摘要 :
As the most important viral cause of severe respiratory disease in infants and increasing recognition as important in the elderly and immunocompromised, respiratory syncytial virus (RSV) is responsible for a massive health burden ...
展开
As the most important viral cause of severe respiratory disease in infants and increasing recognition as important in the elderly and immunocompromised, respiratory syncytial virus (RSV) is responsible for a massive health burden worldwide. Prophylactic antibodies were successfully developed against RSV. However, their use is restricted to a small group of infants considered at high risk of severe RSV disease. There is still no specific therapeutics or vaccines to combat RSV. As such, it remains a major unmet medical need for most individuals. The World Health Organisations International Clinical Trials Registry Platform (WHO ICTRP) and PubMed were used to identify and review all RSV vaccine, prophylactic and therapeutic candidates currently in clinical trials. This review presents an expert commentary on all RSV-specific prophylactic and therapeutic candidates that have entered clinical trials since 2008.
收起
摘要 :
Background: Rapid detection of respiratory viruses is important for management and infection control in hospitalized patients. Multiplex nucleic acid tests (NATs) have begun to replace conventional methods as gold standards for re...
展开
Background: Rapid detection of respiratory viruses is important for management and infection control in hospitalized patients. Multiplex nucleic acid tests (NATs) have begun to replace conventional methods as gold standards for respiratory virus detection. Objective: To compare the performance of two large multiplex NATS, ResPlex II (RPII) and Respiratory Virus Surveillance kit with electrospray ionization mass spectrometry (RVS/MS) using nasopharyngeal aspirates (NPAs) from hospitalized children who had been tested previously with conventional methods. Study design: Stored residual NPAs (N= 306) were tested concomitantly by RPII and RVS/MS. Alternate NATs were used to adjudicate discordant results. Results: More viruses were detected with multiplex NATs (RPII, 110; RVS/MS, 109) than conventional assays (86); diagnostic gain was primarily for fastidious viruses (coronaviruses and enteroviruses [EVs]/human rhinoviruses [HRVs]). Total positive and negative agreement between the multiplex NATs for all viruses detected was quite high (86% positive agreement, 99% negative agreement). Most individual viruses were detected with fairly equivalent accuracy by the multiplex NATs, except for adenoviruses (RPII sensitivity 40%) and human metapneumovirus (RVS/MS sensitivity 42%). RPII had the advantage of detecting EVs and HRVs, however, it demonstrated considerable EV/HRV cross-reactivity (29 HRV-positive specimens by real-time PCR were positive for EV by RPII and 21 specimens positive for HRV only by RT-PCR were dual positive for EV/HRV by RPII). RPII also had reduced sensitivity for HRV detection (in 36 specimens, HRV was detected by RT-PCR but not by RPII). Conclusions: Both multiplex NATs were promising, but had notable limitations.
收起
摘要 :
Respiratory viruses can be detected in >90% of children with lower respiratory tract infections, such as bronchiolitis, due tothe use of sensitive nucleic acid amplification tests (NAATs) for virus detection.1 NAATsalso detect com...
展开
Respiratory viruses can be detected in >90% of children with lower respiratory tract infections, such as bronchiolitis, due tothe use of sensitive nucleic acid amplification tests (NAATs) for virus detection.1 NAATsalso detect common respiratory viral coinfections, defined as the detection of >1 viralpathogen in the same sample. Even 4–5 different respiratory viruses have been detected in children with acute respiratory infection (ARI).2 In this review, we will discuss the clinical significance of multiple respiratory virus detection (MRVD) that should be the preferred term for this phenomenon3 because it has not been shown that all viruses detected are causing infection. It is possible that some of them are just innocent bystanders inducing no inflammatory response. A large number of studies have shown that MRVD occurs in 20%–40% of children with lower respiratory tract infections, but this finding is less common in adults.2–5 The occurrence of different respiratory viruses in MRVD varies widely in different studies.
收起
摘要 :
Eosinophils have been mainly associated with parasitic infection and pathologies such as asthma. Some patients with asthma present a high number of eosinophils in their airways. Since respiratory viruses are associated with asthma...
