First International Symposium on Influenza and Other Respiratory Viruses: summary and overview: Kapalua, Maui, Hawaii, December 4-6, 1998

Increased production of autoantibodies and specific antibodies in response to influenza virus vaccination in physically active older individuals

Immunosenescence is associated to aging and among many changes in immune response is reported a reduced response to vaccination and an increase in the number of cases of autoimmunity, caused by autoantibodies known as natural antibodies whose function, according to reports, would be protection against infection and inflammation. Although immunosenescence is an irreversible process, regular moderate exercise can attenuate some aspects of the decline in the immune system. So, the aim of this study was to investigate the humoral immune response in physically active elderly individuals before and 30 days after vaccination against influenza virus. The results showed that the percentage of individuals positive for antinuclear antibodies and serum immunoglobulin M and G levels after vaccination were higher in the group that exercised regularly than in the sedentary group. We were also able to demonstrate a significant correlation between levels of natural autoantibodies and response to vaccination.

Antiviral Furanosesquiterpenes from Commiphora erythraea

The crude methanolic extract obtained from C. erythraea resin was chromatographed on silica gel with solvent of increasing polarity. The extract and fractions were evaluated for cytotoxicity and antiviral activity [parainfluenza type 3 virus (PIV3)] by plaque forming units (PFU) reduction assay using HEp-2 cells (human larynx epidermoid carcinoma cell line). From the active fraction, five compounds were isolated and tested. Only two of these showed anti-PIV3 activity with a selectivity index (SI) of 66.6 and 17.5, respectively. Both the compounds are furanosesquiterpenoids.

[Study on the adverse effects and protective effects of influenza vaccine among elderly individuals vaccinated through the public system in the municipality of Tubarão, State of Santa Catarina]

INTRODUCTION

The aim of this study was to investigate the incidence of adverse effects and protective effects from influenza vaccine among elderly individuals who were vaccinated through the public healthcare system in the municipality of Tubarão, State of Santa Catarina.

METHODS

A prospective cohort study was conducted between May and September 2008. A group of 341 patients was recruited, among whom 289 had been vaccinated through the public system (VSUS) and 52 had not been vaccinated (NV). The incidence of protective effects was observed by comparing the VSUS and NV groups.

RESULTS

It was observed that 22.5% of the vaccinated subjects exhibited at least one adverse effect. Comparing the VSUS and NV groups in relation to the incidence of flu symptoms presented during the winter, at least one symptom was observed in 47% and 28.8% (RR = 1.11; 1.02-1.22; p = 0.0156), respectively.

CONCLUSIONS

These findings demonstrate that the incidence of adverse effects was low. The high incidence of flu symptoms in the VSUS group, in comparison with NV, may be related to the profile of subjects who are in the habit of getting vaccinated against influenza.

Season of birth and risk for adult onset glioma

Adult onset glioma is a rare cancer which occurs more frequently in Caucasians than African Americans, and in men than women. The etiology of this disease is largely unknown. Exposure to ionizing radiation is the only well established environmental risk factor, and this factor explains only a small percentage of cases. Several recent studies have reported an association between season of birth and glioma risk. This paper reviews the plausibility of evidence focusing on the seasonal interrelation of farming, allergies, viruses, vitamin D, diet, birth weight, and handedness. To date, a convincing explanation for the occurrence of adult gliomas decades after a seasonal exposure at birth remains elusive.

Antiviral triterpenoids from the medicinal plant Schefflera heptaphylla

Schefflera heptaphylla (L.) Frodin is a principal ingredient of an herbal tea formulation widely used for the treatment of common cold in southern China. An extract of the long leafstalk of the compound leaf of S. heptaphylla exhibited the most potent antiviral activity against respiratory syncytial virus (RSV). Further antiviral-guided fractionation and isolation of the leafstalk extract of S. heptaphylla led to obtain two highly active pure triterpenoids, namely 3alpha-hydroxylup-20(29)-ene-23,28-dioic acid and 3-epi-betulinic acid 3-O-sulfate, together with an inactive saponin, 3alpha-hydroxylup-20(29)-ene-23,28-dioic acid 28-O-alpha-l-rhamnopyranosyl-(1-->4)-O-beta-d-glucopyranosyl-(1-->6)-beta-d-glucopyranoside. An antiviral assay using a cytopathic effect (CPE) reduction method showed that the two triterpenoids possessed broader antiviral activity against respiratory syncytial virus (RSV) with a similar 50% inhibition concentration (IC(50)) value of 6.25 microg/mL, influenza A (H1N1) virus with IC(50) values of 25 and 31.3 microg/mL, Coxsackie B3 (Cox B3) virus with IC(50) values of 12.5 and 20 microg/mL and herpes simplex virus type 1 (HSV-1) with IC(50) values of 18.8 and 25 microg/mL, respectively, whereas the saponin did not have antiviral activity against these four viruses at a concentration of 100 microg/mL.

[A case of severe community acquired pneumonia and non-respiratory illness induced by Influenza A]

BACKGROUND

Severe community acquired pneumonia is a common cause of acute respiratory failure. The influenza virus itself can cause a severe pneumonia and non-respiratory illness.

