusion (pre-F) conformation of respiratory syncytial virus (RSV) F protein has been proposed to play a protective role against infection. An RSV pre-F maternal vaccine has been recently approved in several countries to protect young infants against RSV. We aimed to assess serum IgG titers against the pre-F and post-F conformations of RSV F protein and their association with life-threatening RSV disease (LTD) in previously healthy infants. METHODS A prospective cohort study including hospitalized infants <12 months with a first RSV infection was conducted during 2017-2019. Patients with LTD required intensive care and mechanical respiratory assistance. RSV pre-F exclusive and post-F antibody responses were determined by post-F competition and non-competition immunoassays, respectively, and neutralizing activity was measured by plaque reduction neutralization test. RESULTS Fifty-eight patients were included; the median age was 3.5 months and 41 % were females. Fifteen patients developed LTD. RSV F-specific antibody titers positively correlated with neutralizing antibody titers in acute and convalescent phases but, importantly, they did not associate with LTD. Acute RSV pre-F exclusive and post-F IgG titers negatively correlated with patient age (P = 0.0007 and P < 0.0001), while a positive correlation was observed between the fold changes in RSV F-specific antibody titers between convalescent and acute phase and patient age (P = 0.0014 and P < 0.0001). Infants ≤2 months exhibited significantly lower fold-changes in RSV F-specific and neutralizing antibody titers between convalescence and acute phase than older infants. Additionally, acute RSV antibody titers showed no correlation with nasal RSV load and, furthermore, nasal viral load was not associated with the development of LTD. CONCLUSIONS This study highlights that protection against life-threatening RSV disease is not necessarily antibody-dependent. Further characterization of the immune response against RSV and its role in protection against severe disease is important for the development of the safest possible preventive strategies.
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Affiliation(s)
- Florencia A Bonnin
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina; Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Química Biológica, Buenos Aires 1428, Argentina
| | - Laura B Talarico
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1425, Argentina.
| | - Fausto M Ferolla
- Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires 1425, Argentina
| | - Patricio L Acosta
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1425, Argentina
| | - Emily Phung
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Azad Kumar
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Analía Toledano
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Ana Caratozzolo
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Pablo Neira
- Intensive Care Unit, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Normando Mascardi
- Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Daniela Satragno
- Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - María M Contrini
- Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires 1425, Argentina
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Tracy J Ruckwardt
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eduardo L López
- Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires 1425, Argentina.
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Davy K, Koskinas E, Watson C, Ledwidge M, Mbakaya B, Chisale M, Gallagher J. Respiratory syncytial virus-associated pneumonia in primary care in Malawi. J Trop Pediatr 2024; 70:fmae013. [PMID: 39025514 PMCID: PMC11257717 DOI: 10.1093/tropej/fmae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
OBJECTIVE To identify the prevalence of respiratory syncytial virus (RSV) in a cohort of children under 5 years of age with World Health Organization (WHO)-defined pneumonia and the factors associated with developing severe RSV-associated community-acquired pneumonia (CAP) in primary care in a single centre in Northern Malawi. METHODS The BIOmarkers TO diagnose PnEumonia (BIOTOPE) study was a prospective cohort study conducted from March to June 2016 that took place in a primary care centre in Northern Malawi. Data from this study was used to identify the characteristics of children under 5 years of age who presented with RSV and WHO-defined CAP. Means, standard deviations, medians and ranges were calculated for continuous variables. A univariate logistic regression was performed to examine the potential predictor variables. RESULTS Four hundred and ninety-four infants presented with CAP and were eligible for inclusion in the study; RSV infection was detected in 205 (41.6%) of the infants. Eight factors were associated with increased risk for RSV CAP in the univariate model: age, born at term, presenting for care in June, crowded living environment, not being exclusively breastfed, not having received zinc or vitamin A supplementation in the last six months. Infants with RSV were more likely to have an oxygen saturation ≤92% compared to infants with other causes of pneumonia and more likely to have severe pneumonia as defined by the WHO. CONCLUSION This study supports that RSV-associated CAP is linked to modifiable and non-modifiable risk factors; further research is indicated to determine which interventions would be most impactful. Developing and implementing an infant or maternal vaccine could be a cost-effective way to prevent RSV-associated CAP and mortality in developing nations. More research is needed to understand seasonal patterns of CAP and research over extended periods can offer valuable insights on host, environmental and pathogen-specific factors that contribute to RSV-associated CAP.
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Affiliation(s)
- Kimberly Davy
- School of Medicine, University of Limerick, Limerick V94 T9PX, Ireland
| | - Elena Koskinas
- School of Medicine, University of Limerick, Limerick V94 T9PX, Ireland
| | - Chris Watson
- Medicine, Health and Life Sciences, Queen’s University Belfast Wellcome-Wolfson Institute for Experimental Medicine, Belfast BT9 7BL, UK
| | - Mark Ledwidge
- School of Medicine, University College Dublin, Dublin D04 C1P1, Ireland
| | - Balwani Mbakaya
- Department of Public Health, University of Livingstonia, Mzuzu P.O. 112, Malawi
| | - Master Chisale
- Biological Science Department, Faculty of Science Technology and Innovations, Mzuzu University, Mzuzu, P / Bag 20, Malawi
| | - Joe Gallagher
- Department of General Practice, University College Dublin, University College Dublin, Dublin, Belfield, Dublin 4, D04 C1P1, Ireland
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Feng Y, He T, Zhang B, Yuan H, Zhou Y. Epidemiology and diagnosis technologies of human metapneumovirus in China: a mini review. Virol J 2024; 21:59. [PMID: 38454484 PMCID: PMC10921660 DOI: 10.1186/s12985-024-02327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
Human metapneumovirus (HMPV) is a newly identified pathogen causing acute respiratory tract infections in young infants worldwide. Since the initial document of HMPV infection in China in 2003, Chinese scientists have made lots of efforts to prevent and control this disease, including developing diagnosis methods, vaccines and antiviral agents against HMPV, as well as conducting epidemiological investigations. However, effective vaccines or special antiviral agents against HMPV are currently not approved, thus developing early diagnosis methods and knowing its epidemiological characteristics will be beneficial for HMPV control. Here, we summarized current research focused on the epidemiological characteristics of HMPV in China and its available detection methods, which will be beneficial to increase the public awareness and disease control in the future.
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Affiliation(s)
- Yuan Feng
- Xiangtan Central Hospital, Xiangtan, 411100, Hunan, China
| | - Tao He
- Xiangtan Maternal and Child Health Hospital, Xiangtan, 411100, China
| | - Bo Zhang
- Xiangtan Central Hospital, Xiangtan, 411100, Hunan, China
| | - Haibin Yuan
- Xiangtan Central Hospital, Xiangtan, 411100, Hunan, China
| | - Yinfei Zhou
- Xiangtan Central Hospital, Xiangtan, 411100, Hunan, China.
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Lamichhane J, Upreti M, Nepal K, Upadhyay BP, Maharjan U, Shrestha RK, Chapagain RH, Banjara MR, Shrestha UT. Burden of human metapneumovirus infections among children with acute respiratory tract infections attending a Tertiary Care Hospital, Kathmandu. BMC Pediatr 2023; 23:388. [PMID: 37550689 PMCID: PMC10405573 DOI: 10.1186/s12887-023-04208-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) are one of the most common causes of mortality and morbidity worldwide. Every year millions of children suffer from viral respiratory tract infections (RTIs) ranging from mild to severe illnesses. Human Metapneumovirus (HMPV) is among the most frequent viruses responsible for RTIs. However, HMPV infections and their severity among children have not been explored yet in Nepal. PURPOSE Therefore, the study was focused on HMPV infections and other potential viral etiologies or co-infections using multiplex PCR among children attending Kanti Children's Hospital and assessed the clinical characteristics of the infections as well as found the co-infections. A hospital-based cross-sectional study was designed and a convenience sampling method was used to enroll children of less than 15 years with flu-like symptoms from both outpatients and inpatients departments over three months of the study period. RESULTS HMPV infection (13.3%) was the most predominant infection among the different viral infections in children with ARIs in Kanti Children's Hospital. The HMPV was more prevalent in the age group less than three years (21.8%). Cough and fever were the most common clinical features present in all children infected with HMPV followed by rhinorrhea, sore throat, and wheezing. HMPV-positive children were diagnosed with pneumonia (42.9%), bronchiolitis (28.5%), upper respiratory tract infections (14.3%), and asthma (14.3%). The prevalence of HMPV was high in late winter (14.3%) followed by early spring (13.5%). CONCLUSIONS This study provides the baseline information on HMPV and associated co-infection with other respiratory viruses for the differential diagnosis based on molecular methods and also the comparison of clinical presentations among the different respiratory syndromes.
