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YIN L, STÅLSBY LUNDBORGC, WU D, YANG J, ALVESSON HM, CAI J, LU T, XIE Q, MARRONE G. Effect of pediatric Tuina on children's recurrent acute respiratory tract infections: a retrospective cohort study in Southern China. J TRADIT CHIN MED 2024; 44:586-594. [PMID: 38767644 PMCID: PMC11077153 DOI: 10.19852/j.cnki.jtcm.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/25/2023] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To determine the effectiveness of pediatric Tuina (PT) in preventing recurrent acute respiratory tract infections (ARTIs) in children. METHODS This is a retrospective cohort study based on the electronic medical records of children with recurrent ARTIs in 2016. Children were divided into a PT group or a non-PT group, according to whether they had received PT or not in 2016. The primary outcome was the number of ARTI episodes in 2017 and 2018. The secondary outcomes were the number of ARTIs leading to outpatient department visits and outpatient antibiotic prescriptions due to ARTIs in the same time period. Negative binomial regressions were used to detect the association between PT and the outcomes. RESULTS A total of 2303 children were included in the analysis, including 94 in the PT group and 2209 in the non-PT group. Children who received PT six or more times in 2016 had fewer episodes of ARTIs in 2017 [incidence rate ratio (IRR): 0.59, 95% confidence interval (CI) (0.42-0.84)] and 2018 [IRR: 0.58, 95% CI (0.36-0.94)] and fewer outpatient department visits due to ARTIs in 2017 [IRR: 0.56, 95% CI (0.38-0.83)] than children who had not received PT in 2016. There was no significant difference in the number of outpatient antibiotic prescriptions between the two groups. CONCLUSIONS Receiving PT six or more times within one year is associated with a decrease in recurrent ARTIs in children in the following two years. Randomized controlled trials are needed for effect evaluation prior to establishing PT as a method for preventing recurrent ARTIs among children.
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Affiliation(s)
- Lingjia YIN
- 1 Department of Global Public Health, Karolinska Institutet, Stockholm 17177, Sweden; State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Outcome Assessment Research Team in Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Health Construction Administration Centre, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
| | | | - Darong WU
- 3 State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Outcome Assessment Research Team in Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Health Construction Administration Centre, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Jinghua YANG
- 4 Department of Pediatrics, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | | | - Jianxiong CAI
- 3 State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Outcome Assessment Research Team in Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Health Construction Administration Centre, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Taoying LU
- 3 State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Outcome Assessment Research Team in Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Health Construction Administration Centre, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qianwen XIE
- 5 Outcome Assessment Research Team in Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Gaetano MARRONE
- 2 Department of Global Public Health, Karolinska Institutet, Stockholm 17177, Sweden
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2
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Rebolledo L, Rodríguez-Vigil C, Carmen L, Llorente E, Guallar M, Villoria J, Vicente E. Bacterial immunotherapy is highly effective in reducing recurrent upper respiratory tract infections in children: a prospective observational study. Eur Arch Otorhinolaryngol 2023; 280:4519-4530. [PMID: 37254001 PMCID: PMC10477114 DOI: 10.1007/s00405-023-08035-4] [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: 03/23/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Whilst immunotherapy is an appealing option as it could reduce the burden of recurrent pediatric respiratory tract infections (RTI), there is limited evidence on its effectiveness and more research was requested in order to better understand this therapeutic modality. METHODS We performed a prospective cohort study involving 57 subjects to assess the safety and effectiveness a 3-month regimen of either typified or patient-specific bacterial lysates could have in reducing the number of RTIs in children aged 0 to 11 years with histories of recurrent episodes. RESULTS After a 6-month follow-up, the number of RTIs and school absenteeism dropped sharply and significantly, from an adjusted mean (standard error) of 0.6 (0.04) episodes/month to 0.1 (0.03) episodes/month (74.7% reduction, P < 0.001), and from an adjusted mean score of 4.6 (1.06) points to 0.0 (0.01) points over 10 (99.5% reduction, P < 0.001), respectively. There was also a significant decrease in the severity of symptoms. No adverse reactions were observed. CONCLUSION The use of the study product is associated with a decreased risk of recurrent RTIs in children, with a very favorable safety profile that warrants further investigation in randomized clinical trials.
