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Lee PI, Liu CC, Hu YL, Chen JM. Seasonality and risk factor analysis of respiratory syncytial virus infection in children in Taiwan-A retrospective study from 1995 to 2005. J Med Virol 2023; 95:e29116. [PMID: 37772669 DOI: 10.1002/jmv.29116] [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: 04/20/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023]
Abstract
Respiratory syncytial virus (RSV) is one of the important pathogens leading to acute respiratory tract infection in infants and young children. We aimed to investigate the seasonality of RSV infection in different parts of Taiwan and to delineate the risk factors for severe RSV infections. We collected RSV-infected patients' data by retrospective chart review. A total of 1740 RSV-infected children aged under 18 years were enrolled. The infection was acquired during hospitalization in 103 (7.1%) children, while none of them required ventilator support or needed intensive care before RSV infection. The need for intensive care or ventilator support was significantly associated with congenital heart disease (CHD), chronic lung disease, and neuromuscular diseases. Age <1 year and nosocomially acquired infection are also significant predictors for the need of intensive care. Only the presence of CHD, especially acyanotic CHD, was significantly associated with a fatal outcome. RSV infection occurs all year round. Monthly distribution of RSV infections in Northern Taiwan showed a bimodal pattern, with one peak from March to May, and another from August to October. The distribution in Southern Taiwan showed a single peak from April to July. The occurrence of RSV correlates positively with temperature and rain. The bimodal seasonal distribution pattern in Northern Taiwan may be a transitional pattern shifting from a single high winter peak in temperate areas to a wider summer peak in tropical areas. Continuous surveillance is needed to explore the possible effect of global warming on the seasonality of RSV infection.
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Affiliation(s)
- Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ya-Li Hu
- Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
| | - Jong-Min Chen
- Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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2
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Divarathna MVM, Rafeek RAM, Morel AJ, Aththanayake C, Noordeen F. Epidemiology and risk factors of respiratory syncytial virus associated acute respiratory tract infection in hospitalized children younger than 5 years from Sri Lanka. Front Microbiol 2023; 14:1173842. [PMID: 37434712 PMCID: PMC10330818 DOI: 10.3389/fmicb.2023.1173842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory tract infections (ARTI) and a major cause of morbidity and mortality in children worldwide. Aim This study aimed to describe the prevalence and seasonal patterns of RSV and to determine the actual and predictive association of RSV-associated ARTI and clinical, socio-demographic, and climatic risk factors in children < 5 years. Methods Nasopharyngeal aspirates were collected from 500 children < 5 years admitted to the Kegalle General Hospital, Sri Lanka between May 2016 to July 2018. RSV and RSV subtypes were detected using immunofluorescence assay and real time RT-PCR, respectively. Descriptive and inferential statistics were done for the data analysis using Chi-square, Fisher's exact, Kruskal-Wallis test, and multiple binary logistic regression in the statistical package for social sciences (SPSS), version 16.0. Results Prevalence of RSV-associated ARTI was 28% in children < 5 years. Both RSV subtypes were detected throughout the study period. RSV-B was the dominant subtype detected with a prevalence of 72.14%. RSV infection in general caused severe respiratory disease leading to hypoxemia. Compared to RSV-B, RSV-A infection had more symptoms leading to hypoxemia. Factors increasing the risk of contracting RSV infection included number of people living (n > 6), having pets at home and inhaling toxic fumes. The inferential analysis predicts RSV infection in children < 5 years with ARTI, with a 75.4% probability with clinical and socio-demographic characteristics like age < 1 year, fever for > 4 days, cough, conjunctivitis, stuffiness, fatigue, six or more people at home, having pets at home and inhaling toxic fumes. Climatic factors like increases in temperature (°C), wind speed (Km/h), wind gust (Km/h), rainfall (mm) and atmospheric pressure (mb) showed a strong correlation with the RSV infection in children.
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Affiliation(s)
- Maduja V. M. Divarathna
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rukshan A. M. Rafeek
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, Diagnostic and Research Virology Laboratory, University of Peradeniya, Peradeniya, Sri Lanka
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Neutrophil Functional Heterogeneity and Implications for Viral Infections and Treatments. Cells 2022; 11:cells11081322. [PMID: 35456003 PMCID: PMC9025666 DOI: 10.3390/cells11081322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 12/15/2022] Open
Abstract
Evidence suggests that neutrophils exert specialized effector functions during infection and inflammation, and that these cells can affect the duration, severity, and outcome of the infection. These functions are related to variations in phenotypes that have implications in immunoregulation during viral infections. Although the complexity of the heterogeneity of neutrophils is still in the process of being uncovered, evidence indicates that they display phenotypes and functions that can assist in viral clearance or augment and amplify the immunopathology of viruses. Therefore, deciphering and understanding neutrophil subsets and their polarization in viral infections is of importance. In this review, the different phenotypes of neutrophils and the roles they play in viral infections are discussed. We also examine the possible ways to target neutrophil subsets during viral infections as potential anti-viral treatments.
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Beigelman A, Srinivasan M, Goss CW, Wang J, Zhou Y, True K, Ahrens E, Burgdorf D, Haslam MD, Boomer J, Bram S, Burnham CAD, Casper TJ, Coverstone AM, Kanchongkittiphon W, Kuklinski C, Storch GA, Wallace MA, Yin-DeClue H, Castro M, Schechtman KB, Bacharier LB. Azithromycin to Prevent Recurrent Wheeze Following Severe Respiratory Syncytial Virus Bronchiolitis. NEJM EVIDENCE 2022; 1:10.1056/evidoa2100069. [PMID: 37621674 PMCID: PMC10448891 DOI: 10.1056/evidoa2100069] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND Early-life severe respiratory syncytial virus (RSV) bronchiolitis is a risk factor for childhood asthma. Because azithromycin may attenuate airway inflammation during RSV bronchiolitis, we evaluated whether it would reduce the occurrence of post-RSV recurrent wheeze. METHODS We prospectively enrolled 200 otherwise healthy 1- to 18-month-old children hospitalized with RSV bronchiolitis in this single-center, double-blind, placebo-controlled study and randomly assigned them to receive oral azithromycin (10 mg/kg daily for 7 days, followed by 5 mg/kg daily for 7 days) or placebo. Randomization was stratified by recent open-label antibiotic use. The primary outcome was the occurrence of recurrent wheeze, defined as a third episode of post-RSV wheeze over the following 2 to 4 years. RESULTS As an indication of the biologic activity of azithromycin, nasal wash interleukin-8 levels, at day 14 after randomization, were lower among azithromycin-treated participants (P<0.01). Despite evidence of biologic activity, azithromycin did not reduce the risk of post-RSV recurrent wheeze (47% in the azithromycin group vs. 36% in the placebo group; adjusted hazard ratio, 1.45; 95% confidence interval [CI], 0.92 to 2.29; P=0.11). Azithromycin also did not modify the risk of recurrent wheeze among participants already receiving other antibiotic treatment at the time of enrollment (hazard ratio, 0.94; 95% CI, 0.43 to 2.07). There was a potential signal among antibiotic-naïve participants who received azithromycin to have an increased risk of recurrent wheeze (hazard ratio, 1.79; 95% CI, 1.03 to 3.1). CONCLUSIONS Azithromycin therapy for 14 days during acute severe RSV bronchiolitis did not reduce recurrent wheeze occurrence over the following 2 to 4 years. Our data suggest no benefit of azithromycin administration with the goal of preventing recurrent wheeze in later life. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT02911935.).
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Affiliation(s)
- Avraham Beigelman
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
- Kipper Institute of Allergy and Immunology, Schneider Children's Medical Center of Israel and the Tel Aviv University, Petach Tikvah, Israel
| | - Mythili Srinivasan
- Division of Hospitalist Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | - Charles W Goss
- Division of Biostatistics, Washington University School of Medicine, St. Louis
| | - Jinli Wang
- Division of Biostatistics, Washington University School of Medicine, St. Louis
| | - Yanjiao Zhou
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT
| | - Kelly True
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | - Elizabeth Ahrens
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | - Dana Burgdorf
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | | | - Jonathan Boomer
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Sarah Bram
- Division of Hospitalist Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | - Carey-Ann D Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis
| | | | - Andrea M Coverstone
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | | | - Cadence Kuklinski
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | - Gregory A Storch
- Division of Pediatric Infectious Disease, Department of Pediatrics, Washington University School of Medicine, St. Louis
| | - Meghan A Wallace
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis
| | - Huiqing Yin-DeClue
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS
| | | | - Leonard B Bacharier
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville
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Karakioulaki M, Papakonstantinou E, Goulas A, Stolz D. The Role of Atopy in COPD and Asthma. Front Med (Lausanne) 2021; 8:674742. [PMID: 34490286 PMCID: PMC8418108 DOI: 10.3389/fmed.2021.674742] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/26/2021] [Indexed: 12/31/2022] Open
Abstract
Common to several allergic diseases is the generation of immunoglobulin E (IgE) by plasma cells, when exposed to an innocuous antigen. Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airway inflammatory diseases. Asthma is mediated in some patients through eosinophilic inflammatory mechanisms that include allergic sensitization and Th2-mediated immune airway response. COPD, on the other hand is mainly considered a Th1-mediated inflammatory process with neutrophilic predominance or a non-Th2 inflammation, occasionally associated with the presence of airway bacteria or viruses. IgE production appears to play an important role in the development of both COPD and asthma, as it has been associated to respiratory symptoms, lung function, bacterial and viral infections, airway remodeling and bronchial hyperreactivity in both diseases. The aim of this review is to summarize all current data concerning the role of specific and total IgE in COPD and asthma and to highlight similarities and differences in view of possible therapeutic interventions.
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Affiliation(s)
- Meropi Karakioulaki
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital of Basel, Basel, Switzerland.,First Laboratory of Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Papakonstantinou
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital of Basel, Basel, Switzerland.,First Laboratory of Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Goulas
- First Laboratory of Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Daiana Stolz
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital of Basel, Basel, Switzerland
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Xu J, Wu W, Chen H, Xue Y, Bao X, Zhou J. Substituted N-(4-amino-2-chlorophenyl)-5-chloro-2-hydroxybenzamide analogues potently inhibit respiratory syncytial virus (RSV) replication and RSV infection-associated inflammatory responses. Bioorg Med Chem 2021; 39:116157. [PMID: 33895704 DOI: 10.1016/j.bmc.2021.116157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022]
Abstract
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in young children, and specific treatment for RSV infections remains unavailable. We herein reported a series of substituted N-(4-amino-2-chlorophenyl)-5-chloro-2-hydroxybenzamide analogues as potent RSV inhibitors. Among them, six low cytotoxic compounds (11, 12, 15, 22, 26, and 28) have been identified and selected to study associated inhibitory mechanisms. All these compounds suppressed not only the viral replication but also RSV-induced IRF3 and NF-κB activation and associated production of cytokines/chemokines. The two most potent compounds (15 and 22) were selected for further molecular mechanism studies associated with their suppression effect on RSV-activated IRF3 and NF-κB. These two compounds decreased RSV-induced IRF3 phosphorylation at serine 396 and p65 phosphorylation at serine 536 at both early and late infection phases. In addition, compound 22 also inhibited RSV-induced p65 phosphorylation at serine 276 at the late phase of RSV infection.
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Affiliation(s)
- Jimin Xu
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States
| | - Wenzhe Wu
- Department of Pediatrics, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States
| | - Haiying Chen
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States
| | - Yu Xue
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States
| | - Xiaoyong Bao
- Department of Pediatrics, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States; Sealy Center for Molecular Medicine, and University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States; Institute for Human Infections and Immunity, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States.
| | - Jia Zhou
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States; Sealy Center for Molecular Medicine, and University of Texas Medical Branch (UTMB), Galveston, TX 77555, United States.