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Affiliation(s)
- Jyoti Lamichhane
- GoldenGate International College, Battisputali, Kathmandu, Nepal
| | - Milan Upreti
- GoldenGate International College, Battisputali, Kathmandu, Nepal
| | - Krishus Nepal
- GoldenGate International College, Battisputali, Kathmandu, Nepal
| | | | - Urusha Maharjan
- Central Diagnostic Laboratory & Research Center, Kamalpokhari, Kathmandu, Nepal
| | | | | | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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Fontes V, Ferreira H, Ribeiro M, Pinheiro A, Maramaldo C, Pereira E, Batista L, Júnior A, Lobato L, Silva F, Sousa L, Lima W, Lima C, Soczek S, Carvalho R, Santos M, Fernandes E, Sousa E, Neto L. High Incidence of Respiratory Syncytial Virus in Children with Community-Acquired Pneumonia from a City in the Brazilian Pre-Amazon Region. Viruses 2023; 15:1306. [PMID: 37376604 PMCID: PMC10305439 DOI: 10.3390/v15061306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Although fewer children have been affected by the severe form of the coronavirus disease 2019 (COVID-19), community-acquired pneumonia (CAP) continues to be the leading global cause of child hospitalizations and deaths. AIM This study investigated the incidence of respiratory syncytial virus (RSV) as well its subtypes (RSV A and B), adenovirus (ADV), rhinovirus (HRV), metapneumovirus (HMPV), coronavirus (NL63, OC43, 229E and HKU1), parainfluenza virus subtypes (PI1, PI2 and PI3), bocavirus and influenza A and B viruses (FluA and FluB) in children diagnosed with CAP during the COVID-19 pandemic. METHODS A total of 200 children with clinically confirmed CAP were initially recruited, of whom 107 had negative qPCR results for SARS-CoV-2 and were included in this study. Viral subtypes were identified using a real-time polymerase chain reaction in the nasopharyngeal swab samples. RESULTS Viruses were identified in 69.2% of the patients. RSV infections were the most frequently identified (65.4%), with type RSV B being the most prevalent (63.5%). In addition, HCoV 229E and HRV were detected in 6.5% and 3.7% of the patients, respectively. RSV type B was associated with severe acute respiratory infection (ARI) and a younger age (less than 24 months). CONCLUSIONS New strategies for preventing and treating viral respiratory infections, particularly RSV infections, are necessary.
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Affiliation(s)
- Valéria Fontes
- Laboratory of Virology, Post-Graduate Programme in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
| | - Hivylla Ferreira
- Central Public Health Laboratory of Maranhão—LACEN-MA, Osvaldo Cruz Institute, São Luís, MA 65020-904, Brazil
| | - Marilene Ribeiro
- Hospital of Federal University of Maranhão, HU-UFMA, São Luís, MA 65020-070, Brazil
| | - Aruanã Pinheiro
- Postdoctoral Program in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
| | - Carlos Maramaldo
- Central Public Health Laboratory of Maranhão—LACEN-MA, Osvaldo Cruz Institute, São Luís, MA 65020-904, Brazil
| | - Eduardo Pereira
- Laboratory of Virology, Post-Graduate Programme in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
| | - Luís Batista
- Postgraduate Program in Adult Health (PPGSAD), Federal University of Maranhão, UFMA, São Luís, MA 65080-805, Brazil
| | - Antonio Júnior
- Postgraduate Program in Adult Health (PPGSAD), Federal University of Maranhão, UFMA, São Luís, MA 65080-805, Brazil
| | - Luis Lobato
- Central Public Health Laboratory of Maranhão—LACEN-MA, Osvaldo Cruz Institute, São Luís, MA 65020-904, Brazil
- Post-Graduate Programme in Tropical Medicine, FIOCRUZ-RJ, Rio de Janeiro, RJ 21040-360, Brazil
| | - Fabiano Silva
- Central Public Health Laboratory of Maranhão—LACEN-MA, Osvaldo Cruz Institute, São Luís, MA 65020-904, Brazil
- Post-Graduate Programme in Tropical Medicine, FIOCRUZ-RJ, Rio de Janeiro, RJ 21040-360, Brazil
| | - Luis Sousa
- Laboratory of Virology, Post-Graduate Programme in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
- Central Public Health Laboratory of Maranhão—LACEN-MA, Osvaldo Cruz Institute, São Luís, MA 65020-904, Brazil
| | - Washington Lima
- Post-Graduate Programme in Biodiversity and Biotechnology (BIONORTE), CEUMA University, São Luís, MA 65075-120, Brazil
| | - Claudia Lima
- Laboratory of Virology, Post-Graduate Programme in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
| | - Suzany Soczek
- Post-Graduate Programme in Biotechnology Applied to Child and Adolescent Health, Pelé Pequeno Príncipe Research Institute, Curitiba, PR 80250-060, Brazil
| | - Rafael Carvalho
- Postgraduate Program in Adult Health (PPGSAD), Federal University of Maranhão, UFMA, São Luís, MA 65080-805, Brazil
| | | | - Elizabeth Fernandes
- Post-Graduate Programme in Biotechnology Applied to Child and Adolescent Health, Pelé Pequeno Príncipe Research Institute, Curitiba, PR 80250-060, Brazil
| | - Eduardo Sousa
- Laboratory of Virology, Post-Graduate Programme in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
- Postgraduate Program in Adult Health (PPGSAD), Federal University of Maranhão, UFMA, São Luís, MA 65080-805, Brazil
| | - Lidio Neto
- Laboratory of Virology, Post-Graduate Programme in Microbial Biology, CEUMA University, São Luís, MA 65075-120, Brazil
- Central Public Health Laboratory of Maranhão—LACEN-MA, Osvaldo Cruz Institute, São Luís, MA 65020-904, Brazil
- Post-Graduate Programme in Biodiversity and Biotechnology (BIONORTE), CEUMA University, São Luís, MA 65075-120, Brazil
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Noffel Z, Dobrovolny HM. Quantifying the effect of defective viral genomes in respiratory syncytial virus infections. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:12666-12681. [PMID: 37501460 DOI: 10.3934/mbe.2023564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Defective viral genomes (DVGs) are viral genomes that contain only a partial viral RNA and so cannot replicate within cells on their own. If a cell containing DVGs is subsequently infected with a complete viral genome, the DVG can then use the missing proteins expressed by the full genome in order to replicate itself. Since the cell is producing defective genomes, it has less resources to produce fully functional virions and thus release of complete virions is often suppressed. Here, we use data from challenge studies of respiratory syncytial virus (RSV) in healthy adults to quantify the effect of DVGs. We use a mathematical model to fit the data, finding that late onset of DVGs and prolonged DVG detection are associated with lower infection rates and higher clearance rates. This result could have implications for the use of DVGs as a therapeutic.
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Affiliation(s)
- Zakarya Noffel
- Department of Computer Science, University of Texas at Austin, Austin, TX, US
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, US
| | - Hana M Dobrovolny
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, US
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Piccirilli G, Rocca A, Borgatti EC, Gabrielli L, Zama D, Pierantoni L, Leone M, Totaro C, Pavoni M, Lazzarotto T, Lanari M. Respiratory Syncytial Virus-Load Kinetics and Clinical Course of Acute Bronchiolitis in Hospitalized Infants: Interim Results and Review of the Literature. Pathogens 2023; 12:pathogens12050645. [PMID: 37242316 DOI: 10.3390/pathogens12050645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Respiratory Syncytial Virus (RSV) bronchiolitis is the leading cause of hospitalization in infants. The role of RSV load in disease severity is still debated. We present the interim results of a prospective monocentric study enrolling previously healthy infants hospitalized for RSV bronchiolitis, collecting nasopharyngeal aspirates every 48 h from admission to discharge, and evaluating RSV load dynamics in relation to clinical outcome measures of bronchiolitis severity, including: need, type and duration of oxygen therapy, length of hospitalization, and the bronchiolitis clinical score calculated at admission. The results showed that the highest viral replication occurs within the first 48 hours after admission, with a significant decrease at subsequent time points (p < 0.0001). Moreover, higher RSV-RNA values were associated with the need for oxygen therapy (p = 0.03), particularly high-flow nasal cannula type (p = 0.04), and longer duration of respiratory support (p = 0.04). Finally, higher RSV load values were correlated with lower white blood cells, especially lymphocyte counts and C-reactive protein levels (p = 0.03, p = 0.04, and p = 0.01, respectively), as well as with patients of a younger age (p = 0.02). These data suggest that RSV may actively contribute to the clinical severity of bronchiolitis, together with other potential non-viral factors.
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Affiliation(s)
- Giulia Piccirilli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Alessandro Rocca
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Eva Caterina Borgatti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Liliana Gabrielli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Marta Leone
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Camilla Totaro
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Matteo Pavoni
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Tiziana Lazzarotto
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
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Rodríguez-Guilarte L, Ramírez MA, Andrade CA, Kalergis AM. LAG-3 Contribution to T Cell Downmodulation during Acute Respiratory Viral Infections. Viruses 2023; 15:147. [PMID: 36680187 PMCID: PMC9865459 DOI: 10.3390/v15010147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023] Open
Abstract
LAG-3 is a type I transmembrane protein expressed on immune cells, such as activated T cells, and binds to MHC class II with high affinity. LAG-3 is an inhibitory receptor, and its multiple biological activities on T cell activation and effector functions play a regulatory role in the immune response. Immunotherapies directed at immune checkpoints, including LAG-3, have become a promising strategy for controlling malignant tumors and chronic viral diseases. Several studies have suggested an association between the expression of LAG-3 with an inadequate immune response during respiratory viral infections and the susceptibility to reinfections, which might be a consequence of the inhibition of T cell effector functions. However, important information relative to therapeutic potential during acute viral lower respiratory tract infections and the mechanism of action of the LAG-3 checkpoint remains to be characterized. In this article, we discuss the contribution of LAG-3 to the impairment of T cells during viral respiratory infections. Understanding the host immune response to respiratory infections is crucial for developing effective vaccines and therapies.