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Affiliation(s)
- Laura Rebolledo
- Department of Otorhinolaryngology, San Jorge Hospital, Avenida de Martínez de Velasco 36, 22004, Huesca, Spain
- School of Medicine, University of Zaragoza, Calle de Pedro Cerbuna 12, 50009, Saragossa, Spain
| | - Carmen Rodríguez-Vigil
- Child and Adolescent Oncohematology Unit and Department of Pediatrics, Miguel Servet University Hospital, Paseo de Isabel La Católica 1-3, 50009, Saragossa, Spain
| | - Luis Carmen
- Child Otorhinolaryngology Unit, Department of Otorhinolaryngology, Miguel Servet University Hospital, Paseo de Isabel La Católica 1-3, 50009, Saragossa, Spain
| | - Eva Llorente
- Child Otorhinolaryngology Unit, Department of Otorhinolaryngology, Miguel Servet University Hospital, Paseo de Isabel La Católica 1-3, 50009, Saragossa, Spain
| | - María Guallar
- Child Otorhinolaryngology Unit, Department of Otorhinolaryngology, Miguel Servet University Hospital, Paseo de Isabel La Católica 1-3, 50009, Saragossa, Spain
| | - Jesús Villoria
- Department of Design and Biometrics, Medicxact, S.L., Plaza de La Ermita 4, 28430, Alpedrete, Spain
| | - Eugenio Vicente
- School of Medicine, University of Zaragoza, Calle de Pedro Cerbuna 12, 50009, Saragossa, Spain.
- Child and Adolescent Oncohematology Unit and Department of Pediatrics, Miguel Servet University Hospital, Paseo de Isabel La Católica 1-3, 50009, Saragossa, Spain.
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3
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Diao J, Liu H, Cao H, Chen W. The dysfunction of Tfh cells promotes pediatric recurrent respiratory tract infections development by interfering humoral immune responses. Heliyon 2023; 9:e20778. [PMID: 37876425 PMCID: PMC10590952 DOI: 10.1016/j.heliyon.2023.e20778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/06/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
Recurrent respiratory tract infections (RRTIs) are one of the most common pediatric diseases. Although the pathogenesis of pediatric RRTIs remains unknown, ineffective B cell-dominated humoral immunity has been considered as the core mechanism. During the course of pediatric RRTIs, B cell-dominated humoral immunity has changed from "protector" of respiratory system to "bystander" of respiratory tract infections. Under physiological condition, Tfh cells are essential for B cell-dominated humoral immunity, including regulating GC formation, promoting memory B cell (MB)/plasma cell (PC) differentiation, inducting immunoglobulin (Ig) class switching, and selecting affinity-matured antibodies. However, in disease states, Tfh cells are dysfunctional, which can be reflected by phenotypes and cytokine production. Tfh cell dysfunctions can cause the disorders of B cell-dominated humoral immunity, such as promoting B cell presented apoptosis, abrogating total Ig production, reducing MB/PC populations, and delaying affinity maturation of antigens-specific antibodies. In this review, we focused on the functions of B and Tfh cells in the homeostasis of respiratory system, and specifically discussed the disorders of humoral immunity and aberrant Tfh cell responses in the disease process of pediatric RRTIs. We hoped to provide some clues for the prevention and treatment of pediatric RRTIs.