CASE REPORT

A physician developed an acute respiratory failure associated with hemolytic anemia, acute renal failure, and myocarditis. Influenza A infection was diagnosed by screening for antibodies (complement fixation, ELISA Ig A).

DISCUSSION

Fulminant influenza pneumonia is a rare clinical presentation of influenza infection and usually has a severe clinical course. Influenza infection is also associated with myositis, myocarditis, acute renal failure, encephalopathy, and hemolytic anemia. Rapid laboratary diagnosis can be made by PCR or immunofluorescence applied directly to respiratory specimens. Antiviral treatment did not prove its efficacy in fulminant Influenza. This case report is an opportunity to stress the importance of seroprophylaxis by parenteral vaccination in exposed occupations.

Impacto da vacinação contra influenza na mortalidade por doenças respiratórias em idosos

OBJETIVO: As doenças respiratórias, particularmente as infecciosas, vêm se tornando cada vez mais representativas na morbi-mortalidade da população idosa. O objetivo do estudo foi analisar a tendência de mortalidade por doenças respiratórias e observar o impacto da vacinação contra influenza nos coeficientes de mortalidade. MÉTODOS: O estudo foi realizado no período de 1980 a 2000 em idosos residentes no Estado de São Paulo, utilizando-se dados de mortalidade do Sistema de Informações de Mortalidade do Ministério da Saúde. Trata-se de estudo ecológico de séries temporais. Foram analisadas as tendências das taxas padronizadas de mortalidade por doenças respiratórias infecciosas, segundo faixas etárias (60 a 64, 65 a 69, 70 a 74, 75 a 79 e 80 ou mais anos) e sexo, por meio de modelos de regressão polinomial. Foram calculados intervalos de confiança para a resposta média esperada nos anos subseqüentes à intervenção. RESULTADOS: Os coeficientes aumentaram para ambos os sexos na população idosa. Após a intervenção nota-se tendência ao declínio dos indicadores de mortalidade. Para a população idosa masculina, o coeficiente médio no período de 1980 a 1998 foi de 5,08 óbitos por mil homens com aumento linear não constante de 0,13 ao ano; em 2000, o coeficiente observado foi de 4,72 óbitos por mil homens. Já para as mulheres de 60 anos e mais, o coeficiente anual médio foi de 3,18 óbitos por mil mulheres com incremento não constante de 0,08 ao ano; no ano de 2000 o coeficiente observado foi 2,99 óbitos por mil mulheres, além da redução significativa dos mesmos em todas as faixas etárias. CONCLUSÕES: Os dados indicam a importância das doenças respiratórias entre os idosos e sugerem que a proteção específica contra influenza tem se refletido positivamente na prevenção da mortalidade por essas doenças.

Uncinoside A and B, two new antiviral chromone glycosides from Selaginella uncinata

Five compounds have been isolated from the dried whole plants of Selaginella uncinata, two of them were new chromone glycosides, 5-hydroxy-2,6,8-trimethylchromone 7-O-beta-D-glucopyranoside (uncinoside A) and 5-acetoxyl-2,6,8-trimethylchromone 7-O-beta-D-glucopyranoside (uncinoside B). Their structures were elucidated by spectroscopic methods including one- and two-dimensional NMR techniques. The other three compounds were identified as 8-methyl eugenitol, amentoflavone and hinokiflavone. Uncinoside A and B showed potent antiviral activities against respiratory syncytial virus (RSV) with IC(50) value of 6.9 and 1.3 microg/ml, moderate antiviral activities against parainfluenza type 3 virus (PIV 3) with IC(50) value of 13.8 and 20.8 microg/ml, respectively.

Antiviral flavonoids from the seeds of Aesculus chinensis

A bioassay-guided fractionation of an ethanol extract of the seeds of Aesculus chinensis led to the isolation of two new flavanoids (1 and 2), along with eight known ones (3-10). The structures of the new compounds were elucidated by spectroscopic methods including 2D NMR. All compounds were tested for antiviral activity against respiratory syncytial virus (RSV), parainfluenza virus type 3 (PIV 3), and influenza virus type A (Flu A). Compounds 1, 2, and 6 showed significant antiviral activities against RSV with IC(50) values of 4.5, 6.7, and 4.1 microg/mL and selective index (SI) values of 15.8, 32, and 63.8, respectively. Compound 8 demonstrated significant antiviral activity against Flu A with an IC(50) of 24.5 microg/mL and a SI of 16.0, respectively.

[Trends in mortality due to respiratory diseases in elderly, Brazil, 1980 to 1998]

INTRODUCTION

The increase in life expectancy and the decline in mortality rates in Brazil have an impact on social programs to the elderly, especially related to health care. The objective of the study isto analyze the mortality trends for respiratory diseases in elderly.

METHODS

An ecological time series was carried out and mortality data was obtained from the Mortality Information System of the Ministry of Health (SIM/MS-DATA-SUS). it was analyzed the time trends of standardized mortality rates according to age groups (60 to 69, 70 to 79 and 80 years old and more) and gender, using linear regression models. The proportional mortality for this disease group compared to all causes of death was also studied.