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Affiliation(s)
- Linmar Rodríguez-Guilarte
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Mario A. Ramírez
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Catalina A. Andrade
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Alexis M. Kalergis
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
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Waller H, Carmona-Vicente N, James A, Govender M, Hopkins FR, Larsson M, Hagbom M, Svensson L, Enocsson H, Gustafsson A, Nilsdotter-Augustinsson Å, Sjöwall J, Nordgren J. Viral load at hospitalization is an independent predictor of severe COVID-19. Eur J Clin Invest 2023; 53:e13882. [PMID: 36190270 PMCID: PMC9874715 DOI: 10.1111/eci.13882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Hjalmar Waller
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Noelia Carmona-Vicente
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Axel James
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Melissa Govender
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Francis R Hopkins
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Marie Larsson
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Marie Hagbom
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lennart Svensson
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Division of Infectious Diseases, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Helena Enocsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Annette Gustafsson
- Department of Infectious Diseases, Vrinnevi Hospital, Norrköping, Sweden
| | - Åsa Nilsdotter-Augustinsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Johanna Sjöwall
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Infectious Diseases, Vrinnevi Hospital, Norrköping, Sweden
| | - Johan Nordgren
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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10
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Papan C, Argentiero A, Adams O, Porwoll M, Hakim U, Farinelli E, Testa I, Pasticci MB, Mezzetti D, Perruccio K, Simon A, Liese JG, Knuf M, Stein M, Yacobov R, Bamberger E, Schneider S, Esposito S, Tenenbaum T. Association of viral load with TRAIL, IP-10, CRP biomarker signature and disease severity in children with respiratory tract infection or fever without source: A prospective, multicentre cohort study. J Med Virol 2023; 95:e28113. [PMID: 36043485 DOI: 10.1002/jmv.28113] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND To investigate the association of viral load (VL) with (i) tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10, C-reactive protein, and a combinatorial score (BV score), and (ii) clinical severity. STUDY DESIGN In this prospective, multicentre cohort substudy, children with respiratory tract infection or fever without source were enrolled. VL for influenza virus, rhinovirus, respiratory syncytial virus, and adenovirus was measured from nasopharyngeal swabs. The reference standard diagnosis was established based on expert panel adjudication. RESULTS Of 1140 recruited patients, 333 had a virus monodetection. VL for the aggregated data set correlated with TRAIL and IP-10 levels, with the length of oxygen therapy, and inversely with the BV score. At a single viral level, only the influenza VL yielded a correlation with TRAIL, IP-10 levels, and the BV score. Children with a viral reference standard diagnosis had significantly higher VL than those with bacterial infection (p = 0.0005). Low TRAIL (incidence rate ratio [IRR] 0.6, 95% confidence interval [CI] 0.39-0.91) and young age (IRR 0.62, 95% CI 0.49-0.79) were associated with a longer hospital stay, while young age (IRR 0.33, 95% CI 0.18-0.61), low TRAIL (IRR 0.25, 95% CI 0.08-0.76), and high VL (IRR 1.16, 95% CI 1.00-1.33) were predictive of longer oxygen therapy. CONCLUSION These findings indicate that VL correlates with biomarkers and may serve as a complementary tool pertaining to disease severity.
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Affiliation(s)
- Cihan Papan
- Paediatric Infectious Diseases, Department of Paediatrics, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany.,Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Alberto Argentiero
- Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, Università degli Studi di Perugia, Perugia, Italy
| | - Ortwin Adams
- Institute of Virology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Marian Porwoll
- Paediatric Infectious Diseases, Department of Paediatrics, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Ummaya Hakim
- Paediatric Infectious Diseases, Department of Paediatrics, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Edoardo Farinelli
- Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, Università degli Studi di Perugia, Perugia, Italy
| | - Ilaria Testa
- Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, Università degli Studi di Perugia, Perugia, Italy
| | - Maria B Pasticci
- Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, Università degli Studi di Perugia, Perugia, Italy
| | - Daniele Mezzetti
- Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, Università degli Studi di Perugia, Perugia, Italy
| | - Katia Perruccio
- Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, Università degli Studi di Perugia, Perugia, Italy
| | - Arne Simon
- Department of Paediatric Oncology and Haematology, Saarland University Hospital, Homburg, Germany
| | - Johannes G Liese
- Department of Paediatrics, University of Würzburg, Würzburg, Germany
| | - Markus Knuf
- Department of Paediatrics, Children's Hospital, Helios Dr. Horst Schmidt Klinik, Wiesbaden, Germany.,Department of Paediatrics, University Medicine, Mainz, Germany
| | | | | | - Ellen Bamberger
- Technion-Israel Institute of Technology, Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.,Department of Paediatrics, Bnai-Zion Medical Center, Haifa, Israel
| | - Sven Schneider
- Institute for Clinical Chemistry, University of Heidelberg, Mannheim, Germany
| | - Susanna Esposito
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - Tobias Tenenbaum
- Paediatric Infectious Diseases, Department of Paediatrics, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany.,Clinic for Child and Adolescent Medicine, Sana Klinikum Lichtenberg, Academic Teaching Hospital, Charité-Universitätsmedizin, Berlin, Germany
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11
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Molecular detection and genetic characterization of human metapneumovirus strains circulating in Islamabad, Pakistan. Sci Rep 2022; 12:2790. [PMID: 35181674 PMCID: PMC8857187 DOI: 10.1038/s41598-022-06537-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022] Open
Abstract
Lower respiratory illness is one of the leading causes of death among children in low- and high-income countries. Human metapneumovirus (hMPV) is a key contributor to respiratory illnesses commonly reported among children and causes serious clinical complications ranging from mild respiratory infections to severe lower respiratory tract anomalies mainly in the form of bronchiolitis and pneumonia. However, due to the lack of a national surveillance system, the clinical significance of hMPV remains obscure in the Pakistani population. This study was conducted to screen throat swabs samples collected from 127 children reported with respiratory symptoms at a tertiary care hospital in Islamabad. Out of 127, 21 (16.5%) samples were positive for hMPV with its genotype distribution as A2a (10%), A2b (20%), B1 (10%), and B2 (60%). Phylogenetic analysis showed that the hMPV viruses were closely related to those reported from neighboring countries including India and China. This work will contribute to a better understanding of this virus, its diagnosis, and the handling of patients in clinical setups. Further studies at a large-scale are warranted for a better understanding of the disease burden and epidemiology of hMPV in Pakistan.
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12
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Tang JW, Tellier R, Li Y. Hypothesis: All respiratory viruses (including SARS-CoV-2) are aerosol-transmitted. INDOOR AIR 2022; 32:e12937. [PMID: 35104003 DOI: 10.1111/ina.12937] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/22/2021] [Indexed: 06/14/2023]
Abstract
The potential role of aerosol transmission for seasonal respiratory viruses has been dramatically highlighted during the ongoing COVID-19 pandemic. It is now evident that short-range (conversational) and long-range aerosol transmission plays at least some part in how all these respiratory viruses are transmitted between people. This article highlights and discusses various studies that form the basis for this hypothesis.
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Affiliation(s)
- Julian W Tang
- Clinical Microbiology, Leicester Royal Infirmary, Leicester, UK
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - Raymond Tellier
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong, China
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13
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Ademhan Tural D, Yalcin E, Emiralioglu N, Ozsezen B, Alp A, Sunman B, Gozmen O, Dogru D, Ozcelik U, Kiper N. Human bocavirus and human metapneumovirus in children with lower respiratory tract infections: Effects on clinical, microbiological features and disease severity . Pediatr Int 2022; 64:e15102. [PMID: 35616205 DOI: 10.1111/ped.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/10/2021] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND We aimed to compare the clinical findings of human bocavirus (HBoV) and human metapneumovirus (HMPV) infections, and to analyze the effects of coinfections on clinical features and disease severity in children with HBoV and HMPV infections. METHODS Data were collected from 125 children with lower respiratory tract infections due to HBoV or HMPV, detected from nasal swap by real-time polymerase chain reaction (PCR) during the period from January, 2013 to December, 2017. In total, there were 101 HBoV (group 1) and 23 HMPV (group 2) infections in our data. The patients were further divided into four subgroups according to the coinfection status: HoBV only (subgroup 1, n = 41), HMPV only (subgroup 2, n = 19), HBoV and coinfection with other respiratory viruses (subgroup 3, n = 60), and HMPV and coinfection with other respiratory viruses (subgroup 4, n = 4). RESULTS The majority (88.8%) of the patients were aged 5 years or younger. Coinfections with other respiratory viruses were significantly more common in group 1 (P = 0.001). Among patients who had nosocomial pneumonia, patients with HBoV infections had significantly longer mean length of hospital stay (LOS) than those with HMPV infections (P = 0.032). The hospitalization and antibiotic requirements were significantly higher in subgroup 1 than subgroup 3 (P = 0.005, 0.039, resp.) According to the logistic regression analyses, the LOS increased by 21.7 times with HBoV infections (P = 0.006). CONCLUSIONS Human bocavirus and HMPV infections are serious pathogens mostly seen in children and usually requiring hospitalization regardless of co-infection status. The HBoV infections caused longer LOS than the HMPV infections in patients with nosocomial infections.