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Affiliation(s)
- Jun Diao
- Department of Pediatrics, Yueyang Hospital of Chinese Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huosheng Liu
- Department of Acupuncture and Moxibustion, Jiading Hospital of Traditional Chinese Medicine, Shanghai, 201800, China
| | - Hui Cao
- Department of Liver Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weibin Chen
- Department of Pediatrics, Yueyang Hospital of Chinese Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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4
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Bodas-Pinedo A, Lafuente EM, Pelaez-Prestel HF, Ras-Carmona A, Subiza JL, Reche PA. Combining different bacteria in vaccine formulations enhances the chance for antiviral cross-reactive immunity: a detailed in silico analysis for influenza A virus. Front Immunol 2023; 14:1235053. [PMID: 37675108 PMCID: PMC10477994 DOI: 10.3389/fimmu.2023.1235053] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
Bacteria are well known to provide heterologous immunity against viral infections through various mechanisms including the induction of innate trained immunity and adaptive cross-reactive immunity. Cross-reactive immunity from bacteria to viruses is responsible for long-term protection and yet its role has been downplayed due the difficulty of determining antigen-specific responses. Here, we carried out a systematic evaluation of the potential cross-reactive immunity from selected bacteria known to induce heterologous immunity against various viruses causing recurrent respiratory infections. The bacteria selected in this work were Bacillus Calmette Guerin and those included in the poly-bacterial preparation MV130: Streptococcus pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis, Klebisella pneumoniae, Branhamella catarrhalis and Haemophilus influenzae. The virus included influenza A and B viruses, human rhinovirus A, B and C, respiratory syncytial virus A and B and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Through BLAST searches, we first identified the shared peptidome space (identity ≥ 80%, in at least 8 residues) between bacteria and viruses, and subsequently predicted T and B cell epitopes within shared peptides. Interestingly, the potential epitope spaces shared between bacteria in MV130 and viruses are non-overlapping. Hence, combining diverse bacteria can enhance cross-reactive immunity. We next analyzed in detail the cross-reactive T and B cell epitopes between MV130 and influenza A virus. We found that MV130 contains numerous cross-reactive T cell epitopes with high population protection coverage and potentially neutralizing B cell epitopes recognizing hemagglutinin and matrix protein 2. These results contribute to explain the immune enhancing properties of MV130 observed in the clinic against respiratory viral infections.
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Affiliation(s)
- Andrés Bodas-Pinedo
- Children’s Digestive Unit, Institute for Children and Adolescents, Hospital Clinico San Carlos, Madrid, Spain
| | - Esther M. Lafuente
- Department of Immunology & O2, Faculty of Medicine, University Complutense of Madrid, Ciudad Universitaria, Pza. Ramón y Cajal, Madrid, Spain
| | - Hector F. Pelaez-Prestel
- Department of Immunology & O2, Faculty of Medicine, University Complutense of Madrid, Ciudad Universitaria, Pza. Ramón y Cajal, Madrid, Spain
| | - Alvaro Ras-Carmona
- Department of Immunology & O2, Faculty of Medicine, University Complutense of Madrid, Ciudad Universitaria, Pza. Ramón y Cajal, Madrid, Spain
| | | | - Pedro A. Reche
- Department of Immunology & O2, Faculty of Medicine, University Complutense of Madrid, Ciudad Universitaria, Pza. Ramón y Cajal, Madrid, Spain
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5
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Esposito S, Cassano M, Cutrera R, Menzella F, Varricchio A, Uberti M. Expert consensus on the role of OM-85 in the management of recurrent respiratory infections: A Delphi study. Hum Vaccin Immunother 2022; 18:2106720. [PMID: 35985019 DOI: 10.1080/21645515.2022.2106720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Recurrent infections of upper and lower respiratory tract have an important clinical and economic impact, which can be reduced through appropriate preventive measures, including the use of immunomodulating agents, such as OM-85, which proved to be effective and safe in both adults and children. Although OM-85 can be useful for the prevention of respiratory tract infections, it is still underused in clinical practice. In order to evaluate the level of awareness of the disease burden of recurrent respiratory infections in adults and children and to assess the level of agreement on the prophylactic and therapeutic approach to the disease, including the use of immunomodulants, a Delphi study was performed. A board of six experts in the field of respiratory infections was appointed to elaborate a series of statements covering four main topics (disease, prevention, OM-85, and future strategies), which were thereafter voted by a panel of 30 experts. Results showed that prevention is unanimously recognized as the most important intervention to reduce disease burden, and the use of immunomodulation to improve the effectiveness of vaccination is gaining increasing favor among clinicians. In this respect, OM-85 is recognized as the most studied immunomodulating agent currently available, whose efficacy and safety make it a valuable tool to optimize the management of recurrent respiratory infections in both adults and children. In particular, the combined use of OM-85 and influenza vaccine was recognized as an effective and safe approach to improve the current prevention strategies in order to reduce the burden of recurrent respiratory infections.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Michele Cassano