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7
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Differential asthma odds following respiratory infection in children from three minority populations. PLoS One 2020; 15:e0231782. [PMID: 32369487 PMCID: PMC7199930 DOI: 10.1371/journal.pone.0231782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/31/2020] [Indexed: 01/01/2023] Open
Abstract
RATIONALE Severe early-life respiratory illnesses, particularly those caused by respiratory syncytial virus (RSV) and human rhinovirus (HRV), are strongly associated with the development of asthma in children. Puerto Rican children in particular have a strikingly high asthma burden. However, prior studies of the potential associations between early-life respiratory illnesses and asthma in Puerto Rican and other minority populations have been limited. OBJECTIVES We sought to determine whether early-life respiratory illness was associated with asthma in Puerto Rican, Mexican American, and African American children. METHODS Using a logistic regression analysis, we examined the association between early-life respiratory illnesses (report of upper respiratory infection (URI), pneumonia, bronchitis, and bronchiolitis/RSV) within the first two years of life and physician-diagnosed asthma after the age of two in a large cohort of Puerto Rican, Mexican American, and African American children. MEASUREMENTS AND MAIN RESULTS While early-life respiratory illnesses were associated with greater asthma odds in Puerto Ricans, Mexican Americans, and African Americans, these associations were stronger among Puerto Rican children. Specifically, in Puerto Ricans, the odds was 6.15 (95% CI: 4.21-9.05) if the child reported at least one of the following respiratory illness: URI, pneumonia, bronchitis or bronchiolitis. The odds were also higher in Puerto Ricans when considering these conditions separately. CONCLUSIONS We observed population-specific associations between early-life respiratory illnesses and asthma, which were especially significant and stronger in Puerto Ricans. Taken together with the known high burden of RSV in Puerto Rico, our results may help explain the high burden of asthma in Puerto Ricans.
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8
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Microbiology of Rhinosinusitis and Antimicrobial Resistance. ALL AROUND THE NOSE 2020. [PMCID: PMC7123954 DOI: 10.1007/978-3-030-21217-9_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Acute rhinosinusitis (ARS) is the inflammation of the nasal mucous membrane and can be separated into acute viral and acute bacterial rhinosinusitis. It is frequently observed after viral rhinitis or common cold. Viral, post-viral, and acute bacterial ARS (ABRS) display significantly similar clinical presentation and inflammatory mechanism. Viral infection of the sinus cavity can cause numerous changes such as post-viral inflammation and epithelial damage, which enhance the susceptibility to bacterial infection. The most common virus families that cause ARS are coronavirus and rhinovirus. Approximately 50% of common colds are caused by the human rhinovirus. Other viral offenders include parainfluenza, influenza, respiratory syncytial virus (RSV), adenovirus, and enterovirus. The most widely recognized bacteria in ABRS are S. pneumonia, H. influenza, and M. catarrhalis and S. aureus, while other species and anaerobic bacteria may also contribute to the infection (Payne and Benninger, Clin Infect Dis 45(10):e121–7, 2007; Anonymous, Otolaryngol Head Neck Surg 130(1 SUPPL):1–45, 2004; Brook, Arch Otolaryngol Head Neck Surg 128(5):583–5, 2002). Interestingly, Payne and colleagues performed a meta-analytic study on reports about the microbiology of ABRS, which evaluated the most common bacterial occurrence within the sinus. S. aureus is commonly associated with the pathogenesis of sphenoid sinusitis. The 7-valent pneumococcal vaccine was presented in the United States in 2000 and aided in the reduction of the recovery rate for S. pneumoniae and the increase in the rate of H. influenza. Chronic rhinosinusitis (CRS) vary in comparison to ARS. Bacteria that have been recorded in many samples acquired by endoscopy or sinus puncture in CRS patients are Staphylococcus aureus (both MSSA and MRSA), Staphylococci (coagulase-negative) (SCN), H. influenza, M. catarrhalis, S. pneumonia, S. intermedius, P. aeruginosa, N. species, and other anaerobic bacteria. In this chapter, microbiology of rhinosinusitis and antimicrobial resistance are discussed.
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Trinh HKT, Lee SH, Cao TBT, Park HS. Asthma pharmacotherapy: an update on leukotriene treatments. Expert Rev Respir Med 2019; 13:1169-1178. [PMID: 31544544 DOI: 10.1080/17476348.2019.1670640] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction: Asthma is a chronic inflammatory disease of the airways with a large heterogeneity of clinical phenotypes. There has been increasing interest regarding the role of cysteinyl leukotriene (LT) and leukotriene receptor antagonists (LTRA) in asthma treatment.Areas covered: This review summarized the data (published in PubMed during 1984-2019) regarding LTRA treatment in asthma and LTs-related airway inflammation mechanisms. Involvement of LTs C4/D4/E4 has been demonstrated in the several aspects of airway inflammation and remodeling. Novel pathways related to LTE4, the most potent mediator, and its respective receptors have recently been studied. Antagonists against cysteinyl leukotriene receptor (CysLTR) type 1, including montelukast, pranlukast and zafirlukast, have been widely prescribed in clinical practices; however, some clinical trials have shown insignificant responses to LTRAs in adult asthmatics, while some phenotypes of adult asthma showed more favorable responses to LTRAs including aspirin-exacerbated respiratory disease, elderly asthma, asthma associated with smoking, obesity and allergic rhinitis.Expert opinion: Further investigations are needed to understand the role of LTs in airway inflammation and remodeling of the asthmatic airways. There is a lack of biomarkers to predict responsiveness to LTRA, especially in adult asthmatics. Besides CysLTR1 antagonists, targets aiming other LT pathways should be considered.
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Affiliation(s)
- Hoang Kim Tu Trinh
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea.,Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh city, Vietnam
| | - So-Hee Lee
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea
| | | | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea.,Department of Biomedicine, Ajou University, Suwon, South Korea
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Carvajal JJ, Avellaneda AM, Salazar-Ardiles C, Maya JE, Kalergis AM, Lay MK. Host Components Contributing to Respiratory Syncytial Virus Pathogenesis. Front Immunol 2019; 10:2152. [PMID: 31572372 PMCID: PMC6753334 DOI: 10.3389/fimmu.2019.02152] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 08/27/2019] [Indexed: 12/22/2022] Open
Abstract
Respiratory syncytial virus (RSV) is the most prevalent viral etiological agent of acute respiratory tract infection. Although RSV affects people of all ages, the disease is more severe in infants and causes significant morbidity and hospitalization in young children and in the elderly. Host factors, including an immature immune system in infants, low lymphocyte levels in patients under 5 years old, and low levels of RSV-specific neutralizing antibodies in the blood of adults over 65 years of age, can explain the high susceptibility to RSV infection in these populations. Other host factors that correlate with severe RSV disease include high concentrations of proinflammatory cytokines such as interleukins (IL)-6, IL-8, tumor necrosis factor (TNF)-α, and thymic stromal lymphopoitein (TSLP), which are produced in the respiratory tract of RSV-infected individuals, accompanied by a strong neutrophil response. In addition, data from studies of RSV infections in humans and in animal models revealed that this virus suppresses adaptive immune responses that could eliminate it from the respiratory tract. Here, we examine host factors that contribute to RSV pathogenesis based on an exhaustive review of in vitro infection in humans and in animal models to provide insights into the design of vaccines and therapeutic tools that could prevent diseases caused by RSV.
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Affiliation(s)
- Jonatan J. Carvajal
- Departamento de Biotecnología, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta, Chile
| | - Andrea M. Avellaneda
- Departamento de Biotecnología, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta, Chile
| | - Camila Salazar-Ardiles
- Departamento de Biotecnología, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta, Chile
| | - Jorge E. Maya
- Departamento de Biotecnología, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta, Chile
| | - Alexis M. Kalergis
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad de Chile, Santiago, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Margarita K. Lay
- Departamento de Biotecnología, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta, Chile
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad de Chile, Santiago, Chile
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11
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Ikeda T, Tani N, Aoki Y, Shida A, Morioka F, Ishikawa T. Immunohistochemical detection of respiratory syncytial virus at autopsy. Pediatr Int 2019; 61:781-791. [PMID: 31136043 DOI: 10.1111/ped.13901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/25/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infection can be fatal in infants <1 year after birth. Morphological findings associated with infant death, however, are insufficient, and screening procedures are problematic. The aim of the present study was to establish a postmortem diagnosis of RSV pathogenicity. METHODS Serial forensic autopsies of 55 infants who suddenly died ≤1 year after birth due to viral pneumonia (n = 18), bacterial pneumonia (n = 12), or other diseases and trauma (n = 25) were assessed. Causes of viral pneumonia determined on immunochemical screening and histological staining of airway effusions consisted of RSV (n = 8) and other viruses (n = 10). RESULTS Bronchial epithelial and inflammatory cells in the interstitium around bronchioles and alveoli were immunopositive for RSV. Bronchial epithelium was more frequently positive for RSV (5/8, 62.5%) than for bacterial pneumonia and other causes of death (7/47, 14.9%); and intra-alveolar sites were also more frequently positive for RSV pneumonia (3/8, 37.5%) than for bacterial pneumonia and other causes of death (4/47, 8.5%). Screening immunoassays and immunohistochemical staining for RSV can serve as an index of RSV infection when serum antibody titers, viral identification and polymerase chain reaction (PCR) are not informative. Peribronchiolar interstitial RSV positivity was similar between RSV pneumonia (7/8, 87.5%) and other causes of death (34/47, 72.3%). CONCLUSIONS RSV was the cause of death in only eight infants because RSV infection was difficult to diagnose. Therefore, more deaths associated with RSV need to be investigated. Bronchial epithelium and intra-alveolar cells that are RSV immunopositive might augment RSV pathogenicity in viral pneumonia.
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Affiliation(s)
- Tomoya Ikeda
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan.,Medico-legal Consultation and Postmortem Investigation Support Center, Osaka City University Medical School, Osaka, Japan
| | - Naoto Tani
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan.,Medico-legal Consultation and Postmortem Investigation Support Center, Osaka City University Medical School, Osaka, Japan
| | - Yayoi Aoki
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan
| | - Alissa Shida
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan
| | - Fumiya Morioka
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan
| | - Takaki Ishikawa
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan.,Medico-legal Consultation and Postmortem Investigation Support Center, Osaka City University Medical School, Osaka, Japan
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12
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Zheng X, Gao L, Wang L, Liang C, Wang B, Liu Y, Feng S, Zhang B, Zhou M, Yu X, Xiang K, Chen L, Guo T, Shen HC, Zou G, Wu JZ, Yun H. Discovery of Ziresovir as a Potent, Selective, and Orally Bioavailable Respiratory Syncytial Virus Fusion Protein Inhibitor. J Med Chem 2019; 62:6003-6014. [PMID: 31194544 DOI: 10.1021/acs.jmedchem.9b00654] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ziresovir (RO-0529, AK0529) is reported here for the first time as a promising respiratory syncytial virus (RSV) fusion (F) protein inhibitor that currently is in phase 2 clinical trials. This article describes the process of RO-0529 as a potent, selective, and orally bioavailable RSV F protein inhibitor and highlights the in vitro and in vivo anti-RSV activities and pharmacokinetics in animal species. RO-0529 demonstrates single-digit nM EC50 potency against laboratory strains, as well as clinical isolates of RSV in cellular assays, and more than one log viral load reduction in BALB/c mouse model of RSV viral infection. RO-0529 was proven to be a specific RSV F protein inhibitor by identification of drug resistant mutations of D486N, D489V, and D489Y in RSV F protein and the inhibition of RSV F protein-induced cell-cell fusion in cellular assays.