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Affiliation(s)
- Dilber Ademhan Tural
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Ebru Yalcin
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Nagehan Emiralioglu
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Beste Ozsezen
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Alpaslan Alp
- Department of Medical Microbiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Birce Sunman
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Onur Gozmen
- Department of Pediatrics, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Deniz Dogru
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Ugur Ozcelik
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Nural Kiper
- Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey
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14
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Analysis of the Effect of Nursing Intervention on Children with Respiratory Tract Infection Based on Comprehensive Nursing. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6923823. [PMID: 34567486 PMCID: PMC8460361 DOI: 10.1155/2021/6923823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/15/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
Recurrent respiratory tract infections in children are common. It means that children are repeatedly exposed to external pathogens within a certain time, and the clinical symptoms are reciprocating. This article carries out nursing intervention on children's respiratory tract infection through comprehensive nursing methods and analyzes the intervention effect. Moreover, this paper uses a controlled trial to study the nursing methods of recurrent respiratory tract infections in children. In addition, this paper determines and screens test samples according to relevant standards, conducts different nursing methods on samples of different groups, and compares them with the same indicators. Finally, this paper combines mathematical statistics to make statistics of experimental results and draws tables and statistical graphs. By comparing multiple parameters, it can be seen that the comprehensive nursing intervention has a good effect on the nursing of children with respiratory tract infection compared with the traditional nursing intervention, so this nursing method can be expanded in the future.
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15
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Bouzid D, Vila J, Hansen G, Manissero D, Pareja J, Rao SN, Visseaux B. Systematic review on the association between respiratory virus real-time PCR cycle threshold values and clinical presentation or outcomes. J Antimicrob Chemother 2021; 76:iii33-iii49. [PMID: 34555159 PMCID: PMC8460103 DOI: 10.1093/jac/dkab246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objectives It is unclear whether real-time (rt)-PCR cycle threshold (Ct) values can be utilized to guide clinical and infection-control decisions. This systematic review assesses the association between respiratory pathogen rt-PCR Ct values and clinical presentation or outcomes. Methods We searched MEDLINE, EMBASE and Cochrane library databases on 14–17 January 2020 for studies reporting the presence or absence of an association between Ct values and clinical presentation or outcomes, excluding animal studies, reviews, meta-analyses, and non-English language studies. Results Among 33 studies identified (reporting on between 9 and 4918 participants by pathogen), influenza (n = 11 studies; 4918 participants), human rhinovirus (HRV, n = 11; 2012) and respiratory syncytial virus (RSV, n = 8; 3290) were the most-studied pathogens. Low influenza Ct values were associated with mortality in 1/3 studies, with increased disease severity/duration or ICU admission in 3/9, and with increased hospitalization or length of hospital stay (LOS) in 1/6. Low HRV Ct values were associated with increased disease severity/duration or ICU admission in 3/10 studies, and with increased hospitalization or LOS in 1/3. Low RSV Ct values were associated with increased disease severity/duration or ICU admission in 3/6 studies, and with increased hospitalization or LOS in 4/4. Contradictory associations were also identified for other respiratory pathogens. Conclusions Respiratory infection Ct values may inform clinical and infection-control decisions. However, the study heterogeneity observed in this review highlights the need for standardized workflows to utilize Ct values as a proxy of genomic load and confirm their value for respiratory infection management.
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Affiliation(s)
- Donia Bouzid
- Université de Paris, IAME, INSERM, Paris, France.,Université de Paris, Service d'Accueil des Urgences, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jordi Vila
- Department of Clinical Microbiology, Biomedical Diagnostic Centre, Hospital Clinic, School of Medicine, University of Barcelona, Institute of Global Health, Barcelona, Spain
| | - Glen Hansen
- Microbiology and Molecular Diagnostics, Hennepin County Medical Center, Department of Infectious Diseases, University of Minnesota School of Medicine, Minneapolis, MN, USA.,Department of Pathology & Laboratory Medicine, University of Minnesota, School of Medicine, Minneapolis, MN, USA
| | | | - Josep Pareja
- STAT-Dx Life, S.L. (a QIAGEN Company), Medical Affairs, Barcelona, Spain
| | - Sonia N Rao
- QIAGEN Inc., Medical Affairs, Germantown, MD, USA
| | - Benoit Visseaux
- Université de Paris, IAME, INSERM, Paris, France.,Université de Paris, Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
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16
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Wang L, Chu CY, McCall MN, Slaunwhite C, Holden-Wiltse J, Corbett A, Falsey AR, Topham DJ, Caserta MT, Mariani TJ, Walsh EE, Qiu X. Airway gene-expression classifiers for respiratory syncytial virus (RSV) disease severity in infants. BMC Med Genomics 2021; 14:57. [PMID: 33632195 PMCID: PMC7908785 DOI: 10.1186/s12920-021-00913-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/19/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A substantial number of infants infected with RSV develop severe symptoms requiring hospitalization. We currently lack accurate biomarkers that are associated with severe illness. METHOD We defined airway gene expression profiles based on RNA sequencing from nasal brush samples from 106 full-tem previously healthy RSV infected subjects during acute infection (day 1-10 of illness) and convalescence stage (day 28 of illness). All subjects were assigned a clinical illness severity score (GRSS). Using AIC-based model selection, we built a sparse linear correlate of GRSS based on 41 genes (NGSS1). We also built an alternate model based upon 13 genes associated with severe infection acutely but displaying stable expression over time (NGSS2). RESULTS NGSS1 is strongly correlated with the disease severity, demonstrating a naïve correlation (ρ) of ρ = 0.935 and cross-validated correlation of 0.813. As a binary classifier (mild versus severe), NGSS1 correctly classifies disease severity in 89.6% of the subjects following cross-validation. NGSS2 has slightly less, but comparable, accuracy with a cross-validated correlation of 0.741 and classification accuracy of 84.0%. CONCLUSION Airway gene expression patterns, obtained following a minimally-invasive procedure, have potential utility for development of clinically useful biomarkers that correlate with disease severity in primary RSV infection.
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Affiliation(s)
- Lu Wang
- Department of Biostatistics and Computational Biology, University of Rochester School Medicine, Rochester, NY, USA
| | - Chin-Yi Chu
- Department of Pediatrics, University of Rochester School Medicine, Rochester, NY, USA
| | - Matthew N McCall
- Department of Biostatistics and Computational Biology, University of Rochester School Medicine, Rochester, NY, USA
| | | | - Jeanne Holden-Wiltse
- Department of Biostatistics and Computational Biology, University of Rochester School Medicine, Rochester, NY, USA
| | - Anthony Corbett
- Department of Biostatistics and Computational Biology, University of Rochester School Medicine, Rochester, NY, USA
| | - Ann R Falsey
- Department of Medicine, University of Rochester School Medicine, Rochester, NY, USA
- Department of Medicine, Rochester General Hospital, Rochester, NY, USA
| | - David J Topham
- Department of Microbiology and Immunology, University of Rochester School Medicine, Rochester, NY, USA
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester School Medicine, Rochester, NY, USA
| | - Thomas J Mariani
- Department of Pediatrics, University of Rochester School Medicine, Rochester, NY, USA.
| | - Edward E Walsh
- Department of Medicine, University of Rochester School Medicine, Rochester, NY, USA.
- Department of Medicine, Rochester General Hospital, Rochester, NY, USA.
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester School Medicine, Rochester, NY, USA.
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17
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Haddadin Z, Beveridge S, Fernandez K, Rankin DA, Probst V, Spieker AJ, Markus TM, Stewart LS, Schaffner W, Lindegren ML, Halasa N. Respiratory Syncytial Virus Disease Severity in Young Children. Clin Infect Dis 2020; 73:e4384-e4391. [PMID: 33095882 DOI: 10.1093/cid/ciaa1612] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the leading cause of acute respiratory infections (ARI) in hospitalized children. Although prematurity and underlying medical conditions are known risk factors, most of these children are healthy, and factors including RSV load and subgroups may contribute to RSV-ARI severity. Therefore, we aimed to evaluate the role of RSV in ARI disease severity and determine factors associated with increased RSV-ARI severity in young children. METHOD Children less than five years with fever and/or ARI symptoms were recruited from the emergency department (ED) or inpatient settings at Vanderbilt Children's Hospital. Nasal and/or throat swabs were tested by qRT-PCR for common respiratory viruses, including RSV. A severity score was calculated for RSV-positive children. RESULTS From 11/2015 through 07/2016, 898 participants were enrolled, and 681 (76%) had at least one virus detected, with 191 (28%) testing positive for RSV. RSV-positive children were more likely to be hospitalized, require intensive care unit (ICU) admission, and receive oxygen compared to other-virus-positive children. Higher viral load, White race, younger age, and higher severity score were independently associated with hospitalization in RSV-positive children. No differences in disease severity were noted among children infected with RSV A and B. CONCLUSION RSV was associated with increased ARI severity in young children enrolled from ED and inpatient settings, but no differences in disease severity were noted between RSV A and B. . These findings emphasize the need for effective antiviral therapy and/or preventive measures such as vaccines against RSV in young children.