- Otolaryngology Clinic, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Renato Cutrera
- Pediatrics Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Francesco Menzella
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL - IRCSS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Marzio Uberti
- Società Italiana di Medicina generale e delle Cure Primarie (SIMG), Torino, Italy
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6
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Ziou M, Tham R, Wheeler AJ, Zosky GR, Stephens N, Johnston FH. Outdoor particulate matter exposure and upper respiratory tract infections in children and adolescents: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 210:112969. [PMID: 35183515 DOI: 10.1016/j.envres.2022.112969] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 01/09/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND While the relationship between outdoor particulate matter (PM) and lower respiratory tract infections in children and adolescents is accepted, we know little about the impacts of outdoor PM on the risk of developing or aggravating upper respiratory tract infections (URTIs). METHODS We aimed to review the literature examining the relationship between outdoor PM exposure and URTIs in children and adolescents. A systematic search of EMBASE, MEDLINE, PubMed, Scopus, CINAHL and Web of Science databases was undertaken on April 3, 2020 and October 27, 2021. Comparable short-term studies of time-series or case-crossover designs were pooled in meta-analyses using random-effects models, while the remainder of studies were combined in a narrative analysis. Quality, risk of bias and level of evidence for health effects were appraised using a combination of emerging frameworks in environmental health. RESULTS Out of 1366 articles identified, 34 were included in the systematic review and 16 of these were included in meta-analyses. Both PM2.5 and PM10 levels were associated with hospital presentations for URTIs (PM2.5: RR = 1.010, 95%CI = 1.007-1.014; PM10: RR = 1.016, 95%CI = 1.011-1.021) in the meta-analyses. Narrative analysis found unequivocally that total suspended particulates were associated with URTIs, but mixed results were found for PM2.5 and PM10 in both younger and older children. CONCLUSION This study found some evidence of associations between PM and URTIs in children and adolescents, the relationship strength increased with PM10. However, the number of studies was limited and heterogeneity was considerable, thus there is a need for further studies, especially studies assessing long-term exposure and comparing sources.
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Affiliation(s)
- Myriam Ziou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Graeme R Zosky
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Nicola Stephens
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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7
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Abd Elsameea M, Abd-Elkader M, Fahmy EM, Abdelkreem E, ElTaher MA. Inborn Errors of Immunity among Egyptian Children with Recurrent Acute Otitis Media. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1748761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Abstract
Objective Our objective was to investigate the relative frequency and pattern of inborn errors of immunity (IEIs) among Egyptian children with recurrent acute otitis media (rAOM).
Methods This was a cross-sectional study that included children from the age of 6 months to 16 years with rAOM. Those with structural, functional, and environmental risk factors were excluded. Enrolled children underwent thorough clinical, otorhinolaryngological, and immunological evaluation, including hematological counting, quantitative immunoglobulins assay, lymphocytic flow cytometric immunophenotyping, CH50, and phagocytic function tests.
Results The study included 69 children with rAOM (44 boys and 25 girls; median age 30 months). IEIs were identified in 14 children, including transient hypogammaglobulinemia (three cases), selective IgA deficiency (three cases), agammaglobulinemia (two cases), common variable immunodeficiency (two cases), and one case for each of congenital neutropenia, Chediak–Higashi syndrome, hyper IgM syndrome, and Griscelli syndrome. Parental consanguinity and history of unexplained/infection-related siblings' deaths were significantly associated with IEIs (p = 0.018 and 0.003, respectively). AOM and related complications were more frequent among IEI cases (p = 0.018 and 0.032, respectively). IEI cases had lower levels of hemoglobin (10.7 ± 2.80 vs. 12.3 ± 1.64 g/dL; p = 0.002), IgG (203 [78–1,370] vs. 708 [42.3–1,509] mg/dL; p = 0.000), and IgA (24.3 [3–310] vs. 80 [15.6–305] mg/dL; p = 0.009) compared with non-IEI cases.
Conclusion The current study identified IEIs in one-fifth of children with rAOM, most of which were predominately antibody deficiencies. An immunological workup for rAOM is particularly important in the presence of certain indicators for IEIs, provided that other more common risk factors are excluded.