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Affiliation(s)
- Xiufang Zheng
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Lu Gao
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Lisha Wang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Chungen Liang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Baoxia Wang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Yongfu Liu
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Song Feng
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Bo Zhang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Mingwei Zhou
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Xin Yu
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Kunlun Xiang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Li Chen
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Tao Guo
- International Discovery Service Unit, Research Service Division , WuXi AppTec (Shanghai) Co., Ltd. , Lane 31, Yiwei Road, Waigaoqiao , Shanghai , 200131 , China
| | - Hong C Shen
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Gang Zou
- Ark Biosciences Inc. , 780 Cailun Road, Suite 701, ZhangJiang Hitech Park, Pudong , Shanghai 201203 , China
| | - Jim Zhen Wu
- Ark Biosciences Inc. , 780 Cailun Road, Suite 701, ZhangJiang Hitech Park, Pudong , Shanghai 201203 , China
| | - Hongying Yun
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
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13
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Zheng X, Liang C, Wang L, Wang B, Liu Y, Feng S, Wu JZ, Gao L, Feng L, Chen L, Guo T, Shen HC, Yun H. Discovery of Benzoazepinequinoline (BAQ) Derivatives as Novel, Potent, Orally Bioavailable Respiratory Syncytial Virus Fusion Inhibitors. J Med Chem 2018; 61:10228-10241. [PMID: 30339388 DOI: 10.1021/acs.jmedchem.8b01394] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A novel benzoazepinequnoline (BAQ) series was discovered as RSV fusion inhibitors. BAQ series originated from compound 2, a hit from similarity-based virtual screening. In SAR exploration, benzoazepine allowed modifications in the head moiety. Benzylic sulfonyl on benzoazepine and 6-Me on quinoline were crucial for good anti-RSV activity. Although the basic amine in the head portion was crucial for anti-RSV activity, the attenuated basicity was required to reduce Vss. Introducing oxetane to the head portion led to discovery of compound 1, which demonstrated single-digit nM anti-RSV activity against different RSV strains, reasonable oral exposure in plasma, and 78-fold higher exposure in lung. Compound 1 also displayed 1 log viral reduction in a female BALB/c mice RSV model by b.i.d. oral dosing at 12.5 mg/kg. A single resistant mutant at L138F in fusion protein proved compound 1 to be a RSV fusion inhibitor.
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Affiliation(s)
- Xiufang Zheng
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Chungen Liang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Lisha Wang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Baoxia Wang
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Yongfu Liu
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Song Feng
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Jim Zhen Wu
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Lu Gao
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Lichun Feng
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Li Chen
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Tao Guo
- International Discovery Service Unit, Research Service Division , WuXi AppTec (Shanghai) Co., Ltd. , Lane 31, Yiwei Road , Waigaoqiao, Shanghai 200131 China
| | - Hong C Shen
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
| | - Hongying Yun
- Roche Pharma Research and Early Development , Roche Innovation Center Shanghai , Building 5, 720 Cailun Road , Shanghai 201203 , China
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14
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Basit AH, Abbasi WA, Asif A, Gull S, Minhas FUAA. Training host-pathogen protein-protein interaction predictors. J Bioinform Comput Biol 2018; 16:1850014. [PMID: 30060698 DOI: 10.1142/s0219720018500142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Detection of protein-protein interactions (PPIs) plays a vital role in molecular biology. Particularly, pathogenic infections are caused by interactions of host and pathogen proteins. It is important to identify host-pathogen interactions (HPIs) to discover new drugs to counter infectious diseases. Conventional wet lab PPI detection techniques have limitations in terms of cost and large-scale application. Hence, computational approaches are developed to predict PPIs. This study aims to develop machine learning models to predict inter-species PPIs with a special interest in HPIs. Specifically, we focus on seeking answers to three questions that arise while developing an HPI predictor: (1) How should negative training examples be selected? (2) Does assigning sample weights to individual negative examples based on their similarity to positive examples improve generalization performance? and, (3) What should be the size of negative samples as compared to the positive samples during training and evaluation? We compare two available methods for negative sampling: random versus DeNovo sampling and our experiments show that DeNovo sampling offers better accuracy. However, our experiments also show that generalization performance can be improved further by using a soft DeNovo approach that assigns sample weights to negative examples inversely proportional to their similarity to known positive examples during training. Based on our findings, we have also developed an HPI predictor called HOPITOR (Host-Pathogen Interaction Predictor) that can predict interactions between human and viral proteins. The HOPITOR web server can be accessed at the URL: http://faculty.pieas.edu.pk/fayyaz/software.html#HoPItor .
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Affiliation(s)
- Abdul Hannan Basit
- * Department of Computer and Information Sciences, Biomedical Informatics Research Laboratory, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad 44000, Pakistan.,† Department of Electrical Engineering, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad 44000, Pakistan
| | - Wajid Arshad Abbasi
- * Department of Computer and Information Sciences, Biomedical Informatics Research Laboratory, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad 44000, Pakistan
| | - Amina Asif
- * Department of Computer and Information Sciences, Biomedical Informatics Research Laboratory, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad 44000, Pakistan
| | - Sadaf Gull
- * Department of Computer and Information Sciences, Biomedical Informatics Research Laboratory, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad 44000, Pakistan
| | - Fayyaz Ul Amir Afsar Minhas
- * Department of Computer and Information Sciences, Biomedical Informatics Research Laboratory, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad 44000, Pakistan
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15
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Wesolowska-Andersen A, Everman JL, Davidson R, Rios C, Herrin R, Eng C, Janssen WJ, Liu AH, Oh SS, Kumar R, Fingerlin TE, Rodriguez-Santana J, Burchard EG, Seibold MA. Dual RNA-seq reveals viral infections in asthmatic children without respiratory illness which are associated with changes in the airway transcriptome. Genome Biol 2017; 18:12. [PMID: 28103897 PMCID: PMC5244706 DOI: 10.1186/s13059-016-1140-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/16/2016] [Indexed: 12/01/2022] Open
Abstract
Background Respiratory illness caused by viral infection is associated with the development and exacerbation of childhood asthma. Little is known about the effects of respiratory viral infections in the absence of illness. Using quantitative PCR (qPCR) for common respiratory viruses and for two genes known to be highly upregulated in viral infections (CCL8/CXCL11), we screened 92 asthmatic and 69 healthy children without illness for respiratory virus infections. Results We found 21 viral qPCR-positive and 2 suspected virus-infected subjects with high expression of CCL8/CXCL11. We applied a dual RNA-seq workflow to these subjects, together with 25 viral qPCR-negative subjects, to compare qPCR with sequencing-based virus detection and to generate the airway transcriptome for analysis. RNA-seq virus detection achieved 86% sensitivity when compared to qPCR-based screening. We detected additional respiratory viruses in the two CCL8/CXCL11-high subjects and in two of the qPCR-negative subjects. Viral read counts varied widely and were used to stratify subjects into Virus-High and Virus-Low groups. Examination of the host airway transcriptome found that the Virus-High group was characterized by immune cell airway infiltration, downregulation of cilia genes, and dampening of type 2 inflammation. Even the Virus-Low group was differentiated from the No-Virus group by 100 genes, some involved in eIF2 signaling. Conclusions Respiratory virus infection without illness is not innocuous but may determine the airway function of these subjects by driving immune cell airway infiltration, cellular remodeling, and alteration of asthmogenic gene expression. Electronic supplementary material The online version of this article (doi:10.1186/s13059-016-1140-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Jamie L Everman
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, USA
| | - Rebecca Davidson
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, USA
| | - Cydney Rios
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, USA
| | - Rachelle Herrin
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, USA
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Andrew H Liu
- Department of Pediatrics, National Jewish Health, 1400 Jackson St, Denver, CO, 80206, USA.,Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA
| | - Sam S Oh
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Rajesh Kumar
- Department of Pediatrics, The Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tasha E Fingerlin
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, USA.,Department of Biomedical Research, National Jewish Health, Denver, CO, USA
| | | | - Esteban G Burchard
- Department of Medicine, University of California, San Francisco, CA, USA.,Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Max A Seibold
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, USA. .,Department of Pediatrics, National Jewish Health, 1400 Jackson St, Denver, CO, 80206, USA. .,Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
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16
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Early-life respiratory infections and asthma development: role in disease pathogenesis and potential targets for disease prevention. Curr Opin Allergy Clin Immunol 2016; 16:172-8. [PMID: 26854761 DOI: 10.1097/aci.0000000000000244] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW This article presents recent findings and perspectives on the relationship between early-life respiratory infections and asthma inception, and discusses emerging concepts on strategies that target these infectious agents for asthma prevention. RECENT FINDINGS Cumulative evidence supports the role of early-life viral infections, especially respiratory syncytial virus and human rhinovirus, as major antecedents of childhood asthma. These viruses may have different mechanistic roles in the pathogenesis of asthma. The airway microbiome and virus-bacteria interactions in early life have emerged as additional determinants of childhood asthma. Innovative strategies for the prevention of these early-life infections, or for attenuation of acute infection severity, are being investigated and may identify effective strategies for the primary and secondary prevention of childhood asthma. SUMMARY Early-life infections are major determinants of asthma development. The pathway from early-life infections to asthma is the result of complex interactions between the specific type of the virus, genetic, and environmental factors. Novel intervention strategies that target these infectious agents have been investigated in proof-of-concepts trials, and further study is necessary to determine their capacity for asthma prevention.
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17
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Akk A, Springer LE, Pham CTN. Neutrophil Extracellular Traps Enhance Early Inflammatory Response in Sendai Virus-Induced Asthma Phenotype. Front Immunol 2016; 7:325. [PMID: 27617014 PMCID: PMC4999646 DOI: 10.3389/fimmu.2016.00325] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/15/2016] [Indexed: 12/30/2022] Open
Abstract
Paramyxoviral infection in childhood has been linked to a significant increased rate of asthma development. In mice, paramyxoviral infection with the mouse parainfluenza virus type I, Sendai virus (Sev), causes a limited bronchiolitis followed by persistent asthma traits. We have previously shown that the absence of cysteine protease dipeptidyl peptidase I (DPPI) dampened the acute lung inflammatory response and the subsequent asthma phenotype induced by Sev. Adoptive transfer of wild-type neutrophils into DPPI-deficient mice restored leukocyte influx, the acute cytokine response, and the subsequent mucous cell metaplasia that accompanied Sev-induced asthma phenotype. However, the exact mechanism by which DPPI-sufficient neutrophils promote asthma development following Sev infection is still unknown. We hypothesize that neutrophils recruited to the alveolar space following Sev infection elaborate neutrophil extracellular traps (NETs) that propagate the inflammatory cascade, culminating in the eventual asthma phenotype. Indeed, we found that Sev infection was associated with NET formation in the lung and release of cell-free DNA complexed to myeloperoxidase in the alveolar space and plasma that peaked on day 2 post infection. Absence of DPPI significantly attenuated Sev-induced NET formation in vivo and in vitro. Furthermore, concomitant administration of DNase 1, which dismantled NETs, or inhibition of peptidylarginine deiminase 4 (PAD4), an essential mediator of NET formation, suppressed the early inflammatory responses to Sev infection. Lastly, NETs primed bone marrow-derived cells to release cytokines that can amplify the inflammatory cascade.
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Affiliation(s)
- Antonina Akk
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine , Saint Louis, MO , USA
| | - Luke E Springer
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine , Saint Louis, MO , USA
| | - Christine T N Pham
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine , Saint Louis, MO , USA
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18
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Zheng X, Wang L, Wang B, Miao K, Xiang K, Feng S, Gao L, Shen HC, Yun H. Discovery of Piperazinylquinoline Derivatives as Novel Respiratory Syncytial Virus Fusion Inhibitors. ACS Med Chem Lett 2016; 7:558-62. [PMID: 27326326 PMCID: PMC4904258 DOI: 10.1021/acsmedchemlett.5b00234] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 04/20/2016] [Indexed: 12/26/2022] Open
Abstract
A novel series of piperazinylquinoline derivatives were discovered as respiratory syncytial virus (RSV) fusion inhibitors by the ligand-based screening approach. Among 3,000 hits, 1-amino-3-[[2-(4-phenyl-1-piperidyl)-4-quinolyl]amino]propan-2-ol (7) was proven to be active against the RSV long (A) strain. The anti-RSV activity was improved by converting piperidine to benzylcarbonyl substituted piperazine. The basic side chain was also found to be crucial for anti-RSV activity. The selected analogues, 45 and 50, demonstrated anti-RSV activities up to EC50 = 0.028 μM and 0.033 μM, respectively. A direct anti-RSV effect was confirmed by a plaque reduction assay and a fusion inhibition assay. Both 45 and 50 showed promising DMPK properties with good oral bioavailability, and could potentially lead to novel therapeutic agents targeting the RSV fusion process.