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Affiliation(s)
- Zaid Haddadin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Kailee Fernandez
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Danielle A Rankin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Varvara Probst
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tiffanie M Markus
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laura S Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - William Schaffner
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mary Lou Lindegren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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18
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Wang T, Dong H, Jiang W, Li Y, Sun H, Huang L, Wang M, Zhu C, Ji W, Wang Y, Hao C, Chen Z, Yan Y. Viral etiology and atopic characteristics in high-risk asthmatic children hospitalized for lower respiratory tract infection. Transl Pediatr 2020; 9:541-550. [PMID: 32953552 PMCID: PMC7475309 DOI: 10.21037/tp-20-165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Viral etiology and atopic characteristics, e.g., allergens and fractional exhaled nitric oxide (FeNO), play essential roles in asthma development. This study aimed to investigate associations among them in children at high risk of developing asthma to guide reliable diagnosis and treatment of wheezing. METHODS From April 2016 to August 2017, 135 children aged <3 years identified as being at high risk of asthma and hospitalized for lower respiratory tract infection (LRTI) with wheezing were recruited as research subjects (observation group). Real-time fluorescent polymerase chain reaction (PCR) was used to explore their etiology. Samples were also evaluated with Phadiatop (Pharmacia Diagnostics AB, Uppsala, Sweden). Additionally, 200 non-asthmatic, non-allergic, healthy children who were screened and followed up in the Echocardiography clinic during the study period were recruited as a healthy control group for FeNO measurement, and the observation group also underwent FeNO measurement. RESULTS Among the observation group, viruses were positively detected in 49.63%. The most often detected virus was human rhinovirus (HRV; 25.19%). Compared with children aged <12 months, those aged 1-3 years were more susceptible to HRV infection and had lower sensitivity rates for inhalant allergens and higher T-IgE. The virus-detected group had a higher sensitivity rate for inhalant allergens compared with the virus-undetected group. FeNO in the observation group was lower than that in the healthy control group. The second-wheezing group had higher sensitivity rates for dust mites and fungi and higher T-IgE levels compared with the first-wheezing group. CONCLUSIONS HRV was the most common viral pathogen present during an asthmatic attack in infants and young children at elevated risk of asthma. Allergy is a risk factor for both initial wheezing and repeated wheezing. Inhalant allergen-sensitive children are more susceptible than others to viral infection.
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Affiliation(s)
- Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Heting Dong
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yan Li
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Canhong Zhu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wei Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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19
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Chen L, Chen J, Zhu LM. Respiratory Syncytial Virus Bronchiolitis and Bronchial Asthma (Preprint). JMIR Mhealth Uhealth 2020. [DOI: 10.2196/22309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Jeong S, Park MJ, Song W, Kim HS. Advances in laboratory assays for detecting human metapneumovirus. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:608. [PMID: 32566634 PMCID: PMC7290561 DOI: 10.21037/atm.2019.12.42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Human metapneumovirus (HMPV) is one of the major causes of acute respiratory tract infection (ARI) and shows high morbidity and mortality, particularly in children and immunocompromised patients. Various methods for detecting HMPV have been developed and applied in clinical laboratories. When reviewing the literature, we found that polymerase chain reaction (PCR)-based assays have been most frequently and consistently used to detect HMPV. The most commonly used method was multiplex reverse transcriptase-PCR (RT-PCR; 57.4%), followed by real-time RT-PCR (38.3%). Multiplex RT-PCR became the more popular method in 2011-2019 (69.7%), in contrast to 2001-2009 (28.6%). The advent of multiplex PCR in detecting broader viral pathogens in one run and coinfected viruses influenced the change in user preference. Further, newly developed microarray technologies and ionization mass spectrometry were introduced in 2011-2019. Viral culture (including shell vial assays) and fluorescent immunoassays (with or without culture) were once the mainstays. However, the percentage of studies employing culture and fluorescent immunoassays decreased from 21.4% in 2001-2010 to 15.2% in 2011-2019. Meanwhile, the use of PCR-based methods of HMPV detection increased from 78.6% in 2001-2010 to 84.8% in 2011-2019. The increase in PCR-based methods might have occurred because PCR methods demonstrated better diagnostic performance, shorter hands-on and run times, less hazards to laboratory personnel, and more reliable results than traditional methods. When using these assays, it is important to acquire a comprehensive understanding of the principles, advantages, disadvantages, and precautions for data interpretation. In the future, the combination of nanotechnology and advanced genetic platforms such as next-generation sequencing will benefit patients with HMPV infection by facilitating efficient therapeutic intervention. Analytical and clinical validation are required before using new techniques in clinical laboratories.
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Affiliation(s)
- Seri Jeong
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Min-Jeong Park
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Hyon-Suk Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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21
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McMichael TM, Zhang Y, Kenney AD, Zhang L, Zani A, Lu M, Chemudupati M, Li J, Yount JS. IFITM3 Restricts Human Metapneumovirus Infection. J Infect Dis 2019; 218:1582-1591. [PMID: 29917090 DOI: 10.1093/infdis/jiy361] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/12/2018] [Indexed: 11/12/2022] Open
Abstract
Human metapneumovirus (hMPV) utilizes a bifurcated cellular entry strategy, fusing either with the plasma membrane or, after endocytosis, with the endosome membrane. Whether cellular factors restrict or enhance either entry pathway is largely unknown. We found that the interferon-induced transmembrane protein 3 (IFITM3) inhibits hMPV infection to an extent similar to endocytosis-inhibiting drugs, and an IFITM3 variant that accumulates at the plasma membrane in addition to its endosome localization provided increased virus restriction. Mechanistically, IFITM3 blocks hMPV F protein-mediated membrane fusion, and inhibition of infection was reversed by the membrane destabilizing drug amphotericin B. Conversely, we found that infection by some hMPV strains is enhanced by the endosomal protein toll-like receptor 7 (TLR7), and that IFITM3 retains the ability to restrict hMPV infection even in cells expressing TLR7. Overall, our results identify IFITM3 as an endosomal restriction factor that limits hMPV infection of cells.
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Affiliation(s)
- Temet M McMichael
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Yu Zhang
- Department of Veterinary Biosciences, The Ohio State University, Columbus, Ohio
| | - Adam D Kenney
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Lizhi Zhang
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Ashley Zani
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Mijia Lu
- Department of Veterinary Biosciences, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Mahesh Chemudupati
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Jianrong Li
- Department of Veterinary Biosciences, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Jacob S Yount
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio.,Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
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22
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Walsh EE, Wang L, Falsey AR, Qiu X, Corbett A, Holden-Wiltse J, Mariani TJ, Topham DJ, Caserta MT. Virus-Specific Antibody, Viral Load, and Disease Severity in Respiratory Syncytial Virus Infection. J Infect Dis 2019; 218:208-217. [PMID: 29546402 DOI: 10.1093/infdis/jiy106] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/09/2018] [Indexed: 11/12/2022] Open
Abstract
Background Maternally derived serum antibody and viral load are thought to influence disease severity in primary respiratory syncytial virus (RSV) infection. As part of the AsPIRES study of RSV pathogenesis, we correlated various serum antibody concentrations and viral load with disease severity. Methods Serum neutralizing antibody titers and levels of immunoglobulin G (IgG) to RSV fusion protein (F), attachment proteins of RSV group A and B, the CX3C region of G, and nasal viral load were measured in 139 full-term previously healthy infants with primary RSV infection and correlated with illness severity. Results Univariate analysis showed no relationship between measures of serum antibody and severity. However, a multivariate model adjusting for age at the time of infection found a significant 0.56 decrease in severity score for each 2-fold increase in antibody concentration to RSV F. The benefit of antibody was greatest in infants ≤ 2 months of age. Additionally, estimated antibody titer at birth was correlated with age at infection, suggesting that higher antibody titers delay infection. Viral load did not differ by illness severity. Conclusion Our data support the concept of maternal immunization with an RSV vaccine during pregnancy as a strategy for reducing the burden of RSV infection in full-term healthy infants exposed to RSV during their first winter.