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Affiliation(s)
- Mohammed Abd Elsameea
- Department of Otorhinolaryngology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohammed Abd-Elkader
- Department of Otorhinolaryngology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Eman M. Fahmy
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Elsayed Abdelkreem
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mostafa A. ElTaher
- Department of Otorhinolaryngology, Faculty of Medicine, Sohag University, Sohag, Egypt
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8
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Rennerova Z, Picó Sirvent L, Carvajal Roca E, Paśnik J, Logar M, Milošević K, Majtan J, Jesenak M. Beta-(1,3/1,6)-D-glucan from Pleurotus ostreatus in the prevention of recurrent respiratory tract infections: An international, multicentre, open-label, prospective study. Front Pediatr 2022; 10:999701. [PMID: 36324817 PMCID: PMC9619242 DOI: 10.3389/fped.2022.999701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
Preschool children are particularly susceptible to recurrent upper and lower respiratory tract infections due to their immune immaturity and other contributing factors. Preventing and/or treating children suffering from recurrent respiratory tract infections (RRTIs) is challenging, and it is important to provide more clinical evidence about the safety and efficacy of natural immunomodulating preparations, including β-glucans. The aim of the present study was to assess the incidence of respiratory tract infections (RTIs) in children with a history of RRTIs for a period of 6 months (3 months of pleuran supplementation and 3 months of follow-up) compared with the same period from October to March of the previous year prior to enrolment in the study. A total of 1,030 children with a mean age of 3.49 ± 1.91 years from seven countries were included in this study. The total number of RTIs observed during the study period was significantly lower compared to the same period of the previous year (7.07 ± 2.89 vs. 3.87 ± 3.19; p < 0.001). Analysis of each type of RTI revealed significant reductions in the mean number and duration of infections for all RTI subtypes compared to the previous year. This study also confirmed the beneficial safety profile of pleuran supplementation. In conclusion, pleuran supplementation represents an interesting and prospective supplement in preventing respiratory infections and reveals new strategies for supporting immune functions in the paediatric population.
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Affiliation(s)
- Zuzana Rennerova
- Department of Paediatric Pulmonology and Phthisiology, Faculty of Medicine, Slovak Medical University, National Children Institute of Health, Bratislava, Slovakia
| | - Leandro Picó Sirvent
- Paediatrics Department, Hospital de la Salud, Valencia, Spain.,Faculty of Medicine and Health Sciences, Valencia Catholic University Saint Vincent Martyr, Valencia, Spain
| | - Eva Carvajal Roca
- Paediatrics Department, Hospital de la Salud, Valencia, Spain.,Faculty of Medicine and Health Sciences, Valencia Catholic University Saint Vincent Martyr, Valencia, Spain
| | | | - Mateja Logar
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.,Department of Infectious Diseases and Epidemiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Milošević
- Department of Pulmonology and Allergology, University Children's Hospital, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Juraj Majtan
- Institute of Molecular Biology, Slovak Academy of Sciences, Bratislava, Slovakia.,Department of Microbiology, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia
| | - Milos Jesenak
- Department of Paediatrics, Jessenius Faculty of Medicine, University Teaching Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia.,Department of Clinical Immunology and Allergology, University Teaching Hospital in Martin, Martin, Slovakia
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9
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Zhou B, Niu W, Liu F, Yuan Y, Wang K, Zhang J, Wang Y, Zhang Z. Risk factors for recurrent respiratory tract infection in preschool-aged children. Pediatr Res 2021; 90:223-231. [PMID: 33173178 DOI: 10.1038/s41390-020-01233-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/12/2020] [Accepted: 10/11/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND We aimed to identify potential risk factors for recurrent respiratory tract infection among Chinese preschool-aged children, and further to construct a nomogram prediction model. METHODS This is a cross-sectional survey conducted in Beijing. Utilizing a stratified cluster random sampling strategy, a total of 7222 children from 20 kindergartens were enrolled. Data are analyzed by STATA software and R language. RESULTS Five independent factors were identified to be significantly associated with recurrent respiratory tract infection risk overall and by pathogenic sites. The significant odds of recurrent respiratory tract infection was 8.31 (95% confidence interval [CI]: 5.69-12.12, P < 0.001), 2.31 (2.06-2.58, P < 0.001), 1.72 (1.48-1.99, P < 0.001), 1.24 (1.08-1.43, P = 0.002), and 1.19 (1.09-1.31, P < 0.001) for asthma, allergy, initial use of antibiotics <6 months, breastfeeding duration <6 months, and maternal body mass index, respectively. Besides the leading role played by asthma, allergy, initial use of antibiotics, and breastfeeding might exert a graded, dose-dependent effect on recurrent respiratory tract infection susceptibility. CONCLUSIONS We have identified five potential risk factors for the risk of recurrent respiratory tract infection from 7222 preschool-aged Chinese children. Notably, asthma plays a leading role, and allergy, initial use of antibiotics, and breastfeeding might exert a graded, dose-dependent effect on recurrent respiratory tract infection susceptibility. IMPACT This is the first report of examining the joint contribution of multiple potential risk factors to recurrent respiratory tract infection among Chinese preschool-aged children. We have identified five potential risk factors for the risk of recurrent respiratory tract infection via analyzing survey data from 7222 preschool-aged Chinese children. Asthma plays a leading role, and allergy, initial use of antibiotics, and breastfeeding might exert a graded, dose-dependent effect on recurrent respiratory tract infection susceptibility.