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Affiliation(s)
- Xiufang Zheng
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Lisha Wang
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Baoxia Wang
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Kun Miao
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Kunlun Xiang
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Song Feng
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Lu Gao
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Hong C. Shen
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
| | - Hongying Yun
- Roche Innovation Center Shanghai, Building 5, Lane 720, Cai Lun Road, Shanghai 201203, China
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19
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Fitzgerald DA, Mellis CM. Leukotriene receptor antagonists in virus-induced wheezing : evidence to date. ACTA ACUST UNITED AC 2016; 5:407-17. [PMID: 17154670 DOI: 10.2165/00151829-200605060-00006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Virus-induced wheezing is a relatively benign entity that is usually transient in early childhood but is responsible for much health care utilization. The condition, seen traditionally as a subset of those children diagnosed as having frequent episodic asthma, is often treated with inhaled corticosteroids, despite their lack of efficacy. However, there remains some confusion differentiating atopic asthma from virus-induced wheezing in young children and their respective treatment strategies.The demonstration of cysteinyl leukotrienes in the nasopharyngeal secretions of infants and young children who wheeze prompted investigation of the role of leukotriene receptor antagonists in the treatment of virus-induced wheezing for young children with bronchiolitis and virus-induced wheezing.Montelukast, the only leukotriene receptor antagonist studied in young children, has been proven useful in increasing the number of symptom-free days and delaying the recurrence of wheeze in the month following a diagnosis of respiratory syncytial virus-induced wheezing in children aged 3-36 months. Subsequently, in children aged 2-5 years with frequent episodic asthma, primarily involving viral induced attacks in this age group, regular therapy with daily montelukast for 12 months reduced the rate of asthma exacerbations by 31% over placebo, delayed the time to the first exacerbation by 2 months, and lowered the need to prescribe inhaled corticosteroids as preventative therapy. Additionally, montelukast has been demonstrated to be efficacious as an acute episode modifier in children aged 2-14 years (85% children <6 years) with virus-induced wheezing where it was prescribed at the onset of a viral infection in children with an established pattern of viral induced episodes of wheeze in the preceding year. In this study, emergency department visits were reduced by 45%, visits to all health care practitioners were reduced by 23%, and time of preschool/school and parental time off work was reduced by 33% for children who took montelukast for a median of 10 days.At present, there is good evidence to support the use of bronchodilators in the acute treatment of virus- induced wheezing, and increasing evidence to support the use of leukotriene receptor antagonists, in particular montelukast, in the management of children with virus-induced wheezing.
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Affiliation(s)
- Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, AustraliaDiscipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
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20
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Tahan F, Celik S, Eke Gungor H. Effect of montelukast on clinical score and cytokine levels of infants for clinically diagnosed acute bronchiolitis. Allergol Immunopathol (Madr) 2015; 43:376-82. [PMID: 25575728 DOI: 10.1016/j.aller.2014.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 06/22/2014] [Accepted: 06/30/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Acute bronchiolitis comprises a major cause for morbidity in infants with viral infection which induces an immune inflammatory response that may produce long lasting harmful effects. Currently, there is no effective therapy for bronchiolitis. OBJECTIVE Our aim was to investigate the efficacy of five-day montelukast therapy in acute bronchiolitis management. METHODS The study included 50 infants with acute bronchiolitis. The infants with first episode of acute bronchiolitis were randomly assigned to receive daily montelukast dose of 4mg over five days after admission or no treatment. Plasma eotaxin, IL-4, IL-8 and IFN-gamma levels were evaluated before and after treatment by ELISA method. In the present study, the primary outcome measure was change in clinical severity score, whilst secondary outcome measures were changes in plasma eotaxin, IL-4, IL-8, IFN-gamma levels. RESULTS No significant differences was found in clinical severity score with five-day montelukast treatment (p>0.05, Mann-Whitney U test). There were no significant differences in plasma eotaxin, IL-4, IL-8, IFN-gamma levels between the groups (p>0.05 Mann-Whitney U test). There was significant decrease in plasma IFN-gamma levels following five-day montelukast treatment (p=0.027, Wilcoxon). There were no significant differences in plasma IL-4, IL-8, IFN-gamma levels between the groups after five-day montelukast treatment (p>0.05, Wilcoxon). There was significant increase in eotaxin levels after five-day montelukast treatment (p=0.009, Wilcoxon). CONCLUSION Our study showed that montelukast affected plasma IFN-gamma and eotaxin levels after five days of treatment. Further studies are needed to demonstrate effects of montelukast on chemokine levels in bronchiolitis.
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Affiliation(s)
- Fulya Tahan
- Erciyes University, School of Medicine, Department of Pediatric Allergy, 38039 Kayseri, Turkey.
| | - Serkan Celik
- Erciyes University, School of Medicine, Department of Pediatric Allergy, 38039 Kayseri, Turkey
| | - Hatice Eke Gungor
- Erciyes University, School of Medicine, Department of Pediatric Allergy, 38039 Kayseri, Turkey
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21
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Carbonell-Estrany X, Pérez-Yarza EG, García LS, Guzmán Cabañas JM, Bòria EV, Atienza BB. Long-Term Burden and Respiratory Effects of Respiratory Syncytial Virus Hospitalization in Preterm Infants-The SPRING Study. PLoS One 2015; 10:e0125422. [PMID: 25955487 PMCID: PMC4425575 DOI: 10.1371/journal.pone.0125422] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/23/2015] [Indexed: 01/20/2023] Open
Abstract
The health status of premature infants born 321-350 weeks' gestational age (wGA) hospitalized for RSV infection in the first year of life (cases; n = 125) was compared to that of premature infants not hospitalized for RSV (controls; n = 362) through 6 years. The primary endpoints were the percentage of children with wheezing between 2-6 years and lung function at 6 years of age. Secondary endpoints included quality of life, healthcare resource use, and allergic sensitization. A significantly higher proportion of cases than controls experienced recurrent wheezing through 6 years of age (46.7% vs. 27.4%; p = 0.001). The vast majority of lung function tests appeared normal at 6 years of age in both cohorts. In children with pulmonary function in the lower limit of normality (FEV1 Z-score [-2; -1]), wheezing was increased, particularly for cases vs. controls (72.7% vs. 18.9%, p = 0.002). Multivariate analysis revealed the most important factor for wheezing was RSV hospitalization. Quality of life on the respiratory subscale of the TAPQOL was significantly lower (p = 0.001) and healthcare resource utilization was significantly higher (p<0.001) in cases than controls. This study confirms RSV disease is associated with wheezing in 32-35 wGA infants through 6 years of age.
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Affiliation(s)
- Xavier Carbonell-Estrany
- Neonatology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi Suñer (IDIBAPS), Barcelona, Spain
| | - Eduardo G. Pérez-Yarza
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia—Instituto Biodonostia, San Sebastián, Spain
- Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain
- Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain
| | | | | | | | - Belén Bernardo Atienza
- Neonatology Division, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario “Gregorio Marañón”, Madrid, Spain
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Beigelman A, Isaacson-Schmid M, Sajol G, Baty J, Rodriguez OM, Leege E, Lyons K, Schweiger TL, Zheng J, Schechtman KB, Castro M, Bacharier LB. Randomized trial to evaluate azithromycin's effects on serum and upper airway IL-8 levels and recurrent wheezing in infants with respiratory syncytial virus bronchiolitis. J Allergy Clin Immunol 2015; 135:1171-8.e1. [PMID: 25458910 PMCID: PMC4426225 DOI: 10.1016/j.jaci.2014.10.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 09/26/2014] [Accepted: 10/02/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) bronchiolitis in infancy is a major risk factor for recurrent wheezing and asthma. Because azithromycin attenuated neutrophilic airway inflammation in a murine viral bronchiolitis model, demonstration of similar effects in human subjects might provide a strategy for the prevention of postbronchiolitis recurrent wheezing. OBJECTIVES We sought to investigate whether azithromycin treatment during RSV bronchiolitis reduces serum and nasal lavage IL-8 levels and the occurrence of postbronchiolitis recurrent wheezing. METHOD We performed a randomized, double-masked, placebo-controlled proof-of-concept trial in 40 otherwise healthy infants hospitalized with RSV bronchiolitis who were treated with azithromycin or placebo for 14 days. IL-8 levels were measured in nasal lavage fluid and serum on randomization, day 8, and day 15 (nasal lavage only). The occurrence of wheezing episodes was assessed monthly over the ensuing 50 weeks. RESULTS Compared with placebo, azithromycin treatment did not reduce serum IL-8 levels at day 8 (P = .6) but resulted in a greater decrease in nasal lavage fluid IL-8 levels by day 15 (P = .03). Twenty-two percent of azithromycin-treated participants experienced at least 3 wheezing episodes compared with 50% of participants in the placebo group (P = .07). Azithromycin treatment resulted in prolonged time to the third wheezing episode (P = .048) and in fewer days with respiratory symptoms over the subsequent year in comparison with placebo (36.7 vs 70.1 days, P = .01). CONCLUSION In this proof-of-concept study azithromycin treatment during RSV bronchiolitis reduced upper airway IL-8 levels, prolonged the time to the third wheezing episode, and reduced overall respiratory morbidity over the subsequent year.
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Affiliation(s)
- Avraham Beigelman
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo.
| | - Megan Isaacson-Schmid
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Geneline Sajol
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Jack Baty
- Division of Biostatistics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Oscar M Rodriguez
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Erin Leege
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Kevin Lyons
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Toni L Schweiger
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Jie Zheng
- Division of Biostatistics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Kenneth B Schechtman
- Division of Biostatistics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - Leonard B Bacharier
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
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A longitudinal study on early hospitalized airway infections and subsequent childhood asthma. PLoS One 2015; 10:e0121906. [PMID: 25919024 PMCID: PMC4412821 DOI: 10.1371/journal.pone.0121906] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/04/2015] [Indexed: 12/26/2022] Open
Abstract
Background Acute airway infections, including bronchiolitis, are common causes of early childhood hospitalization. The development of later asthma may be related to early airway infections in young children. This study is to investigate the relationship between hospitalized airway infections (HAI) in young children (< 3 years old) and later childhood asthma. Methods Hospitalized children (< 3 years old) with bronchiolitis or other acute airway infections (other HAI group) from 1997-2000 were retrieved from the National Health Insurance Research Database of Taiwan, and compared to age- and gender-matched subjects with regards to asthma until 10 years of age; and potential comorbidities and medical care conditions. Results In total, 3,264 children (1,981 with bronchiolitis; 1,283 with other HAIs) were compared to 18,527 controls. The incidence of childhood asthma was higher in the study (16.2%) than the control (11.7%) group, and most cases were diagnosed between 3-5 years old. The hazard ratios were 1.583 (95% CI: 1.414-1.772) and 1.226 (95% CI: 1.053-1.428) for the bronchiolitis and other HAI subgroups, respectively, compared to the control group, and 1.228 (95% CI: 1.075-1.542) in the bronchiolitis subgroup compared to the other HAIs subgroup. A significantly higher odds ratio (1.973, 95% CI: 1.193-3.263) for the children with congenital heart disease (CHD) in the bronchiolitis subgroup was found at an age of 3-5 years compared to the control group. Conclusions and Clinical Relevance Young children (< 3 years old) hospitalized due to acute HAIs are at a higher risk of developing childhood asthma at age 3 to 10 years. The parents of children with HAIs at age 0 to 2 years should be informed for the higher risk of developing childhood asthma, especially in children with CHD and bronchiolitis.