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Affiliation(s)
- Edward E Walsh
- Department of Medicine, University of Rochester School of Medicine.,Department of Medicine, Rochester General Hospital, Rochester, New York
| | - Lu Wang
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine
| | - Ann R Falsey
- Department of Medicine, University of Rochester School of Medicine.,Department of Medicine, Rochester General Hospital, Rochester, New York
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine
| | - Anthony Corbett
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine
| | - Jeanne Holden-Wiltse
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine
| | - Thomas J Mariani
- Department of Neonatology, University of Rochester School of Medicine.,Program in Pediatric Molecular and Personalized Medicine, University of Rochester School of Medicine.,Department of Pediatrics, University of Rochester School of Medicine
| | - David J Topham
- Department of Microbiology and Immunology, University of Rochester School of Medicine
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester School of Medicine
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23
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Ek P, Böttiger B, Dahlman D, Hansen KB, Nyman M, Nilsson AC. A combination of naso- and oropharyngeal swabs improves the diagnostic yield of respiratory viruses in adult emergency department patients. Infect Dis (Lond) 2019; 51:241-248. [PMID: 30760088 DOI: 10.1080/23744235.2018.1546055] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Along with the current development of molecular diagnostic methods of respiratory viruses, the bedside patient sampling techniques need to be evaluated. We here asked the question whether the addition of an oropharynx swab to the traditional nasopharynx swab might improve the diagnostic yield of multiplex PCR analysis. Ct values from the two sampling sites were compared as well as patient tolerability. METHODS In an emergency department in Malmö, Sweden, 98 adult patients with respiratory disease were sampled both from the nasopharynx and oropharynx for virus diagnostics by PCR. RESULTS Influenza (AH1, AH3, B), human metapneumovirus (hMPV) or respiratory syncytial virus (RSV) were detected by PCR in 58 subjects. The diagnostic yield was improved by combining nasopharyngeal and oropharyngeal sampling - a virus was detected in another 6 patients compared to traditional nasopharyngeal sampling (p = .031, McNemar's test). In 38/55 subjects viral load was higher in the nasopharynx than in the oropharynx. Self-reported discomfort was significantly lower from oropharyngeal sampling than from nasopharyngeal sampling. CONCLUSIONS Adding an oropharynx sample to a nasopharynx sample increased the diagnostic yield of respiratory viruses. Oropharyngeal sampling was well tolerated.
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Affiliation(s)
- Peter Ek
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
| | - Blenda Böttiger
- b Department of Clinical Microbiology, Division of Laboratory Medicine , Lund University , Lund , Sweden
| | - Disa Dahlman
- c Division of Psychiatry, Department of Clinical Sciences Lund , Lund University , Lund , Sweden.,d Malmö Addiction Centre , Skåne University Hospital , Malmö , Sweden.,e Center for Primary Health Care Research, Department of Clinical Sciences , Lund University/Region Skåne , Malmö , Sweden
| | - Karin B Hansen
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
| | - Mattias Nyman
- b Department of Clinical Microbiology, Division of Laboratory Medicine , Lund University , Lund , Sweden
| | - Anna C Nilsson
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
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24
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Pochon C, Voigt S. Respiratory Virus Infections in Hematopoietic Cell Transplant Recipients. Front Microbiol 2019; 9:3294. [PMID: 30687278 PMCID: PMC6333648 DOI: 10.3389/fmicb.2018.03294] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/18/2018] [Indexed: 12/13/2022] Open
Abstract
Highly immunocompromised pediatric and adult hematopoietic cell transplant (HCT) recipients frequently experience respiratory infections caused by viruses that are less virulent in immunocompetent individuals. Most of these infections, with the exception of rhinovirus as well as adenovirus and parainfluenza virus in tropical areas, are seasonal variable and occur before and after HCT. Infectious disease management includes sampling of respiratory specimens from nasopharyngeal washes or swabs as well as sputum and tracheal or tracheobronchial lavages. These are subjected to improved diagnostic tools including multiplex PCR assays that are routinely used allowing for expedient detection of all respiratory viruses. Disease progression along with high mortality is frequently associated with respiratory syncytial virus, parainfluenza virus, influenza virus, and metapneumovirus infections. In this review, we discuss clinical findings and the appropriate use of diagnostic measures. Additionally, we also discuss treatment options and suggest new drug formulations that might prove useful in treating respiratory viral infections. Finally, we shed light on the role of the state of immune reconstitution and on the use of immunosuppressive drugs on the outcome of infection.
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Affiliation(s)
- Cécile Pochon
- Allogeneic Hematopoietic Stem Cell Transplantation Unit, Department of Pediatric Oncohematology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Sebastian Voigt
- Department of Pediatric Oncology/Hematology/Stem Cell Transplantation, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
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25
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Tam CC, Offeddu V, Anderson KB, Weg AL, Macareo LR, Ellison DW, Rangsin R, Fernandez S, Gibbons RV, Yoon IK, Simasathien S. Association between semi-quantitative microbial load and respiratory symptoms among Thai military recruits: a prospective cohort study. BMC Infect Dis 2018; 18:462. [PMID: 30217168 PMCID: PMC6137728 DOI: 10.1186/s12879-018-3358-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/23/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Multiplex real-time polymerase chain reaction assays have improved diagnostic sensitivity for a wide range of pathogens. However, co-detection of multiple agents and bacterial colonization make it difficult to distinguish between asymptomatic infection or illness aetiology. We assessed whether semi-quantitative microbial load data can differentiate between symptomatic and asymptomatic states for common respiratory pathogens. METHODS We obtained throat and nasal swab samples from military trainees at two Thai Army barracks. Specimens were collected at the start and end of 10-week training periods (non-acute samples), and from individuals who developed upper respiratory tract infection during training (acute samples). We analysed the samples using a commercial multiplex respiratory panel comprising 33 bacterial, viral and fungal targets. We used random effects tobit models to compare cycle threshold (Ct) value distributions from non-acute and acute samples. RESULTS We analysed 341 non-acute and 145 acute swab samples from 274 participants. Haemophilus influenzae type B was the most commonly detected microbe (77.4% of non-acute and 64.8% of acute samples). In acute samples, nine specific microbe pairs were detected more frequently than expected by chance. Regression models indicated significantly lower microbial load in non-acute relative to acute samples for H. influenzae non-type B, Streptococcus pneumoniae and rhinovirus, although it was not possible to identify a Ct-value threshold indicating causal etiology for any of these organisms. CONCLUSIONS Semi-quantitative measures of microbial concentration did not reliably differentiate between illness and asymptomatic colonization, suggesting that clinical symptoms may not always be directly related to microbial load for common respiratory infections.
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Affiliation(s)
- Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore. .,London School of Hygiene & Tropical Medicine, WC1E7HT, London, UK.
| | - Vittoria Offeddu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
| | - Kathryn B Anderson
- University of Minnesota, Minneapolis, 55455, USA.,Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Alden L Weg
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Louis R Macareo
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Damon W Ellison
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | | | - In-Kyu Yoon
- International Vaccine Institute, Seoul, 08826, South Korea
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26
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Ma X, Conrad T, Alchikh M, Reiche J, Schweiger B, Rath B. Can we distinguish respiratory viral infections based on clinical features? A prospective pediatric cohort compared to systematic literature review. Rev Med Virol 2018; 28:e1997. [PMID: 30043515 PMCID: PMC7169127 DOI: 10.1002/rmv.1997] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 12/19/2022]
Abstract
Studies have shown that the predictive value of “clinical diagnoses” of influenza and other respiratory viral infections is low, especially in children. In routine care, pediatricians often resort to clinical diagnoses, even in the absence of robust evidence‐based criteria. We used a dual approach to identify clinical characteristics that may help to differentiate infections with common pathogens including influenza, respiratory syncytial virus, adenovirus, metapneumovirus, rhinovirus, bocavirus‐1, coronaviruses, or parainfluenza virus: (a) systematic review and meta‐analysis of 47 clinical studies published in Medline (June 1996 to March 2017, PROSPERO registration number: CRD42017059557) comprising 49 858 individuals and (b) data‐driven analysis of an inception cohort of 6073 children with ILI (aged 0‐18 years, 56% male, December 2009 to March 2015) examined at the point of care in addition to blinded PCR testing. We determined pooled odds ratios for the literature analysis and compared these to odds ratios based on the clinical cohort dataset. This combined analysis suggested significant associations between influenza and fever or headache, as well as between respiratory syncytial virus infection and cough, dyspnea, and wheezing. Similarly, literature and cohort data agreed on significant associations between HMPV infection and cough, as well as adenovirus infection and fever. Importantly, none of the abovementioned features were unique to any particular pathogen but were also observed in association with other respiratory viruses. In summary, our “real‐world” dataset confirmed published literature trends, but no individual feature allows any particular type of viral infection to be ruled in or ruled out. For the time being, laboratory confirmation remains essential. More research is needed to develop scientifically validated decision models to inform best practice guidelines and targeted diagnostic algorithms.