展开
Eosinophils have been mainly associated with parasitic infection and pathologies such as asthma. Some patients with asthma present a high number of eosinophils in their airways. Since respiratory viruses are associated with asthma exacerbations, several studies have evaluated the role of eosinophils against respiratory viruses. Eosinophils contain and produce molecules with antiviral activity, including RNases and reactive nitrogen species. They can also participate in adaptive immunity, serving as antigen-presenting cells. Eosinophil antiviral response has been demonstrated against some respiratory viruses in vitro and in vivo, including respiratory syncytial virus and influenza. Given the implication of respiratory viruses in asthma, the eosinophil antiviral role might be an important factor to consider in this pathology.
收起
摘要 :
The characteristics and risk factors of respiratory syncytial virus (RSV) infection among children has not yet been fully understood. To address the characteristics of RSV-associated illness and risk factors of RSV infection among...
展开
The characteristics and risk factors of respiratory syncytial virus (RSV) infection among children has not yet been fully understood. To address the characteristics of RSV-associated illness and risk factors of RSV infection among children under 5 years of age in Suzhou, China. From April 2011 to March 2014, we conducted a prospective surveillance among children in Suzhou, China. Nasal or throat swabs were collected from outpatients with influenza-like illness (ILI) and inpatients with severe acute respiratory infections (SARI). RSV was detected by reverse-transcriptase polymerase chain reaction and direct fluorescent antibody assay for children with ILI and SARI, respectively. Multivariable logistic-regression models were constructed to explore risk factors and symptoms of RSV infection. Of 3267 ILI and 1838 SARI children enrolled in the study, 192 (5.9%) and 287 (15.6%) tested positive for RSV, respectively. Among ILI patients, children with RSV infections visited clinics more often (P=0.005) and had longer duration of fever (P=0.032) than those without RSV infection. All RSV-positive children had an increased risk of having cough (OR=2.9), rhinorrhea (OR=1.6), breathing difficulty (OR=3.4), wheezing (OR=3.3), and irritability (OR=2.7). Children aged <2 years, had history of prematurity (OR=2.0) and recent respiratory infections (OR=1.3) were more likely to get infected by RSV. Children with SARI had higher positive rate of RSV than those with ILI. Cough, rhinorrhea, and wheezing were the most common symptoms in RSV infection. Children aged <2 years, had history of prematurity and recent respiratory infections were the potential risk factors for RSV infection.
收起
摘要 :
PURPOSE OF REVIEW: Recently, several previously unrecognized respiratory viral pathogens have been identified and several influenza A virus subtypes, previously known to infect poultry and wild birds, were transmitted to humans. H...
展开
PURPOSE OF REVIEW: Recently, several previously unrecognized respiratory viral pathogens have been identified and several influenza A virus subtypes, previously known to infect poultry and wild birds, were transmitted to humans. Here we review the recent literature on these respiratory viruses. RECENT FINDINGS: Human metapneumovirus has now been detected worldwide, causing severe respiratory tract illnesses primarily in very young, elderly and immunocompromised individuals. Animal models and reverse genetic techniques were designed for human metapneumovirus, and the first vaccine candidates have been developed. Considerable genetic and antigenic diversity was observed for human metapneumovirus, but the implication of this diversity for vaccine development and virus epidemiology requires further study. Two previously unrecognized human coronaviruses were discovered in 2004 in The Netherlands and Hong Kong. Their clinical impact and epidemiology are largely unknown and warrant further investigation. Several influenza A virus subtypes were transmitted from birds to humans, and these viruses continue to constitute a pandemic threat. The clinical symptoms associated with these zoonotic transmissions range from mild respiratory illnesses and conjunctivitis to pneumonia and acute respiratory distress syndrome, sometimes resulting in death. More basic research into virus ecology and evolution and development of effective vaccines and antiviral strategies are required to limit the impact of influenza A virus zoonoses and the threat of an influenza pandemic. SUMMARY: Previously unknown and emerging respiratory viruses are an important threat to human health. Development of virus diagnostic tests, antiviral strategies, and vaccines for each of these pathogens is crucial to limit their impact.
收起
摘要 :
PURPOSE OF REVIEW: The present review focuses on the recent discovery, and clinical and epidemiological features of a virus associated with respiratory tract infections. RECENT FINDINGS: In June 2001, researchers in The Netherland...