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Evidence mounts that viruses drive atopic development. J Allergy Clin Immunol 2013; 131:1340-1. [PMID: 23561800 DOI: 10.1016/j.jaci.2013.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 03/25/2013] [Indexed: 11/22/2022]
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Bacharier LB, Cohen R, Schweiger T, Yin-Declue H, Christie C, Zheng J, Schechtman KB, Strunk RC, Castro M. Determinants of asthma after severe respiratory syncytial virus bronchiolitis. J Allergy Clin Immunol 2012; 130:91-100.e3. [PMID: 22444510 DOI: 10.1016/j.jaci.2012.02.010] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 02/09/2012] [Accepted: 02/14/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND The development of asthma after respiratory syncytial virus (RSV) bronchiolitis has been demonstrated in case-control studies, although the determinants of post-RSV asthma remain undefined. OBJECTIVES We sought to evaluate the potential determinants of physician-diagnosed asthma after severe RSV bronchiolitis during infancy. METHODS We enrolled 206 children during an initial episode of severe RSV bronchiolitis at 12 months of age or less in a prospective cohort study and followed these children for up to 6 years. In a subset of 81 children, we analyzed CCL5 (RANTES) mRNA expression in upper airway epithelial cells. RESULTS Forty-eight percent of children had physician-diagnosed asthma before the seventh birthday. Independent determinants significantly associated with increased risk for physician-diagnosed asthma by the seventh birthday included maternal asthma (odds ratio [OR], 5.2; 95% CI, 1.7-15.9; P = .004), exposure to high levels of dog allergen (OR, 3.2; 95% CI, 1.3-7.7; P = .012), aeroallergen sensitivity at age 3 years (OR, 10.7; 95% CI, 2.1-55.0; P = .005), recurrent wheezing during the first 3 years of life (OR, 7.3; 95% CI, 1.2-43.3; P = .028), and CCL5 expression in nasal epithelia during acute RSV infection (OR, 3.8; 95% CI, 1.2-2.4; P < .001). White children (OR, 0.19; 95% CI, 0.04-0.93; P = .041) and children attending day care (OR, 0.18; 95% CI, 0.04-0.84; P = .029) had a decreased risk of physician-diagnosed asthma. CONCLUSIONS Approximately 50% of children who experience severe RSV bronchiolitis have a subsequent asthma diagnosis. The presence of increased CCL5 levels in nasal epithelia at the time of bronchiolitis or the development of allergic sensitization by age 3 years are associated with increased likelihood of subsequent asthma.
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Affiliation(s)
- Leonard B Bacharier
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110-1093, USA
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Shifren A, Witt C, Christie C, Castro M. Mechanisms of remodeling in asthmatic airways. J Allergy (Cairo) 2012; 2012:316049. [PMID: 22315625 PMCID: PMC3270414 DOI: 10.1155/2012/316049] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 09/07/2011] [Accepted: 10/10/2011] [Indexed: 01/09/2023] Open
Abstract
Asthma is a chronic inflammatory airway disorder characterized by airway hyperresponsiveness and reversible airflow obstruction. Subgroups of asthma patients develop airflow obstruction that is irreversible or only partially reversible and experience an accelerated rate of lung function decline. The structural changes in the airways of these patients are referred to as airway remodeling. All elements of the airway wall are involved, and remodeled airway wall thickness is substantially increased compared to normal control airways. Airway remodeling is thought to contribute to the subphenotypes of irreversible airflow obstruction and airway hyperresponsiveness, and it has been associated with increased disease severity. Reversal of remodeling is therefore of paramount therapeutic importance, and mechanisms responsible for airway remodeling are feasible therapeutic targets for asthma treatment. This paper will focus on our current understanding of the mechanisms of airway remodeling in asthma and potential targets for future intervention.
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Affiliation(s)
- Adrian Shifren
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Chad Witt
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Chandrika Christie
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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The clinical spectrum of patients with deficiency of Signal Transducer and Activator of Transcription-1. Pediatr Infect Dis J 2011; 30:352-5. [PMID: 20962705 DOI: 10.1097/inf.0b013e3181fdff4a] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STAT-1 (Signal Transducer and Activator of Transcription-1) is a key signaling component of interferon gamma responses. We present long-term manifestations in siblings with a mutation in the STAT1 gene, which include invasive salmonellosis, recurrent severe respiratory syncytial virus pneumonitis, and hepatosplenic mycobacterial disease, and we summarize all other reported cases with STAT-1 deficiency.
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Wood AJ, Antoszewska H, Fraser J, Douglas RG. Is chronic rhinosinusitis caused by persistent respiratory virus infection? Int Forum Allergy Rhinol 2011; 1:95-100. [PMID: 22287325 PMCID: PMC7159729 DOI: 10.1002/alr.20030] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Revised: 11/02/2010] [Accepted: 11/09/2010] [Indexed: 11/25/2022]
Abstract
Background Many chronic rhinosinusitis (CRS) patients recall an upper respiratory tract infection as the inciting event of their chronic illness. Viral infections have been shown to cause obstruction of the osteomeatal complex, which is likely to be a critical step in the development of CRS. There is clear overlap between the pathogenesis of CRS and asthma. Infections with respiratory viruses in childhood increase the risk of subsequently developing asthma. Viral infections in established asthmatics are associated with acute exacerbations. We sought to determine whether respiratory viruses could be detected within the sinonasal mucosa of CRS patients using polymerase chain reaction (PCR) techniques. Methods Sinus mucosa was sampled from 13 patients with CRS and 2 patients with normal sinuses. PCR was used to look for common respiratory viruses (parainfluenza 1, 2, and 3; respiratory syncytial virus [RSV]; human metapneumovirus [hMPV]; adenovirus [ADV]; rhinovirus; coronavirus; bocavirus [BoV]; cytomegalovirus [CMV]; and influenza A and B). Results No respiratory viruses were detected in any of the samples. Conclusion Persistence of respiratory viruses within the sinonasal mucosa is unlikely to be a cause of ongoing inflammation in CRS. The possibility remains that a transient viral infection provides the initial inflammatory stimulus. © 2011 ARS‐AAOA, LLC.
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Affiliation(s)
- Andrew James Wood
- Department of Otolaryngology-Head and Neck Surgery, The University of Auckland, Auckland, New Zealand
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Cheung DS, Ehlenbach SJ, Kitchens T, Riley DA, Grayson MH. Development of atopy by severe paramyxoviral infection in a mouse model. Ann Allergy Asthma Immunol 2011; 105:437-443.e1. [PMID: 21130381 DOI: 10.1016/j.anai.2010.09.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 09/09/2010] [Accepted: 09/09/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Atopic diseases have been increasing in prevalence, yet the initial inciting events that lead to atopy are not understood. Paramyxoviral infections have been suggested to play a role; however, much of these data are correlative. OBJECTIVE To determine whether exposure to a nonviral antigen during a paramyxoviral infection is sufficient to drive IgE production against the bystander antigen and whether clinical disease against this antigen would result. METHODS Wild-type C57BL6 mice or mice deficient in FcεRIα (FcεRIα(-/-)) or IgE (IgE(-/-)) were inoculated with Sendai virus (SeV) or UV-inactivated SeV (UV-SeV) and subsequently exposed to ovalbumin (OVA) intranasally. Mice were further challenged 3 times with intranasal OVA on days 20 to 22 after inoculation with SeV, and airway hyperreactivity and mucous cell metaplasia were determined. RESULTS Exposure to OVA during SeV infection led to significant OVA specific IgE production (median, 548 vs 0 ng/mL; P = .03; SeV vs UV-SeV). This induction of OVA specific IgE production depended on FcεRI because FcεRIα(-/-) mice produced significantly less IgE (112 ng/mL; P = .03; vs wild-type mice). Furthermore, in wild-type mice OVA exposure and challenge significantly enhanced SeV-induced airway hyperreactivity and mucous cell metaplasia, but this failed to occur in either FcεRIα(-/-) or IgE(-/-) mice. CONCLUSION A single exposure to a bystander allergen during a paramyxoviral infection is sufficient to drive allergen specific IgE production in a partial FcεRI-dependent mechanism. These data begin to provide mechanistic insight into how viral infections might drive development of atopic disease.
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Affiliation(s)
- Dorothy S Cheung
- Medical College of Wisconsin, MACC Fund Research Center, Milwaukee, WI 53226, USA
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Cheung DS, Ehlenbach SJ, Kitchens RT, Riley DA, Thomas LL, Holtzman MJ, Grayson MH. Cutting edge: CD49d+ neutrophils induce FcepsilonRI expression on lung dendritic cells in a mouse model of postviral asthma. THE JOURNAL OF IMMUNOLOGY 2010; 185:4983-7. [PMID: 20876348 DOI: 10.4049/jimmunol.1002456] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The increasing prevalence of atopy and asthma remains unexplained but may be due to infection with respiratory viruses. In support of this hypothesis, we showed that experimental asthma after viral infection in mice depended on type I IFN-driven upregulation of FcεRI on conventional dendritic cells (cDCs) in the lung. In this article, we demonstrate that FcεRI expression on lung cDCs depends on an unexpected activity of a CD49d(+) subset of polymorphonuclear neutrophils (PMNs) that are found in the lungs of wild-type C57BL6 but not mice deficient in type I IFNR. Expression of FcεRI depends in part on a CD11b-dependent interaction between PMNs and cDCs. This study demonstrates a PMN-cDC interaction in the lung that is necessary for the ability of viral infection to induce atopic disease.
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Affiliation(s)
- Dorothy S Cheung
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Beigelman A, Mikols CL, Gunsten SP, Cannon CL, Brody SL, Walter MJ. Azithromycin attenuates airway inflammation in a mouse model of viral bronchiolitis. Respir Res 2010; 11:90. [PMID: 20591166 PMCID: PMC2906448 DOI: 10.1186/1465-9921-11-90] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 06/30/2010] [Indexed: 01/11/2023] Open
Abstract
Background Viral bronchiolitis is the leading cause of hospitalization in young infants. It is associated with the development of childhood asthma and contributes to morbidity and mortality in the elderly. Currently no therapies effectively attenuate inflammation during the acute viral infection, or prevent the risk of post-viral asthma. We hypothesized that early treatment of a paramyxoviral bronchiolitis with azithromycin would attenuate acute and chronic airway inflammation. Methods Mice were inoculated with parainfluenza type 1, Sendai Virus (SeV), and treated daily with PBS or azithromycin for 7 days post-inoculation. On day 8 and 21 we assessed airway inflammation in lung tissue, and quantified immune cells and inflammatory mediators in bronchoalveolar lavage (BAL). Results Compared to treatment with PBS, azithromycin significantly attenuated post-viral weight loss. During the peak of acute inflammation (day 8), azithromycin decreased total leukocyte accumulation in the lung tissue and BAL, with the largest fold-reduction in BAL neutrophils. This decreased inflammation was independent of changes in viral load. Azithromycin significantly attenuated the concentration of BAL inflammatory mediators and enhanced resolution of chronic airway inflammation evident by decreased BAL inflammatory mediators on day 21. Conclusions In this mouse model of paramyxoviral bronchiolitis, azithromycin attenuated acute and chronic airway inflammation. These findings demonstrate anti-inflammatory effects of azithromycin that are not related to anti-viral activity. Our findings support the rationale for future prospective randomized clinical trials that will evaluate the effects of macrolides on acute viral bronchiolitis and their long-term consequences.
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Affiliation(s)
- Avraham Beigelman
- Division of Allergy, Immunology & Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St, Louis, MO; USA.
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Kohlmann R, Schwannecke S, Tippler B, Ternette N, Temchura VV, Tenbusch M, Überla K, Grunwald T. Protective efficacy and immunogenicity of an adenoviral vector vaccine encoding the codon-optimized F protein of respiratory syncytial virus. J Virol 2009; 83:12601-10. [PMID: 19776123 PMCID: PMC2786764 DOI: 10.1128/jvi.01036-09] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 09/17/2009] [Indexed: 11/20/2022] Open
Abstract
Adenoviral vectors (AdV) have received considerable attention for vaccine development because of their high immunogenicity and efficacy. In previous studies, it was shown that DNA immunization of mice with codon-optimized expression plasmids encoding the fusion protein of respiratory syncytial virus (RSV F) resulted in enhanced protection against RSV challenge compared to immunization with plasmids carrying the wild-type cDNA sequence of RSV F. In this study, we constructed AdV carrying the codon-optimized full-length RSV F gene (AdV-F) or the soluble form of the RSV F gene (AdV-Fsol). BALB/c mice were immunized twice with AdV-F or AdV-Fsol and challenged with RSV intranasally. Substantial levels of antibody to RSV F were induced by both AdV vaccines, with peak neutralizing-antibody titers of 1:900. Consistently, the viral loads in lung homogenates and bronchoalveolar lavage fluids were significantly reduced by a factor of more than 60,000. The protection against viral challenge could be measured even 8 months after the booster immunization. AdV-F and AdV-Fsol induced similar levels of immunogenicity and protective efficacy. Therefore, these results encourage further development of AdV vaccines against RSV infection in humans.