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Affiliation(s)
- Bo Zhou
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,International Medical Services, China-Japan Friendship Hospital, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Fangyu Liu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Yuan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,International Medical Services, China-Japan Friendship Hospital, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Kundi Wang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Jing Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Yunfeng Wang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Zhixin Zhang
- International Medical Services, China-Japan Friendship Hospital, Beijing, China. .,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
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10
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Vázquez A, Fernández-Sevilla LM, Jiménez E, Pérez-Cabrera D, Yañez R, Subiza JL, Varas A, Valencia J, Vicente A. Involvement of Mesenchymal Stem Cells in Oral Mucosal Bacterial Immunotherapy. Front Immunol 2020; 11:567391. [PMID: 33329530 PMCID: PMC7711618 DOI: 10.3389/fimmu.2020.567391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/19/2020] [Indexed: 12/19/2022] Open
Abstract
Recent clinical observations indicate that bacterial vaccines induce cross-protection against infections produced by different microorganisms. MV130, a polyvalent bacterial sublingual preparation designed to prevent recurrent respiratory infectious diseases, reduces the infection rate in patients with recurrent respiratory tract infections. On the other hand, mesenchymal stem cells (MSCs) are key cell components that contribute to the maintenance of tissue homeostasis and exert both immunostimulatory and immunosuppressive functions. Herein, we study the effects of MV130 in human MSC functionality as a potential mechanism that contributes to its clinical benefits. We provide evidence that during MV130 sublingual immunization of mice, resident oral mucosa MSCs can take up MV130 components and their numbers remain unchanged after vaccination, in contrast to granulocytes that are recruited from extramucosal tissues. MSCs treated in vitro with MV130 show an increased viability without affecting their differentiation potential. In the short-term, MSC treatment with MV130 induces higher leukocyte recruitment and T cell expansion. In contrast, once T-cell activation is initiated, MV130 stimulation induces an up-regulated expression of immunosuppressor factors in MSCs. Accordingly, MV130-primed MSCs reduce T lymphocyte proliferation, induce the differentiation of dendritic cells with immunosuppressive features and favor M2-like macrophage polarization, thus counterbalancing the immune response. In addition, MSCs trained with MV130 undergo functional changes, enhancing their immunomodulatory response to a secondary stimulus. Finally, we show that MSCs are able to uptake, process and retain a reservoir of the TLR ligands derived from MV130 digestion which can be subsequently transferred to dendritic cells, an additional feature that also may be associated to trained immunity.