展开
PURPOSE OF REVIEW: The present review focuses on the recent discovery, and clinical and epidemiological features of a virus associated with respiratory tract infections. RECENT FINDINGS: In June 2001, researchers in The Netherlands reported the discovery of a virus associated with respiratory tract disease in infants and children. Genetic studies of this newly discovered viral pathogen revealed that it was a paramyxovirus. This virus is the first human pathogen in the Genus Metapneumovirus and was called human metapneumovirus (hMPV). hMPV may be a common respiratory virus. Seroepidemiologic studies in The Netherlands suggested that, by age 5 years, nearly all individuals have been exposed to hMPV. The results of several studies suggest that hMPV may account for about 10% of respiratory tract infections in which a common respiratory virus, such as respiratory syncytial virus, or influenza or parainfluenza viruses, could not be detected. hMPV has been detected in patients with either upper or lower respiratory tract disease, or both. Symptoms associated with hMPV include cough, dyspnea, wheeze, and hypoxia. This newly recognized pathogen has been detected in children and adults. Epidemiological findings suggest that it may circulate worldwide and may have a seasonal distribution. SUMMARY: hMPV is a newly emerging respiratory pathogen and may be the cause of a significant proportion of both upper and lower respiratory tract infection in infants, children, and adults.
收起
摘要 :
PURPOSE OF REVIEW: Several epidemiologic studies have enhanced our understanding of the impact of respiratory viruses on bone marrow transplant recipients. RECENT FINDINGS: Respiratory viral infections occur frequently following s...
展开
PURPOSE OF REVIEW: Several epidemiologic studies have enhanced our understanding of the impact of respiratory viruses on bone marrow transplant recipients. RECENT FINDINGS: Respiratory viral infections occur frequently following stem cell transplantation but present atypically. Many patients have asymptomatic infections. There is a growing armamentarium of antiviral agents currently under development, although prospective studies in transplant patients are needed. SUMMARY: Respiratory viral infections occur frequently after hematopoietic stem cell transplant. Newer agents may prove useful in the prevention and treatment of respiratory viral infections in this population.
收起
摘要 :
PURPOSE OF REVIEW: Several epidemiologic studies have enhanced our understanding of the impact of respiratory viruses on bone marrow transplant recipients. RECENT FINDINGS: Respiratory viral infections occur frequently following s...
展开
PURPOSE OF REVIEW: Several epidemiologic studies have enhanced our understanding of the impact of respiratory viruses on bone marrow transplant recipients. RECENT FINDINGS: Respiratory viral infections occur frequently following stem cell transplantation but present atypically. Many patients have asymptomatic infections. There is a growing armamentarium of antiviral agents currently under development, although prospective studies in transplant patients are needed. SUMMARY: Respiratory viral infections occur frequently after hematopoietic stem cell transplant. Newer agents may prove useful in the prevention and treatment of respiratory viral infections in this population.
收起
摘要 :
BACKGROUND: Many laboratories using R-Mix cell lines inoculate other shell vial cultures to improve the recovery of viruses, and in particular, perform terminal hemadsorption (THad) following 10-14 days of incubation to improve de...
展开
BACKGROUND: Many laboratories using R-Mix cell lines inoculate other shell vial cultures to improve the recovery of viruses, and in particular, perform terminal hemadsorption (THad) following 10-14 days of incubation to improve detection of respiratory viruses. We explored the cost-effectiveness and added benefits of THad on conventional shell vial cultures from respiratory samples for laboratories using R-Mix cell lines. OBJECTIVES: To determine if eliminating the practice of THad from conventional shell vial culture when R-Mix cultures are negative, would result in a significant reduction in the number of hemadsorbing respiratory viruses detected. STUDY DESIGN: THad results were retrospectively reviewed for 41,129 respiratory shell vial cultures that were set up concurrently with R-Mix cultures. RESULTS: Greater than 95% of hemadsorbing respiratory viruses were recovered by R-Mix standard protocol within 24h of inoculation, and only 5% were detected by THad at 10-14 days. CONCLUSION: The practice of hemadsorption at days 10-14 for conventional shell vial cultures from respiratory specimens should be discontinued for laboratories using R-Mix due to its low yield, questionable clinical impact of delayed results and additional costs.
收起
原文获取