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Affiliation(s)
- Rebekka Kohlmann
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Sarah Schwannecke
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Bettina Tippler
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Nicola Ternette
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Vladimir V. Temchura
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Matthias Tenbusch
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Klaus Überla
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
| | - Thomas Grunwald
- Department of Molecular and Medical Virology, Ruhr-Universitaet Bochum, Bochum, Germany
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Proesmans M, Sauer K, Govaere E, Raes M, De Bilderling G, De Boeck K. Montelukast does not prevent reactive airway disease in young children hospitalized for RSV bronchiolitis. Acta Paediatr 2009; 98:1830-4. [PMID: 19659463 DOI: 10.1111/j.1651-2227.2009.01463.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the long-term effect of montelukast on symptoms of cough and wheeze following RSV bronchiolitis. METHODS Fifty eight patients (aged < or = 24 months) hospitalized with a first episode of RSV bronchiolitis were enrolled in this double blind prospective randomized trial comparing montelukast (n = 31) vs placebo (n = 27). RESULTS During the 3-month treatment period, there were no statistical significant differences between the two groups for symptom-free days and nights (48.5 [interquartile range 33.0.0-66.0] for montelukast vs 57.0 [29.0-71.0] for placebo p = 0.415) nor disease-free days and nights (44.5 days [26.0-54.0] vs 53.0 [22.3-71.0]; p = 0.266). During the 1 year follow-up, there were 41 exacerbations in the montelukast group vs 54 exacerbations in the placebo group (p = 0.57). Time to first exacerbation was not different. Number of unscheduled visits and need to start inhaled steroids were comparable in the two groups. CONCLUSION Treatment with montelukast after hospital admission for RSV bronchiolitis in children younger than 2 years of age did not reduce symptoms of cough and wheeze. We cannot exclude that a subgroup of children may, however, benefit from this treatment.
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Affiliation(s)
- M Proesmans
- Department of Pediatrics, Pediatric Pulmonology University Hospital of Leuven, Leuven, Belgium.
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Dodd J, Riffault S, Kodituwakku JS, Hayday AC, Openshaw PJM. Pulmonary V gamma 4+ gamma delta T cells have proinflammatory and antiviral effects in viral lung disease. THE JOURNAL OF IMMUNOLOGY 2009; 182:1174-81. [PMID: 19124761 DOI: 10.4049/jimmunol.182.2.1174] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Host defenses, while effecting viral clearance, contribute substantially to inflammation and disease. This double action is a substantial obstacle to the development of safe and effective vaccines against many agents, particularly respiratory syncytial virus (RSV). RSV is a common cold virus and the major cause of infantile bronchiolitis worldwide. The role of alphabeta T cells in RSV-driven immunopathology is well studied, but little is known about the role of "unconventional" T cells. During primary RSV challenge of BALB/c mice, some Vgamma7+ gammadelta T cells were present; however, immunization with a live vaccinia vector expressing RSV F protein substantially enhanced Vgamma4+ gammadelta T cell influx after RSV infection. Harvested early, these cells produced IFN-gamma, TNF, and RANTES after ex vivo stimulation. By contrast, those recruited 5 days after challenge made IL-4, IL-5, and IL-10. Depletion of gammadelta T cells in vivo reduced lung inflammation and disease severity and slightly increased peak viral replication but did not prevent viral clearance. These studies demonstrate a novel role for gammadelta T cells in the development of immunopathology and cellular influx into the lungs after immunization and RSV challenge. Though a minor population, gammadelta T cells have a critical influence on disease and are an attractive interventional target in the alleviation of viral lung disease.
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Affiliation(s)
- Jonathan Dodd
- Center for Respiratory Infections, National Heart and Lung Institute, St. Mary's Campus, Imperial College London, UK
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Shirato K, Taguchi F. Mast cell degranulation is induced by A549 airway epithelial cell infected with respiratory syncytial virus. Virology 2009; 386:88-93. [PMID: 19195674 DOI: 10.1016/j.virol.2009.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Revised: 11/10/2008] [Accepted: 01/07/2009] [Indexed: 10/21/2022]
Abstract
Respiratory syncytial virus (RSV), a major causative agent of respiratory tract infections, influences allergic diseases. Mast cells, important effector cells in allergic disease, also express chemokine (C-X(3)-C motif) receptor 1 (CX(3)CR1). The RSV attachment glycoprotein (G protein) is structurally similar to CX(3)C ligand 1 (CX(3)CL1), the CX(3)CR1 ligand, suggesting that RSV directly interacts with and affects mast cell function, including degranulation. In this paper, the effect of RSV infection on mast cell function was studied using the human mast cell line (HMC-1). The results showed that RSV infection and replication was inefficient in HMC-1 cells than in human epithelial A549 cells. Additionally, HMC-1 degranulation occurred only in coculture with RSV-infected A549 cells, with up-regulation of TNFalpha secretion. However, direct RSV inoculation and incubation with RSV-infected A549 cell culture medium failed to induce HMC-1 degranulation, suggesting that virus-infected cells are critical for degranulation during RSV infection; however, degranulation does not occur by direct RSV infection into mast cells.
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Affiliation(s)
- Kazuya Shirato
- Laboratory of Acute Respiratory Viral Diseases and Cytokines, Department of Virology III, National Institute of Infectious Diseases, Murayama Branch 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011 Japan.
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Amirav I, Luder AS, Kruger N, Borovitch Y, Babai I, Miron D, Zuker M, Tal G, Mandelberg A. A double-blind, placebo-controlled, randomized trial of montelukast for acute bronchiolitis. Pediatrics 2008; 122:e1249-55. [PMID: 18984650 DOI: 10.1542/peds.2008-1744] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cysteinyl leukotrienes are implicated in the inflammation of bronchiolitis. Recently, a specific cysteinyl leukotriene receptor antagonist, montelukast (Singulair [MSD, Haarlem, Netherlands]), has been approved for infants in granule sachets. OBJECTIVE Our goal was to evaluate the effect of montelukast on clinical progress and on cytokines in acute bronchiolitis. METHODS This was a randomized, placebo-controlled, double-blind, parallel-group study in 2 medical centers. Fifty-three infants (mean age: 3.8+/-3.5 months) with a first episode of acute bronchiolitis were randomly assigned to receive either 4-mg montelukast sachets or placebo, every day, from hospital admission until discharge. The primary outcome was length of stay, and secondary outcomes included clinical severity score (maximum of 12) and changes in type 1 and 2 cytokine levels (including interleukin4/IFN-gamma ratio as a surrogate for the T-helper 2/T-helper 1 ratio) in nasal lavage. RESULTS Both groups were comparable at baseline, and cytokine levels correlated positively with disease severity. There were neither differences in length of stay (4.63+/-1.88 [placebo group] vs 4.65+/-1.97 days [montelukast group]) nor in clinical severity score and cytokine levels between the 2 groups. No differences in interleukin 4/IFN-gamma ratio between the 2 groups were seen. There was a slight tendency for infants in the montelukast group to recover more slowly than those in the placebo group (clinical severity score at discharge: 6.1+/-2.4 vs 4.8+/-2.2, respectively). CONCLUSIONS Montelukast did not improve the clinical course in acute bronchiolitis. No significant effect of montelukast on the T-helper 2/T-helper 1 cytokine ratio when given in the early acute phase could be demonstrated.
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Affiliation(s)
- Israel Amirav
- Ziv Medical Centre, Department of Pediatrics, Safed 13100, Israel.
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37
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Abstract
Respiratory syncytial virus (RSV) is the leading cause of severe respiratory disease in infants and is an important source of morbidity and mortality in the elderly and immunocompromised. This review will discuss the humoral and cellular adaptive immune responses to RSV infection and how these responses are shaped in the immature immune system of the infant and the aged environment of the elderly. Furthermore, we will provide an overview of our current understanding of the role the various arms of the adaptive immune response play in mediating the delicate balance between the successful elimination of the virus from the host and the induction of immunopathology. Efficacious immunization against RSV remains a high priority within the field and we will highlight recent advances made in vaccine design.
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Affiliation(s)
- Matthew R Olson
- Department of Microbiology, 51 Newton Road, 3−532 Bowen Science Building, University of Iowa, Iowa City, IA 52242, USA Tel.: +1 319 335 8433 Fax: +1 319 335 9006
| | - Steven M Varga
- Department of Microbiology, Interdisciplinary Graduate Program in Immunology, 51 Newton Road, 3−532 Bowen Science Building, University of Iowa, Iowa City, IA 52242, USA Tel.: +1 319 335 7784 Fax: +1 319 335 9006
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38
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Wu P, Dupont WD, Griffin MR, Carroll KN, Mitchel EF, Gebretsadik T, Hartert TV. Evidence of a causal role of winter virus infection during infancy in early childhood asthma. Am J Respir Crit Care Med 2008; 178:1123-9. [PMID: 18776151 DOI: 10.1164/rccm.200804-579oc] [Citation(s) in RCA: 241] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
RATIONALE Bronchiolitis during infancy is associated with an increased risk of childhood asthma. Whether winter viral infections cause asthma or are a manifestation of a predisposition to asthma development is unknown. OBJECTIVES To study the relationship of winter virus infection during infancy and the development of childhood asthma. METHODS We studied over 95,000 infants born between 1995 and 2000 and followed through 2005 who were enrolled in the Tennessee Medicaid program from birth through early childhood to determine whether infant birth in relationship to the winter virus peak alters the risk of developing early childhood asthma. MEASUREMENTS AND MAIN RESULTS Among 95,310 children studied during five winter virus seasons from birth through early childhood, the risk of developing asthma tracked with the timing of infant birth in relationship to the winter virus peak. Infant birth approximately 4 months before the winter virus peak carried the highest risk, with a 29% increase in odds of developing asthma compared with birth 12 months before the peak (adjusted odds ratio, 1.29; 95% confidence interval, 1.19-1.40). Infant age at the winter virus peak was comparable to or greater than other known risk factors for asthma. CONCLUSIONS Timing of birth in relationship to winter virus season confers a differential and definable risk of developing early childhood asthma, establishing winter virus seasonality as a causal factor in asthma development. Delay of exposure or prevention of winter viral infection during early infancy could prevent asthma.
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Affiliation(s)
- Pingsheng Wu
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-8300, USA
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39
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Castro M, Schweiger T, Yin-DeClue H, Ramkumar TP, Christie C, Zheng J, Cohen R, Schechtman KB, Strunk R, Bacharier LB. Cytokine response after severe respiratory syncytial virus bronchiolitis in early life. J Allergy Clin Immunol 2008; 122:726-733.e3. [PMID: 18760461 DOI: 10.1016/j.jaci.2008.07.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 07/08/2008] [Accepted: 07/11/2008] [Indexed: 11/16/2022]
Abstract
BACKGROUND Immune response after viral infection usually involves T(H)1-mediated response; however, severe respiratory syncytial virus (RSV) infection appears to be associated with the development of asthma, a T(H)2-predominant phenotype. OBJECTIVE To understand the early and subsequent immunologic response to a serious RSV infection in children over time. METHODS A total of 206 previously healthy infants hospitalized with severe RSV bronchiolitis were enrolled in a prospective cohort called the RSV Bronchiolitis in Early Life study. Peripheral blood T cells were obtained immediately after RSV infection and at 2, 4, and 6 years of age, stimulated with phorbol 12-myristate 13-acetate and ionomycin, and analyzed for IL-2, IL-4, IL-13, and IFN-gamma by flow cytometry and real-time PCR. RESULTS Of the children, 48% (n = 97) developed asthma (physician-diagnosed), and 48% (n = 97) had eczema by age 6 years; 32% (n = 48 of 150) developed allergic sensitization by 3 years of age. Children with asthma had lower IL-13 expression at 6 years of age than those without (P = .001). IFN-gamma, IL-2, and IL-4 levels did not differ by asthma or eczema status during follow-up (all P > .05). Allergic sensitization was not associated with differences in cytokine levels during follow-up (all P > .05). CONCLUSION Severe RSV infection early in life is associated with a high incidence of asthma and eczema. Contrary to expectations, subsequent immunologic development in those who developed asthma, eczema, or allergic sensitization was not associated with a T(H)2 phenotype in the peripheral blood.