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Affiliation(s)
- Xiaolin Ma
- Department of Pediatrics, Charité University Berlin, Berlin, Germany.,National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany.,Capital Institute of Pediatrics, Beijing, China
| | - Tim Conrad
- Department of Mathematics and Computer Sciences, Freie Universität Berlin, Berlin, Germany
| | - Maren Alchikh
- Department of Pediatrics, Charité University Berlin, Berlin, Germany.,Vienna Vaccine Safety Initiative, Berlin, Germany
| | - Janine Reiche
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Brunhilde Schweiger
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Barbara Rath
- Vienna Vaccine Safety Initiative, Berlin, Germany.,University of Nottingham School of Medicine, Nottingham, UK.,Université Bourgogne Franche-Comte, Besançon, France
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27
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Frequency and Molecular Typing of Human Metapneumovirus in Children with Acute Respiratory Tract Infection in Bojnurd, Northeastern Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2018. [DOI: 10.5812/pedinfect.12552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Zhou J, Peng Y, Peng X, Gao H, Sun Y, Xie L, Zhong L, Duan Z, Xie Z, Cao Y. Human bocavirus and human metapneumovirus in hospitalized children with lower respiratory tract illness in Changsha, China. Influenza Other Respir Viruses 2018; 12:279-286. [PMID: 29266860 PMCID: PMC5820417 DOI: 10.1111/irv.12535] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Lower respiratory tract illness is a major cause of morbidity and mortality in children worldwide, however, information about the epidemiological and clinical characteristics of LRTIs caused by HMPV and HBoV in China is limited. OBJECTIVES Human bocavirus (HBoV) and human metapneumovirus (HMPV) are two important viruses for children with lower respiratory tract infections (LRTI). We aimed to assay the correlation between viral load and clinical characteristics of HBoV and HMPV with LRTI in Changsha, China. METHODS Nasopharyngeal aspirates (NPAs) from children with LRTI were collected. Real-time PCR was used to screen HBoV and HMPV. Analyses were performed using SPSS 16.0 software. RESULTS Pneumonia was the most frequent diagnosis. There was no significant difference between HBoV- and HMPV-positive patients in age (P = .506) or hospitalization duration (P = .280); 24.1% and 18.2% were positive for HBoV and HMPV. HBoV infections peaked in summer (32.2%), and HMPV infections peaked in winter (28.9%). The HBoV-positive patients had a shorter hospitalization duration than the HBoV-negative patients (P = .021), and the HMPV-positive patients had a higher prevalence of fever than the HMPV-negative patients (P = .002). The HBoV viral load was significantly higher among patients aged <1 year (P = .006). The mean HBoV and HMPV viral loads were not significantly different between patients with single infections and coinfections. Patients infected with HBoV only were older than those coinfected with HBoV and other respiratory viruses (P = .005). No significant difference was found in the clinical characteristics of patients infected with HMPV only and those coinfected with HMPV and other respiratory viruses. CONCLUSION Pneumonia was the most frequent diagnosis caused by HBoV and HMPV. Neither HBoV nor HMPV viral load was correlated with disease severity.
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Affiliation(s)
- Jie‐ying Zhou
- Department of Laboratory MedicalThe First People's Hospital of Hunan ChenzhouChenzhouChina
- Key Laboratory for Medical VirologyMinistry of HealthNational Institute for Viral Disease Control and Prevention, ChinaCenter for Disease ControlBeijingChina
- Department of Laboratory MedicalThe First Affiliated Hospital of Hunan Normal UniversityChangshaChina
| | - Ying Peng
- Key Laboratory for Medical VirologyMinistry of HealthNational Institute for Viral Disease Control and Prevention, ChinaCenter for Disease ControlBeijingChina
- Department of PaediatricsThe First Affiliated Hospital of Hunan Normal UniversityChangshaChina
| | - Xiao‐you Peng
- Department of Laboratory MedicalThe First People's Hospital of Hunan ChenzhouChenzhouChina
| | - Han‐chun Gao
- Key Laboratory for Medical VirologyMinistry of HealthNational Institute for Viral Disease Control and Prevention, ChinaCenter for Disease ControlBeijingChina
| | - Ya‐ping Sun
- Yuhang District Center for Disease Control and PreventionHangzhouChina
| | - Le‐yun Xie
- Department of PaediatricsThe First Affiliated Hospital of Hunan Normal UniversityChangshaChina
| | - Li‐li Zhong
- Department of PaediatricsThe First Affiliated Hospital of Hunan Normal UniversityChangshaChina
| | - Zhao‐jun Duan
- Key Laboratory for Medical VirologyMinistry of HealthNational Institute for Viral Disease Control and Prevention, ChinaCenter for Disease ControlBeijingChina
| | - Zhi‐ping Xie
- Key Laboratory for Medical VirologyMinistry of HealthNational Institute for Viral Disease Control and Prevention, ChinaCenter for Disease ControlBeijingChina
| | - You‐de Cao
- Department of Laboratory MedicalThe First Affiliated Hospital of Hunan Normal UniversityChangshaChina
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29
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Gómez-Novo M, Boga JA, Álvarez-Argüelles ME, Rojo-Alba S, Fernández A, Menéndez MJ, de Oña M, Melón S. Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection. J Med Virol 2018; 90:861-866. [PMID: 29315642 DOI: 10.1002/jmv.25020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/19/2017] [Indexed: 11/06/2022]
Abstract
Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P < 0.001). The viral mean load was 4.81 ± 1.98 log10 copies/1000 cells for patients under the age of 4-year-old (P < 0.001). The viral mean loads were 4.51 ± 2.04 cells in patients with low respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression.
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Affiliation(s)
- Miriam Gómez-Novo
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - José A Boga
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Susana Rojo-Alba
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana Fernández
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - María J Menéndez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - María de Oña
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Santiago Melón
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
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30
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Zhang L, Liu W, Liu D, Chen D, Tan W, Qiu S, Xu D, Li X, Liu T, Zhou R. Epidemiological and clinical features of human metapneumovirus in hospitalised paediatric patients with acute respiratory illness: a cross-sectional study in Southern China, from 2013 to 2016. BMJ Open 2018; 8:e019308. [PMID: 29437754 PMCID: PMC5829904 DOI: 10.1136/bmjopen-2017-019308] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Human metapneumovirus (HMPV) is one of the most important respiratory viral pathogens affecting infants and children worldwide. Our study describes the epidemiological and clinical characteristics of HMPV present in patients hospitalised with acute respiratory illness (ARI) in Guangzhou, Southern China. STUDY DESIGN A cross-sectional study. SETTING Two tertiary hospitals in Guangzhou. PARTICIPANTS AND METHODS Throat swabs were collected over a 3-year period from 5133 paediatric patients (≤14 years) hospitalised with ARI. Patients who are HMPV positive with clinical presentations (101/103) were recorded for further analysis. RESULTS Of the 5133 patients included in the study, 103 (2.0%) were positive for HMPV. HMPV was more prevalent in children ≤5 years (2.2%, 98/4399) compared with older children (>5-14 years) (0.7%, 5/734) (P=0.004). Two seasonal HMPV peaks were observed each year and mainly occurred in spring and early summer. Overall, 18.4% (19/103) of patients who are HMPV positive were codetected with other pathogens, most frequently respiratory syncytial virus (36.8%, 7/19). Patients who are HMPV positive presented with a wide spectrum of clinical features, including cough (100.0%, 101/101), abnormal pulmonary breath sound (91.1%, 92/101), fever (88.1%, 89/101), expectoration (77.2%, 78/101), coryza (50.5%, 51/101) and wheezing (46.5%, 47/101). The main diagnosis of patients who are HMPV positive was bronchopneumonia (66.7%, 56/84). Fever (≥38˚C) (91.6%, 76/83) was detected more often in patients with only HMPV detected than in patients with HMPV plus other pathogen(s) detected (72.2%, 13/18) (P=0.037), whereas diarrhoea was more common in patients with HMPV plus other pathogen(s) detected (22.2%, 4/18), compared with patients with HMPV only (3.6%, 3/83) (P=0.018). CONCLUSIONS HMPV is an important respiratory pathogen in children with ARI in Guangzhou, particularly in children ≤5 years old. HMPV has a seasonal variation. Bronchopneumonia is a major diagnosis in patients who are HMPV positive.
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Affiliation(s)
- Ling Zhang
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Wenkuan Liu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Donglan Liu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Dehui Chen
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Weiping Tan
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Shuyan Qiu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Duo Xu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Xiao Li
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Tiantian Liu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Rong Zhou
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
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31
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Tao XW, Zeng LK, Wang HZ, Liu HC. LncRNA MEG3 ameliorates respiratory syncytial virus infection by suppressing TLR4 signaling. Mol Med Rep 2017; 17:4138-4144. [PMID: 29257348 DOI: 10.3892/mmr.2017.8303] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/17/2017] [Indexed: 11/06/2022] Open
Abstract
Maternally expressed gene 3 (MEG3), a long noncoding RNA (lncRNA) has been dysregulated in various tumors. However, the expression level and functional role of MEG3 in the progression of respiratory syncytial virus (RSV) infection remains to be elucidated. The present study quantified the expression level of MEG3 in the nasopharyngeal (NPA) samples of RSV‑infected patients and in BEAS‑2B cells infected with RSV. The findings of the present study demonstrated that the expression level of lncRNA MEG3 was reduced in the NPA samples of RSV‑infected patients and in BEAS‑2B cells infected with RSV. In vitro transfection revealed increased mRNA expression levels of toll‑like receptor 4 (TLR4), tumor necrosis factor‑α (TNFα) and interleukin (IL)‑8 following RSV infection in BEAS‑2B cells. Additionally, ectopic expression of MEG3 reduced the expression level of TLR4, subsequently suppressing the mRNA expression levels of TNFα and IL‑8, indicating the protective role of MEG3 in the process of RSV infection. It is of note, that RSV infection‑induced p38 mitogen activated protein kinase (MAPK) and nuclear factor‑κB (NF‑κB) activation was partly abolished by overexpression of MEG3. In conclusion, to the best of our knowledge, the present study provided the first evidence that lncRNA MEG3 expression level was reduced in the NPA samples of patients with RSV infection and RSV‑infected cells. Additionally, it was demonstrated that MEG3 protected human airway epithelial cells from RSV infection, primarily by suppressing TLR4‑dependent p38 MAPK and NF‑κB signaling.
