Relationship between rhinovirus and pediatric respiratory infection
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Abstract:
In recent years, the incidence and mortality rate of pediatric respiratory infection have been increasing globally, with rhinovirus being of particular correlation to pediatric respiratory infection.In addition to upper respiratory tract infection, rhinovirus RNA is also found in the lower respiratory tract during the infection period.The epithelial cells of the upper respiratory tract are the target cells of rhinovirus.In recent years, studies done on the relationship between rhinovirus infection and upper respiratory tract infection have provided evidence for clinical treatment.Further investigation is needed on the pathological mechanisms of rhinovirus-induced respiratory infections.
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Rhinovirus; Respiratory tract infection; ChildrenKeywords:
Rhinovirus
Respiratory tract
Common cold
Respiratory infection
Rhinovirus
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Objective: This study was performed with the aim to define the genotypes of RSV strains in pediatric patients with lower respiratory tract infections (LRTIs), and to evaluate their molecular correlations. Method: Nasopharyngeal swab samples were obtained from 72 patients with LRTI, between December 2012 and May 2013, in the Pediatrics Department of Akdeniz University Hospital. Twenty- eight RSV-A isolates and one RSV-B isolate were determined by real-time PCR (RealStar RSV RT-PCR, Altona Diagnostics). The part of the G gene was sequenced for genotyping 20 RSV-A strains. Nucleotide sequences were analyzed with ClustalX program (version 2.1). The phylogenetic tree was constructed with “neighbor-joining” by the using the MEGA (version 6.06) software. Results: The median age of the patients were 35 days (range: 8-6061). All RSV-A isolates were identified as genotype GA2. Eleven isolates were identical; six of them caused hospital-acquired and five communityacquired RSV infections. Six patients were considered to have nosocomial infections including 4 cases in the Neonatal Intensive Care Unit (premature), one in the Neonatal Clinics and one in the Pediatric HematologyOncology Clinics. Five of eleven identical isolates were identified in patients with community-acquired infections. Conclusion: Nosocomial and community-acquired RSV infections in our hospital were caused by RSV A GA2 subtype. Identical strains were detected in community- acquired infections in the same region, and; these strains also caused nosocomial infections. Monitoring of RSV infections, detecting of genotype with molecular microbiological analysis and applied standard isolation precautions are important in clinics at increased risk for nosocomial infections.
Respiratory tract
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Upper respiratory tract infections are one of the most common infectious diseases in man and are characterized by relatively mild symptoms. However, complications of bacterial superinfection or asthma exacerbations are not seldomly seen. Most upper respiratory tract infections are caused by rhinoviruses. The rhinovirus is a non-enveloped 30nm RNA-virus with over 100 serotypes that belongs to the Picornaviridae family and only replicates in primates. It is characterized by a single positive stranded genome acting not only as a template for RNA synthesis, but also encoding for a single polypeptide necessary for viral replication. The viral capsid has an icosahedral symmetry and demonstrates deep canyons, with a receptor-binding domain. Rhinoviruses are transmitted mainly via direct-or indirect contact with infected secretions and invade their host by binding to the ICAM-1 receptor on the nasal epithelium. Typical for rhinovirus upper respiratory tract infections are isolated scattered foci of infected epithelium, not showing any striking damage or cytopathic alterations, between large areas of normal epithelium.Today there is still little detailed knowledge on the pathophysiology of common cold, especially on the aspect of cellular migration and defense. A better understanding in mechanisms underlying this cellular response would not only have therapeutical consequences, but may also explain the relationship between viral infectious rhinitis and asthma or atopy.During a rhinovirus infection, a selective neutrophil and monocyte recruitment is observed. In vitro and in vivo data have demonstrated a time-limited, rhinovirus-induced increase in bradykinin, cytokine, chemokine and sICAM-1 concentrations. Epithelial derived proinflammatory cytokines initiate an adhesion cascade and activate T lymphocytes that create a Till-type cytokine environment within the infected tissue, necessary to eradicate the viral infection. The selective recruitment of neutrophils seems linked to increased concentrations of the chemokine IL-8 and common cold symptoms. It is doubtful that the cytokine-regulated-production of specific neutralising immunoglobulins is necessary for recovery from viral illnesses and presumably only contributes to a late and temporary protection against rhinovirus reinfection.These observations confirm the crucial role that cytokines and mediators play in the pathogenesis of a rhinovirus infection by mediating chemotaxis, transmigration and activation of inflammatory-and immunocompetent cells.
Rhinovirus
Pathophysiology
Respiratory tract
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Respiratory tract
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Respiratory syncytial virus (RSV) and rhinovirus (RV) are predominant viruses associated with lower respiratory tract infection in infants. We compared the symptoms of lower respiratory tract infection caused by RSV and RV in hospitalized infants. RV showed the same symptoms as RSV, so on clinical grounds, no difference can be made between these pathogens. No relation between polymerase chain reaction cycle threshold value and length of hospital stay was found.
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Rhinovirus
Common cold
Metapneumovirus
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The immunopathogenesis of respiratory syncytial virus (RSV) and human rhinovirus lower respiratory tract infections in children remains to be defined. We measured nasal wash concentrations of 29 cytokines in infants with RSV or human rhinovirus lower respiratory tract infections. Concentrations of interferon-γ in RSV and innate immunity cytokines in both infections inversely correlated with disease severity.
Rhinovirus
Respiratory tract
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The upper respiratory tract includes the sinuses, nasal passages, pharynx, and larynx, and is susceptible to a variety of pathogens including many viruses. Although other pathogens can also cause infections of the upper respiratory tract, we are focusing on viral illnesses for the purposes of this review. Upper respiratory tract infections (URIs) include sinusitis, nasopharyngitis (common cold), pharyngitis, epiglottitis, and tracheitis. URI’s are one of the most frequent causes for visits to see a physician in the United States. Despite the fact that many URIs are caused by viral pathogens, more than half of patients in both the clinic and the emergency department setting with a diagnosis of URI received antibiotics. URIs are generally mild, and self-limited illnesses; however, it is important to recognize clinical entities that may be severe and warrant more extensive diagnostic workup and treatment such as epiglottitis and tracheitis. This review covers the pathophysiology, diagnosis, treatment, disposition and outcome for multiple viral URIs seen commonly in the emergency department setting. This review contains 3 figures, 8 tables, and 87 references. Key words: Common cold, epiglottitis, nasopharyngitis, pharyngitis, sinusitis, tracheitis, upper respiratory tract infection
Tracheitis
Epiglottitis
Common cold
Laryngitis
Respiratory tract
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Respiratory viruses alter the nasopharyngeal microbiome and may be associated with a distinct microbial signature. To test this hypothesis, we compared the nasopharyngeal microbiome of 135 previously healthy infants with acute respiratory infection due to human rhinovirus (HRV; n = 52) or respiratory syncytial virus (RSV; n = 83). The nasopharyngeal microbiome was assessed by sequencing the V4 region of the 16S ribosomal RNA. Respiratory viruses were identified by quantitative reverse-transcription polymerase chain reaction. We found significant differences in the overall taxonomic composition and abundance of certain bacterial genera between infants infected with HRV and those infected with RSV. Our results suggest that respiratory tract viral infections are associated with different nasopharyngeal microbial profiles.
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Respiratory tract
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