RESULTS

There were increasing trends for mortality rates in both sexes, especially among males. The proportion of deaths due to respiratory diseases was higher among older ages.

CONCLUSION

Respiratory diseases are one of the main causes of hospitalization and death in the elderly population. Prevention and care for elderly, as well as further etiology studies should be a priority in Brazil.

Comparison of efficacies of RWJ-270201, zanamivir, and oseltamivir against H5N1, H9N2, and other avian influenza viruses

The orally administered neuraminidase (NA) inhibitor RWJ-270201 was tested in parallel with zanamivir and oseltamivir against a panel of avian influenza viruses for inhibition of NA activity and replication in tissue culture. The agents were then tested for protection of mice against lethal H5N1 and H9N2 virus infection. In vitro, RWJ-270201 was highly effective against all nine NA subtypes. NA inhibition by RWJ-270201 (50% inhibitory concentration, 0.9 to 4.3 nM) was superior to that by zanamivir and oseltamivir carboxylate. RWJ-270201 inhibited the replication of avian influenza viruses of both Eurasian and American lineages in MDCK cells (50% effective concentration, 0.5 to 11.8 microM). Mice given 10 mg of RWJ-270201 per kg of body weight per day were completely protected against lethal challenge with influenza A/Hong Kong/156/97 (H5N1) and A/quail/Hong Kong/G1/97 (H9N2) viruses. Both RWJ-270201 and oseltamivir significantly reduced virus titers in mouse lungs at daily dosages of 1.0 and 10 mg/kg and prevented the spread of virus to the brain. When treatment began 48 h after exposure to H5N1 virus, 10 mg of RWJ-270201/kg/day protected 50% of mice from death. These results suggest that RWJ-270201 is at least as effective as either zanamivir or oseltamivir against avian influenza viruses and may be of potential clinical use for treatment of emerging influenza viruses that may be transmitted from birds to humans.

Community respiratory virus infections following lung transplantation

Respiratory infections remain a significant cause of morbidity and mortality after lung transplantation. In addition to cytomegalovirus, the community respiratory viruses such as respiratory syncytial virus (RSV), parainfluenza virus (PIV), influenza virus, and adenovirus, are important causes of infection in transplant recipients, often involve the lower respiratory tract, and may be associated with significant morbidity and mortality. In this review, we summarize the current state of knowledge regarding the epidemiology, clinical manifestations, diagnosis, treatment and outcomes associated with RSV, PIV, influenza virus, and adenovirus infections in lung transplant recipients.

The neuraminidase inhibitor GS4104 (oseltamivir phosphate) is efficacious against A/Hong Kong/156/97 (H5N1) and A/Hong Kong/1074/99 (H9N2) influenza viruses

In 1997, an H5N1 avian influenza A/Hong Kong/156/97 virus transmitted directly to humans and killed six of the 18 people infected. In 1999, another avian A/Hong/1074/99 (H9N2) virus caused influenza in two children. In such cases in which vaccines are unavailable, antiviral drugs are crucial for prophylaxis and therapy. Here we demonstrate the efficacy of the neuraminidase inhibitor GS4104 (oseltamivir phosphate) against these H5N1 and H9N2 viruses. GS4071 (the active metabolite of oseltamivir) inhibited viral replication in MDCK cells (EC(50) values, 7.5-12 microM) and neuraminidase activity (IC(50) values, 7.0-15 nM). When orally administered at doses of 1 and 10 mg/kg per day, GS4104 prevented death of mice infected with A/Hong Kong/156/97 (H5N1), mouse-adapted A/Quail/Hong Kong/G1/97 (H9N2), or human A/Hong Kong/1074/99 (H9N2) viruses and reduced virus titers in the lungs and prevented the spread of virus to the brain of mice infected with A/Hong Kong/156/97 (H5N1) and mouse-adapted A/Quail/Hong Kong/G1/97 (H9N2) viruses. When therapy was delayed until 36 h after exposure to the H5N1 virus, GS4104 was still effective and significantly increased the number of survivors as compared with control. Oral administration of GS4104 (0.1 mg/kg per day) in combination with rimantadine (1 mg/kg per day) reduced the number of deaths of mice infected with 100 MLD(50) of H9N2 virus and prevented the deaths of mice infected with 5 MLD(50) of virus. Thus, GS4104 is efficacious in treating infections caused by H5N1 and H9N2 influenza viruses in mice.

Antiviral agents in the critically ill child

The treatment for most viral infections in children primarily is supportive. Severe viral illnesses and significant secondary complications that require treatment in the intensive care unit may occur in immunocompromised patients and also in infants and children who were previously healthy. Antiviral agents with specific activity against certain respiratory viruses, herpesviruses, and enteric viruses are available. New drugs are under development, and their use in pediatric patients is a subject of active research. The clinician's knowledge of the mechanisms of action, spectrum of activity, and side effects of these drugs is an important tool for their judicious use in the treatment of the critically ill child. Copyright © 2000 by W.B. Saunders Company