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Affiliation(s)
- Mario Castro
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo.
| | - Toni Schweiger
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Huiquing Yin-DeClue
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Thiruvamoor P Ramkumar
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Chandrika Christie
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Jie Zheng
- Department of Biostatistics, Washington University School of Medicine, St Louis, Mo
| | - Rebecca Cohen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Kenneth B Schechtman
- Department of Biostatistics, Washington University School of Medicine, St Louis, Mo
| | - Robert Strunk
- Department of Pediatrics, Washington University School of Medicine, St Louis, Mo
| | - Leonard B Bacharier
- Department of Pediatrics, Washington University School of Medicine, St Louis, Mo
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40
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Akk AM, Simmons PM, Chan HW, Agapov E, Holtzman MJ, Grayson MH, Pham CTN. Dipeptidyl peptidase I-dependent neutrophil recruitment modulates the inflammatory response to Sendai virus infection. THE JOURNAL OF IMMUNOLOGY 2008; 180:3535-42. [PMID: 18292580 DOI: 10.4049/jimmunol.180.5.3535] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The role of innate immunity in the pathogenesis of asthma is unclear. Although increased presence of neutrophils is associated with persistent asthma and asthma exacerbations, how neutrophils participate in the pathogenesis of asthma remains controversial. In this study, we show that the absence of dipeptidyl peptidase I (DPPI), a lysosomal cysteine protease found in neutrophils, dampens the acute inflammatory response and the subsequent mucous cell metaplasia that accompanies the asthma phenotype induced by Sendai virus infection. This attenuated phenotype is accompanied by a significant decrease in the accumulation of neutrophils and the local production of CXCL2, TNF, IL-1beta, and IL-6 in the lung of infected DPPI-/- mice. Adoptive transfer of DPPI-sufficient neutrophils into DPPI-/- mice restored the levels of CXCL2 and enhanced cytokine production on day 4 postinfection and subsequent mucous cell metaplasia on day 21 postinfection. These results indicate that DPPI and neutrophils play a critical role in Sendai virus-induced asthma phenotype as a result of a DPPI-dependent neutrophil recruitment and cytokine response.
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Affiliation(s)
- Antonina M Akk
- Division of Rheumatology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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Tasker L, Lindsay RWB, Clarke BT, Cochrane DWR, Hou S. Infection of mice with respiratory syncytial virus during neonatal life primes for enhanced antibody and T cell responses on secondary challenge. Clin Exp Immunol 2008; 153:277-88. [PMID: 18549446 DOI: 10.1111/j.1365-2249.2008.03591.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Primary neonatal immune responses to infection or vaccines are weak when compared with those of adults. In addition, memory responses of neonatally primed animals may be absent, weak or T helper type 2 (Th2)-biased. Respiratory syncytial virus (RSV) is an important pathogen of human infants and infection during the neonatal period has been linked to the development of asthma in later life. Here we report that acute intranasal infection of neonatal mice with RSV induces significant RSV-specific antibody and CD8 T cell responses. These responses were boosted after RSV rechallenge during adulthood, demonstrating the establishment of memory after neonatal priming. Primary infection during neonatal life was associated, following rechallenge, with limited viral replication in the lung. Recall responses of both spleen and lymph node cells from neonatally primed and adult-primed mice were associated with interferon-gamma secretion, indicative of a Th1-type response. However, interleukin (IL)-4 and IL-5 secretion were enhanced only in spleen and lymph node cells from neonatally primed mice. Rechallenge of neonatally primed mice was also associated with increased concentrations of chemokines monocyte chemoattractant protein-1, macrophage inflammatory protein-1alpha and regulated upon activation normal T cell expressed and secreted in the lung. These may play a role in the enhanced inflammatory cell recruitment and immunopathology induced following RSV reinfection. Our results demonstrate therefore that immunity to RSV can be established during neonatal life and, importantly, that the quality of the subsequent response is dependent upon the age of first infection.
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Affiliation(s)
- L Tasker
- Edward Jenner Institute for Vaccine Research, Newbury, Berks, UK
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Hansbro NG, Horvat JC, Wark PA, Hansbro PM. Understanding the mechanisms of viral induced asthma: new therapeutic directions. Pharmacol Ther 2008; 117:313-53. [PMID: 18234348 PMCID: PMC7112677 DOI: 10.1016/j.pharmthera.2007.11.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 11/19/2007] [Indexed: 12/12/2022]
Abstract
Asthma is a common and debilitating disease that has substantially increased in prevalence in Western Societies in the last 2 decades. Respiratory tract infections by respiratory syncytial virus (RSV) and rhinovirus (RV) are widely implicated as common causes of the induction and exacerbation of asthma. These infections in early life are associated with the induction of wheeze that may progress to the development of asthma. Infections may also promote airway inflammation and enhance T helper type 2 lymphocyte (Th2 cell) responses that result in exacerbations of established asthma. The mechanisms of how RSV and RV induce and exacerbate asthma are currently being elucidated by clinical studies, in vitro work with human cells and animal models of disease. This research has led to many potential therapeutic strategies and, although none are yet part of clinical practise, they show much promise for the prevention and treatment of viral disease and subsequent asthma.
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Key Words
- aad, allergic airways disease
- ahr, airway hyperresponsiveness
- apc, antigen-presenting cell
- asm, airway smooth muscle
- balf, broncho-alveolar lavage fluid
- bec, bronchoepithelial cell
- bfgf, basic fibroblast growth factor
- cam, cellular adhesion molecules
- ccr, cc chemokine receptor
- cgrp, calcitonin gene-related peptide
- crp, c reactive protein
- dsrna, double stranded rna
- ecp, eosinophil cationic protein
- ena-78, epithelial neutrophil-activating peptide-78
- fev1, forced expiratory volume
- fi, formalin-inactivated
- g-csf and gm-csf, granulocyte and granulocyte-macrophage colony stimulating factor
- ics, inhaled corticosteroid
- ifn, interferon, ifn
- il, interleukin
- ip-10, ifn-γ inducible protein-10
- laba, long acting beta agonist
- ldh, lactate dehydrogenase
- ldlpr, low density lipoprotein receptor
- lrt, lower respiratory tract
- lt, leukotriene
- mab, monoclonal antibody
- mcp, monocyte chemoattractant proteins
- mdc, myeloid dendritic cell
- mhc, major histocompatibility
- mip, macrophage inhibitory proteins
- mpv, metapneumovirus
- nf-kb, nuclear factor (nf)-kb
- nk cells, natural killer cells
- nk1, neurogenic receptor 1
- or, odds ratio
- paf, platelet-activating factor
- pbmc, peripheral blood mononuclear cell
- pdc, plasmacytoid dendritic cell
- pef, peak expiratory flow
- penh, enhanced pause
- pfu, plaque forming units
- pg, prostaglandin
- pkr, protein kinase r
- pvm, pneumonia virus of mice
- rad, reactive airway disease
- rantes, regulated on activation normal t cell expressed and secreted
- rr, relative risk
- rsv, respiratory syncytial virus
- rv, rhinovirus (rv)
- ssrna, single stranded rna
- tgf, transforming growth factor
- th, t helper lymphocytes
- tlr, toll-like receptors
- tnf, tumor necrosis factor
- urt, upper respiratory tract
- vegf, vascular endothelial growth factor
- vs, versus
- wbc, white blood cell
- respiratory syncytial virus
- rhinovirus
- induction
- exacerbation
- asthma
- allergy
- treatment
- prevention
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Affiliation(s)
- Nicole G. Hansbro
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health, The University of Newcastle, New South Wales 2308, Australia
- Vaccines, Immunology/Infection, Viruses and Asthma Group, Hunter Medical Research Institute, Locked Bag 1 New Lambton, New South Wales 2305, Australia
| | - Jay C. Horvat
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health, The University of Newcastle, New South Wales 2308, Australia
- Vaccines, Immunology/Infection, Viruses and Asthma Group, Hunter Medical Research Institute, Locked Bag 1 New Lambton, New South Wales 2305, Australia
| | - Peter A. Wark
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health, The University of Newcastle, New South Wales 2308, Australia
- Vaccines, Immunology/Infection, Viruses and Asthma Group, Hunter Medical Research Institute, Locked Bag 1 New Lambton, New South Wales 2305, Australia
- Department of Respiratory & Sleep Medicine, John Hunter Hospital & Sleep Medicine, School of Medical Practice, University of Newcastle, Newcastle, Australia
| | - Philip M. Hansbro
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health, The University of Newcastle, New South Wales 2308, Australia
- Vaccines, Immunology/Infection, Viruses and Asthma Group, Hunter Medical Research Institute, Locked Bag 1 New Lambton, New South Wales 2305, Australia
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43
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Understanding respiratory syncytial virus (RSV) vaccine-enhanced disease. Immunol Res 2008; 39:225-39. [PMID: 17917067 DOI: 10.1007/s12026-007-0071-6] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 12/14/2022]
Abstract
Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in infants and children worldwide. In addition, RSV causes serious disease in elderly and immune compromised individuals. RSV infection of children previously immunized with a formalin-inactivated (FI)-RSV vaccine is associated with enhanced disease and pulmonary eosinophilia that is believed to be due to an exaggerated memory Th2 response. As a consequence, there is currently no licensed RSV vaccine and detailed studies directed towards prevention of vaccine-associated disease are a critical first step in the development of a safe and effective vaccine. The BALB/c mouse model of RSV infection faithfully mimics the human respiratory disease. Mice previously immunized with either FI-RSV or a recombinant vaccinia virus (vv) that expresses the attachment (G) glycoprotein exhibit extensive lung inflammation and injury, pulmonary eosinophilia, and enhanced disease following challenge RSV infection. CD4 T cells secreting Th2 cytokines are necessary for this response because their depletion eliminates eosinophilia. Intriguing recent studies have demonstrated that RSV-specific CD8 T cells can inhibit Th2-mediated pulmonary eosinophilia in vvG-primed mice by as yet unknown mechanisms. Information gained from the animal models will provide important information and novel approaches for the rational design of a safe and efficacious RSV vaccine.
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44
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Montgomery-Downs HE, Crabtree VM, Sans Capdevila O, Gozal D. Infant-feeding methods and childhood sleep-disordered breathing. Pediatrics 2007; 120:1030-5. [PMID: 17974740 DOI: 10.1542/peds.2007-0722] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Childhood sleep-disordered breathing has an adverse impact on cognitive development, behavior, quality of life, and use of health care resources. Early viral infections and other immune-mediated responses may contribute to development of the chronic inflammation of the upper airway and hypertrophic upper airway lymphadenoid tissues underlying childhood sleep-disordered breathing. Breastfeeding provides immunologic protection against such early exposures. Therefore, we sought to explore whether sleep-disordered breathing severity would differ for children who were breastfed as infants. METHODS The parents or guardians of 196 habitually snoring children (mean +/- SD: 6.7 +/- 2.9 years old) who were undergoing overnight polysomnography at Kosair Children's Hospital Sleep Medicine and Apnea Center completed a retrospective survey on the method(s) used to feed the child as an infant. RESULTS Among habitually snoring children, those who were fed breast milk for at least 2 months had significantly reduced sleep-disordered breathing severity on every measure assessed, including apnea-hypopnea index, oxyhemoglobin desaturation nadir, and respiratory arousal index. Breastfeeding for longer than 5 months did not contribute additional benefits. CONCLUSIONS Our findings support the notion that breastfeeding may provide long-term protection against the severity of childhood sleep-disordered breathing. Future research should explore mechanism(s) whereby infant-feeding methods may affect the pathophysiology of development of childhood sleep-disordered breathing.
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Affiliation(s)
- Hawley Evelyn Montgomery-Downs
- West Virginia University, Department of Psychology, 1124 Life Sciences Building, PO Box 6040, Morgantown, WV 26506-6040, USA.