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Affiliation(s)
- Alberto Vázquez
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Lidia M Fernández-Sevilla
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
| | - Eva Jiménez
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
| | - David Pérez-Cabrera
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Rosa Yañez
- Hematopoietic Innovative Therapies Division, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Investigaciones Sanitarias de la Fundación Jiménez Díaz, Madrid, Spain
| | | | - Alberto Varas
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
| | - Jaris Valencia
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
| | - Angeles Vicente
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
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11
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Esposito S, Jones MH, Feleszko W, Martell JAO, Falup-Pecurariu O, Geppe N, Martinón-Torres F, Shen KL, Roth M, Principi N. Prevention of New Respiratory Episodes in Children with Recurrent Respiratory Infections: An Expert Consensus Statement. Microorganisms 2020; 8:E1810. [PMID: 33213053 PMCID: PMC7698530 DOI: 10.3390/microorganisms8111810] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/01/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023] Open
Abstract
In healthy infants and young children, the development of respiratory tract infections (RTIs) is extremely common. In this paper, we present an international consensus of the available approaches for the prevention of recurrent RTIs in children, including the atopic/allergic ones as well as those with asthma. Few convincing measures for reducing the frequency and clinical relevance of recurrent respiratory episodes in RTI-prone children have been developed until now. Among the most recently suggested measures, immunotherapy is attractive, but only for OM-85 is there a sufficient number of well-conducted clinical trials confirming efficacy in RTIs prevention with an adequate safety profile. In the case of probiotics, it is not clear which bacteria can offer the best results and which dosage and schedule of administration are the most effective. The problems of dosage and the schedule of administration are not solved also for vitamin D, despite some promising efficacy results. While we wait for new knowledge, the elimination or reduction as much as possible of the environmental factors that favor RTIs, vaccination when available and/or indicated, and the systematic application of the traditional methods for infection prevention, such as hand washing, remain the best measures to prevent recurrent infections in RTI-prone children.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, 43126 Parma, Italy
| | - Marcus Herbert Jones
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre (RS) 90619-900, Brazil;
| | - Wojciech Feleszko
- Department of Pediatric Pneumonology and Allergy, The Medical University of Warsaw, 00-927 Warsaw, Poland;
| | - José A. Ortega Martell
- Department of Immunology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo 42082, Mexico;
| | - Oana Falup-Pecurariu
- Faculty of Medicine, Transilvania University, Children’s Clinic Hospital, 500036 Brasov, Romania;
| | - Natalia Geppe
- Department of Paediatrics, Sechenov First Moscow State Medical University, 115093 Moscow, Russia;
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Kun-Ling Shen
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
| | - Michael Roth
- Pulmonary Cell Research and Pneumology, Department of Biomedicine and Internal Medicine, University Hospital Basel, 4002 Basel, Switzerland;
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12
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Li S, Xie H, Chiang HJ, Liu Z, Han Z, Liang J, Wang L, Wang Q, Li J, Li Y. Effectiveness of TCM cauterization in recurrent tonsillitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22597. [PMID: 33031313 PMCID: PMC10545315 DOI: 10.1097/md.0000000000022597] [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: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Recurrent tonsillitis (RT) is often treated with antibiotic therapy and surgery. Although these treatments have advantages, they are also controversial. The purpose of this study is to analyze the safety and effectiveness of traditional Chinese medicine (TCM) cauterization in the treatment of RT, so as to provide an alternative for the clinicians and to cover the shortage of therapeutic methods. METHODS AND ANALYSIS This protocol is guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. We will formulate strict inclusion and exclusion criteria in English databases (PubMed, EMBASE, and Web of Science), Chinese databases (CNKI, Wanfang databases, CBM, and VIP), and search literatures in different clinical registration platforms (Cochrane Library, Chinese Cochrane Centre's Clinical Trial Registry Platform). The included articles will be evaluated using Cochrane RCT evaluation criteria. Stata 15.0 will be used for data analysis. Subgroup analysis, sensitivity analysis, and meta-regression will detect sources of heterogeneity. Egger's Test or Begg's Test will detect publication bias quantitatively. CONCLUSION Cauterization can effectively control the recurrence of tonsillitis through clinical trials, but evidence-based medicine needs to be adopted to provide strong evidence for its effectiveness. The purpose of our research is to provide the evidence. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/PZ69Q.
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Affiliation(s)
- Sha Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Hui Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Han-Jen Chiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Zhiqing Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Zhenzhen Han
- Yibin Hospital of T.C.M, West of South Bank District, Yibin City, Sichuan Province, P.R. China
| | - Jiao Liang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Lu Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Qiu Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Jiongke Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yusi Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
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