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Affiliation(s)
- Xu-Wei Tao
- Department of Neonatology, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Ling-Kong Zeng
- Department of Neonatology, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Hui-Zhen Wang
- Department of Neonatology, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Han-Chu Liu
- Department of Neonatology, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
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Schlaberg R, Queen K, Simmon K, Tardif K, Stockmann C, Flygare S, Kennedy B, Voelkerding K, Bramley A, Zhang J, Eilbeck K, Yandell M, Jain S, Pavia AT, Tong S, Ampofo K. Viral Pathogen Detection by Metagenomics and Pan-Viral Group Polymerase Chain Reaction in Children With Pneumonia Lacking Identifiable Etiology. J Infect Dis 2017; 215:1407-1415. [PMID: 28368491 PMCID: PMC5565793 DOI: 10.1093/infdis/jix148] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background. Community-acquired pneumonia (CAP) is a leading cause of pediatric hospitalization. Pathogen identification fails in approximately 20% of children but is critical for optimal treatment and prevention of hospital-acquired infections. We used two broad-spectrum detection strategies to identify pathogens in test-negative children with CAP and asymptomatic controls. Methods. Nasopharyngeal/oropharyngeal (NP/OP) swabs from 70 children <5 years with CAP of unknown etiology and 90 asymptomatic controls were tested by next-generation sequencing (RNA-seq) and pan viral group (PVG) PCR for 19 viral families. Association of viruses with CAP was assessed by adjusted odds ratios (aOR) and 95% confidence intervals controlling for season and age group. Results. RNA-seq/PVG PCR detected previously missed, putative pathogens in 34% of patients. Putative viral pathogens included human parainfluenza virus 4 (aOR 9.3, P = .12), human bocavirus (aOR 9.1, P < .01), Coxsackieviruses (aOR 5.1, P = .09), rhinovirus A (aOR 3.5, P = .34), and rhinovirus C (aOR 2.9, P = .57). RNA-seq was more sensitive for RNA viruses whereas PVG PCR detected more DNA viruses. Conclusions. RNA-seq and PVG PCR identified additional viruses, some known to be pathogenic, in NP/OP specimens from one-third of children hospitalized with CAP without a previously identified etiology. Both broad-range methods could be useful tools in future epidemiologic and diagnostic studies.
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Affiliation(s)
- Robert Schlaberg
- Department of Pathology.,ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah ; and
| | - Krista Queen
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Keith Tardif
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah; and
| | | | | | - Brett Kennedy
- Department of Human Genetics, University of Utah, and
| | - Karl Voelkerding
- Department of Pathology.,ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah ; and
| | - Anna Bramley
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jing Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Mark Yandell
- Department of Human Genetics, University of Utah, and
| | - Seema Jain
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia
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33
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Rezaee F, Harford TJ, Linfield DT, Altawallbeh G, Midura RJ, Ivanov AI, Piedimonte G. cAMP-dependent activation of protein kinase A attenuates respiratory syncytial virus-induced human airway epithelial barrier disruption. PLoS One 2017; 12:e0181876. [PMID: 28759570 PMCID: PMC5536269 DOI: 10.1371/journal.pone.0181876] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/07/2017] [Indexed: 12/24/2022] Open
Abstract
Airway epithelium forms a barrier to the outside world and has a crucial role in susceptibility to viral infections. Cyclic adenosine monophosphate (cAMP) is an important second messenger acting via two intracellular signaling molecules: protein kinase A (PKA) and the guanidine nucleotide exchange factor, Epac. We sought to investigate effects of increased cAMP level on the disruption of model airway epithelial barrier caused by RSV infection and the molecular mechanisms underlying cAMP actions. Human bronchial epithelial cells were infected with RSV-A2 and treated with either cAMP releasing agent, forskolin, or cAMP analogs. Structure and functions of the Apical Junctional Complex (AJC) were evaluated by measuring transepithelial electrical resistance and permeability to FITC-dextran, and determining localization of AJC proteins by confocal microscopy. Increased intracellular cAMP level significantly attenuated RSV-induced disassembly of AJC. These barrier-protective effects of cAMP were due to the activation of PKA signaling and did not involve Epac activity. Increased cAMP level reduced RSV-induced reorganization of the actin cytoskeleton, including apical accumulation of an essential actin-binding protein, cortactin, and inhibited expression of the RSV F protein. These barrier-protective and antiviral-function of cAMP signaling were evident even when cAMP level was increased after the onset of RSV infection. Taken together, our study demonstrates that cAMP/PKA signaling attenuated RSV-induced disruption of structure and functions of the model airway epithelial barrier by mechanisms involving the stabilization of epithelial junctions and inhibition of viral biogenesis. Improving our understanding of the mechanisms involved in RSV-induced epithelial dysfunction and viral pathogenesis will help to develop novel anti-viral therapeutic approaches.
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Affiliation(s)
- Fariba Rezaee
- Pediatric Research Center and Pediatric Institute, Cleveland Clinic Children’s, Cleveland, Ohio, United States of America
- Pathobiology Department, Lerner Research Institute, Cleveland, Ohio, United States of America
| | - Terri J. Harford
- Pediatric Research Center and Pediatric Institute, Cleveland Clinic Children’s, Cleveland, Ohio, United States of America
- Pathobiology Department, Lerner Research Institute, Cleveland, Ohio, United States of America
| | - Debra T. Linfield
- Pediatric Research Center and Pediatric Institute, Cleveland Clinic Children’s, Cleveland, Ohio, United States of America
- Pathobiology Department, Lerner Research Institute, Cleveland, Ohio, United States of America
| | - Ghaith Altawallbeh
- Pediatric Research Center and Pediatric Institute, Cleveland Clinic Children’s, Cleveland, Ohio, United States of America
- Pathobiology Department, Lerner Research Institute, Cleveland, Ohio, United States of America
| | - Ronald J. Midura
- Biomedical Engineering Department, Lerner Research Institute, Cleveland, Ohio, United States of America
| | - Andrei I. Ivanov
- Department of Human and Molecular Genetics, Virginia Institute of Molecular Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Giovanni Piedimonte
- Pediatric Research Center and Pediatric Institute, Cleveland Clinic Children’s, Cleveland, Ohio, United States of America
- Pathobiology Department, Lerner Research Institute, Cleveland, Ohio, United States of America
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34
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Cheemarla NR, Baños-Lara MDR, Naidu S, Guerrero-Plata A. Neutrophils regulate the lung inflammatory response via γδ T cell infiltration in an experimental mouse model of human metapneumovirus infection. J Leukoc Biol 2017; 101:1383-1392. [PMID: 28336678 DOI: 10.1189/jlb.4a1216-519rr] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 12/28/2022] Open
Abstract
Neutrophils are the most abundant leukocytes in human circulation. They are the first immune cell population recruited to the sites of infection. However, the role of neutrophils to regulate host immune responses during respiratory viral infections is largely unknown. To elucidate the role of neutrophils in respiratory antiviral defense, we used an experimental mouse model of human metapneumovirus (HMPV) infection. HMPV, a member of the Paramyxoviridae family, is a leading respiratory pathogen causing severe symptoms, such as bronchiolitis and pneumonia, in young, elderly, and immunocompromised patients. We demonstrate that neutrophils are the predominant population of immune cells recruited into the lungs after HMPV infection. This led us to hypothesize that neutrophils represent a key player of the immune response during HMPV infection, thereby regulating HMPV-induced lung pathogenesis. Specific depletion of neutrophils in vivo using a mAb and simultaneous infection with HMPV exhibited higher levels of inflammatory cytokines, pulmonary inflammation, and severe clinical disease compared with HMPV-infected, competent mice. Interestingly, the lack of neutrophils altered γδ T cell accumulation in the lung. The absence of γδ T cells during HMPV infection led to reduced pulmonary inflammation. These novel findings demonstrate that neutrophils play a critical role in controlling HMPV-induced inflammatory responses by regulating γδ T cell infiltration to the site of infection.
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Affiliation(s)
- Nagarjuna R Cheemarla
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and
| | - Ma Del Rocío Baños-Lara
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and
| | - Shan Naidu
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and
| | - Antonieta Guerrero-Plata
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and .,Center for Experimental Infectious Disease Research, Louisiana State University, Baton Rouge, Louisiana, USA
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