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45
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Monick MM, Powers LS, Hassan I, Groskreutz D, Yarovinsky TO, Barrett CW, Castilow EM, Tifrea D, Varga SM, Hunninghake GW. Respiratory syncytial virus synergizes with Th2 cytokines to induce optimal levels of TARC/CCL17. THE JOURNAL OF IMMUNOLOGY 2007; 179:1648-58. [PMID: 17641031 PMCID: PMC4060898 DOI: 10.4049/jimmunol.179.3.1648] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Respiratory syncytial virus (RSV) is a ubiquitous virus that preferentially infects airway epithelial cells, causing asthma exacerbations and severe disease in immunocompromised hosts. Acute RSV infection induces inflammation in the lung. Thymus- and activation-regulated chemokine (TARC) recruits Th2 cells to sites of inflammation. We found that acute RSV infection of BALB/c mice increased TARC production in the lung. Immunization of BALB/c mice with individual RSV proteins can lead to the development of Th1- or Th2-biased T cell responses in the lung after RSV infection. We primed animals with a recombinant vaccinia virus expressing either the RSV fusion (F) protein or the RSV attachment (G) protein, inducing Th1- and Th2-biased pulmonary memory T cell responses, respectively. After RSV infection, TARC production significantly increased in the vaccinia virus G-primed animals only. These data suggest a positive feedback loop for TARC production between RSV infection and Th2 cytokines. RSV-infected lung epithelial cells cultured with IL-4 or IL-13 demonstrated a marked increase in the production of TARC. The synergistic effect of RSV and IL-4/IL-13 on TARC production reflected differential induction of NF kappa B and STAT6 by the two stimuli (both are in the TARC promoter). These findings demonstrate that RSV induces a chemokine TARC that has the potential to recruit Th2 cells to the lung.
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Affiliation(s)
- Martha M Monick
- Department of Internal Medicine, University of Iowa Carver College of Medicine and Veterans Administration Medical Center, Iowa City, IA 52242, USA.
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Meyer G, Deplanche M, Schelcher F. Human and bovine respiratory syncytial virus vaccine research and development. Comp Immunol Microbiol Infect Dis 2007; 31:191-225. [PMID: 17720245 DOI: 10.1016/j.cimid.2007.07.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2007] [Indexed: 11/23/2022]
Abstract
Human (HRSV) and bovine (BRSV) respiratory syncytial viruses (RSV) are two closely related viruses, which are the most important causative agents of respiratory tract infections of young children and calves, respectively. BRSV vaccines have been available for nearly 2 decades. They probably have reduced the prevalence of RSV infection but their efficacy needs improvement. In contrast, despite decades of research, there is no currently licensed vaccine for the prevention of HRSV disease. Development of a HRSV vaccine for infants has been hindered by the lack of a relevant animal model that develops disease, the need to immunize immunologically immature young infants, the difficulty for live vaccines to find the right balance between attenuation and immunogenicity, and the risk of vaccine-associated disease. During the past 15 years, intensive research into a HRSV vaccine has yielded vaccine candidates, which have been evaluated in animal models and, for some of them, in clinical trials in humans. Recent formulations have focused on subunit vaccines with specific CD4+ Th-1 immune response-activating adjuvants and on genetically engineered live attenuated vaccines. It is likely that different HRSV vaccines and/or combinations of vaccines used sequentially will be needed for the various populations at risk. This review discusses the recent advances in RSV vaccine development.
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Affiliation(s)
- Gilles Meyer
- INRA-ENVT, UMR1225 IHAP, Interactions Hôtes-Virus et Vaccinologie, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, BP 87614, 31076 Toulouse Cedex, France.
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47
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Da Dalt L, Callegaro S, Carraro S, Andreola B, Corradi M, Baraldi E. Nasal lavage leukotrienes in infants with RSV bronchiolitis. Pediatr Allergy Immunol 2007; 18:100-4. [PMID: 17338781 DOI: 10.1111/j.1399-3038.2006.00500.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Respiratory syncytial virus (RSV) bronchiolitis is a very common infection in infants and, after the acute phase, a number of patients develop a reactive airway disease that lasts for years. Although the pathogenesis of the lung damage after RSV bronchiolitis is still largely unknown, previous studies suggest that leukotrienes may play an active part in it. The aim of this study was to measure leukotriene levels in the nasal lavage fluid (NLF) collected in infants during RSV bronchiolitis and 1 month later. Cysteinyl leukotrienes (Cys-LTs) and leukotriene B(4) (LTB(4)) were measured in the NLF of 22 infants with their first episode of RSV bronchiolitis and 16 healthy infants. A second NLF sample was collected to measure leukotriene levels 1 month after the acute disease. NLF Cys-LT levels were significantly higher in infants with RSV bronchiolitis than in healthy controls [950 pg/ml (285.5-2155.9) vs. 110.5 pg/ml (66.5-451.3), p = 0.01], and they remained so a month after the acute infection (p = 0.02). A subanalysis showed no difference in Cys-LTs concentrations, either between bronchiolitis infants with and without a family history of atopy, or between those with and without passive exposure to cigarette smoke. No significant difference was found between the LTB(4) levels measured in the bronchiolitis cases and the control children. Cys-LTs are significantly increased in the NLF of infants with acute RSV bronchiolitis, and remain so at 1-month follow-up, suggesting a possible role of these eicosanoids in the pathogenesis of the disease.
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Affiliation(s)
- Liviana Da Dalt
- Department of Pediatrics, University of Padova, Padova, Italy.
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48
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Elliott J, Lynch OT, Suessmuth Y, Qian P, Boyd CR, Burrows JF, Buick R, Stevenson NJ, Touzelet O, Gadina M, Power UF, Johnston JA. Respiratory syncytial virus NS1 protein degrades STAT2 by using the Elongin-Cullin E3 ligase. J Virol 2007; 81:3428-36. [PMID: 17251292 PMCID: PMC1866062 DOI: 10.1128/jvi.02303-06] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Respiratory syncytial virus (RSV) infection causes bronchiolitis and pneumonia in infants. RSV has a linear single-stranded RNA genome encoding 11 proteins, 2 of which are nonstructural (NS1 and NS2). RSV specifically downregulates STAT2 protein expression, thus enabling the virus to evade the host type I interferon response. Degradation of STAT2 requires proteasomal activity and is dependent on the expression of RSV NS1 and NS2 (NS1/2). Here we investigate whether RSV NS proteins can assemble ubiquitin ligase (E3) enzymes to target STAT2 to the proteasome. We demonstrate that NS1 contains elongin C and cullin 2 binding consensus sequences and can interact with elongin C and cullin 2 in vitro; therefore, NS1 has the potential to act as an E3 ligase. By knocking down expression of specific endogenous E3 ligase components using small interfering RNA, NS1/2, or RSV-induced STAT2, degradation is prevented. These results indicate that E3 ligase activity is crucial for the ability of RSV to degrade STAT2. These data may provide the basis for therapeutic intervention against RSV and/or logically designed live attenuated RSV vaccines.
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Affiliation(s)
- Joanne Elliott
- Molecular Immunity, Infection and Immunity Group, Centre for Cancer Research and Cell Biology, Queens University Belfast, Whitla Medical Building, 97 Lisburn Rd., Belfast BT9 7BL, Northern Ireland
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Holtzman MJ, Kim EY, Lo MS, Tyner JW, Shornick LP, Sumino KC, Zhang Y. Defining and adjusting divergent host responses to viral infection. Immunol Res 2006; 32:123-41. [PMID: 16106064 DOI: 10.1385/ir:32:1-3:123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Our laboratory focuses on the signal-transduction basis for mucosal immunity, inflammation, and remodeling, especially in relation to respiratory viral infection. Our approach aims to answer two major questions: (1) What are the mechanisms that control common viral infections? and (2) How can these transient infections cause long-term diseases, such as asthma? Our studies show that antiviral defense depends critically on a specialized network of mucosal epithelial cells and macrophages. When this network is compromised, the host is highly susceptible to infection, but when it is engineered to be broadly hyperresponsive to interferon, the host is markedly resistant to otherwise lethal viral infections. Similar but less effective hyperresponsiveness appears in asthma, suggesting that evolving attempts to improve antiviral defense may instead cause inflammatory disease. Indeed, in susceptible genetic backgrounds, respiratory viruses can also cause a hit-and-run phenomenon that is manifest by the development of a permanent asthmatic phenotype long after the infection has been cleared. This complex phenotype can be segregated into individual traits using pharmacologic, immunologic, and genetic strategies to achieve more precise definition of just how viruses can reprogram host behavior. Evidence of reprogramming is manifest by persistent abnormalities in epithelial cell survival and macrophage activation that when corrected can prevent the development of disease phenotypes. Our results led us to pursue the hypothesis that specific components of the innate immune system may manifest an aberrant antiviral response as a basis for chronic inflammatory diseases and that adjusting this response can improve short- and long-term outcomes after viral infection.
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Affiliation(s)
- Michael J Holtzman
- Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Bhandari V, Choo-Wing R, Chapoval SP, Lee CG, Tang C, Kim YK, Ma B, Baluk P, Lin MI, McDonald DM, Homer RJ, Sessa WC, Elias JA. Essential role of nitric oxide in VEGF-induced, asthma-like angiogenic, inflammatory, mucus, and physiologic responses in the lung. Proc Natl Acad Sci U S A 2006; 103:11021-6. [PMID: 16832062 PMCID: PMC1544167 DOI: 10.1073/pnas.0601057103] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Indexed: 12/30/2022] Open
Abstract
VEGF, nitric oxide (NO), inflammation, and vascular- and extravascular remodeling coexist in asthma and other disorders. In these responses, VEGF regulates angiogenesis. VEGF also induces inflammation and remodeling. The mechanisms of the latter responses have not been defined, however. We hypothesized that VEGF-induces extravascular tissue responses via NO-dependent mechanisms. To evaluate this hypothesis, we compared the effects of transgenic VEGF165 in lungs from normal mice, mice treated with pan-NO synthase (NOS) or endothelial NOS (eNOS) inhibitors, and mice with null mutations of inducible NOS (iNOS) or eNOS. These studies demonstrate that VEGF selectively stimulates eNOS and iNOS. They also demonstrate that VEGF induces pulmonary alterations via NO-dependent and -independent mechanisms with angiogenesis, edema, mucus metaplasia, airway hyperresponsiveness, lymphocyte accumulation, dendritic cell hyperplasia and S-nitrosoglutathione reductase stimulation being NO-dependent and dendritic cell activation being NO-independent. Furthermore, they demonstrate that eNOS and iNOS both contribute to these responses. NO/NOS-based interventions may be therapeutic in VEGF-driven inflammation and remodeling.
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Affiliation(s)
- Vineet Bhandari
- *Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, LCI 401-B, New Haven, CT 06520-8057
| | - Rayman Choo-Wing
- *Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, LCI 401-B, New Haven, CT 06520-8057
| | - Svetlana P. Chapoval
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, 441-C TAC, New Haven, CT 06520-8057
| | - Chun G. Lee
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, 441-C TAC, New Haven, CT 06520-8057
| | - C. Tang
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, 441-C TAC, New Haven, CT 06520-8057
| | - Y. K. Kim
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, 441-C TAC, New Haven, CT 06520-8057
| | - Bing Ma
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, 441-C TAC, New Haven, CT 06520-8057
| | - Peter Baluk
- Cardiovascular Research Institute, Department of Anatomy and Comprehensive Cancer Center, University of California, 513 Paramus Avenue, San Francisco, CA 94143-0130
| | - Michelle I. Lin
- Department of Pharmacology, Yale University School of Medicine, Boyer Center for Molecular Medicine, 295 Congress Avenue, Room 436, New Haven, CT 06520-8057; and
| | - Donald M. McDonald
- Cardiovascular Research Institute, Department of Anatomy and Comprehensive Cancer Center, University of California, 513 Paramus Avenue, San Francisco, CA 94143-0130
| | - Robert J. Homer
- Department of Pathology, Yale University School of Medicine, 310 Cedar Street, New Haven, CT 06520-8057
| | - William C. Sessa
- Department of Pharmacology, Yale University School of Medicine, Boyer Center for Molecular Medicine, 295 Congress Avenue, Room 436, New Haven, CT 06520-8057; and
| | - Jack A. Elias
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, 441-C TAC, New Haven, CT 06520-8057
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