scholarly journals Approaches to Antiviral Chemotherapy for Acute Respiratory Infections

1998 ◽  
Vol 9 (2) ◽  
pp. 93-107 ◽  
Author(s):  
Shiro Shigeta

The causative agents of acute respiratory infections (ARI) in infants and children are mostly thought to be viruses. Some ARI in adult patients may be caused by bacteria but most often the causes are virus infections. When ARI affect immunocompromised patients or the elderly the mortality rates are significantly higher than in immunocompetent individuals. Many types of viruses cause ARI. Among them, influenza viruses A and B and respiratory syncytial virus (RSV) are thought to be the most important because of the severity of illness after infection and their high communicability in the human population. Recently, several novel antiviral drugs against ARI have been developed and some are proceeding in clinical trials. This review covers current investigations into antiviral compounds targeted at several points in the virus life-cycle. This includes PM-523, which broadly inhibits ortho- and paramyxoviruses, two neuraminidase inhibitors for influenza virus, neutralizing antibody to RSV and chimeric soluble ICAM-1–IgA molecules targeted against rhinoviruses.

2020 ◽  
Vol 99 (6) ◽  
pp. 8-14
Author(s):  
A.V. Gorelov ◽  
◽  
S.V. Nikolaeva ◽  
◽  

Acute respiratory infections (ARI) are still topical, holding the first place in the structure of infectious pediatric pathology. The most common causative agents of ARI are viruses. Currently, about 200 respiratory viruses are known, among which the most significant are influenza and parainfluenza viruses, rhinoviruses, respiratory syncytial virus, adenoviruses. Relatively recently, previously unknown serotypes of coronaviruses (SARS-CoV, MERS-CoV, NL63 and HKU), bocaviruses and metapneumovirus were described, and at the end of 2019 a new coronavirus SARS-CoV-2 was discovered, which causes COVID-19 infection. Pneumotropic bacteria Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, etc. contributed to the incidence of respiratory infections. Pertussis remains a serious infection for young children, which in recent years, despite the typical clinical picture, presents certain difficulties for diagnosis. The ability of ARI to provoke the development of secondary bacterial complications (bronchitis, bronchiolitis and pneumonia) often dictates the unjustified prescription of antibiotic therapy, which has led in recent years to an increase in antibiotic resistance. Thus, the relevance of ARI at the present stage is not in doubt, and the above problems dictate the need for an individual approach to each patient.


Author(s):  
Daniel E Noyola ◽  
Sally Hunsberger ◽  
Raydel Valdés Salgado ◽  
John H Powers ◽  
Arturo Galindo-Fraga ◽  
...  

Abstract Background Molecular detection methods allow for the simultaneous detection of several infectious agents. This study assesses whether co-infection with two viruses as compared to one is associated with increased hospitalization in those with acute respiratory infections. Methods We prospectively enrolled a cohort of pediatric and adult participants with influenza-like illness during 2010-2014 in Mexico. Clinical information and respiratory samples were collected at enrollment. Respiratory viruses were detected with multiplex PCR and influenza specific RT-PCR assays. Participants were followed-up 14 and 28 days after inclusion. Severity of disease as measured by hospitalization with acute respiratory infections was compared between single and dual viral infections. Results Among 5,662 participants in the study, either one (n=3,285) or two (n=641) viruses were detected in 3,926 participants. Rhinovirus (n=1,433), influenza (n=888), and coronaviruses (n=703) were the most frequently detected viruses (either alone or in co-infection). Bocavirus, respiratory syncytial virus (RSV), metapneumovirus, and rhinovirus cases were hospitalized more often than other viruses. Bocavirus+rhinovirus cases were hospitalized more often than those with rhinovirus alone (but not bocavirus alone). RSV cases were more likely to be hospitalized than cases with co-infections of RSV and parainfluenza virus or coronavirus. Metapneumovirus cases were hospitalized more often than those co-infected with metapneumovirus+coronavirus. Conclusions In this study, detection of two viruses did not significantly increase hospitalizations compared with single virus infections. Larger studies will allow for distinguishing between sequential and simultaneous infection as well as for a better understanding of the role of each virus during the evolution of acute respiratory episodes.


Author(s):  
С.В. Николаева ◽  
Д.В. Усенко ◽  
Ю.Н. Хлыповка ◽  
А.В. Горелов

Вирусные инфекции дыхательных путей являются наиболее частой причиной инфекционных заболеваний, особенно у детей. В большинстве случаев, особенно при поражении верхних дыхательных путей, острые респираторные вирусные инфекции протекают в легкой или среднетяжелой форме и часто купируются самостоятельно. Фармакологические средства для лечения или профилактики данных инфекций у детей в настоящее время ограничены. Многочисленные исследования доказали эффективность пробиотиков в лечении и профилактике заболеваний желудочно-кишечного тракта, таких как инфекционные и антибиотик-ассоциированные диареи, диареи путешественников, некротизирующий энтероколит, инфекция Helicobacter pylori, а также атопических заболеваний. Становится актуальным изучение эффективности пробиотиков в качестве средств профилактики острых респираторных инфекций среди детей и взрослых. Данные in vitro демонстрируют, что пробиотики обладают штаммоспецифическим иммуномодулирующим действием на иммунные клетки. Показано, что пробиотики эффективны в подавлении репликации различных респираторных вирусов, включая вирусы гриппа и респираторно-синцитиальный вирус. Подобные эффекты были продемонстрированы на мышах, было показано, что пробиотики способны снижать титры вируса в тканях легких и модулировать экспрессию противовирусных и провоспалительных генов до и после вирусной инфекции. Доклинические исследования также показывают уменьшение симптомов заболевания у мышей, что указывает на потенциальную клиническую пользу. Данные литературы по изучению применения пробиотиков и синбиотиков при вирусных инфекциях респираторного тракта показывают, что их использование связано с более низкой частотой и меньшей продолжительностью легких форм респираторной инфекции как у детей, так и у взрослых. Целесообразно дальнейшее проведение исследований для получения адекватных выводов об эффективности пробиотиков и синбиотиков при острых респираторных инфекциях. Viral infections of the respiratory tract are the most common cause of infectious diseases, especially in children. In most cases, especially when the upper respiratory tract is affected, acute respiratory viral infections are mild to moderate and often stop spontaneously. Pharmacological agents for the treatment or prevention of these infections in children are currently limited. Numerous studies have proven the effectiveness of probiotics in the treatment and prevention of diseases of the gastrointestinal tract, such as infectious and antibiotic-associated diarrhea, traveler's diarrhea, necrotizing enterocolitis, Helicobacter pylori infection, as well as atopic diseases. It is becoming urgent to study the effectiveness of probiotics as prophylactic agents for acute respiratory infections. among children and adults. In vitro data demonstrate that probiotics have strain-specific immunomodulatory effects on immune cells. Probiotics have been shown to be effective in suppressing the replication of various respiratory viruses, including influenza viruses and respiratory syncytial virus. Similar effects have been demonstrated in mice with the ability of probiotics to reduce viral titers in lung tissues and modulate the expression of antiviral and pro-inflammatory genes before and after viral infection. Preclinical studies also show improvement in symptoms in mice, indicating potential clinical benefit. Literature data on the use of probiotics and synbiotics for viral infections of the respiratory tract show that their use is associated with a lower frequency and duration of mild forms of respiratory infection in both children and adults. It is advisable to further conduct research necessary to obtain adequate conclusions about the effectiveness of probiotics and synbiotics in acute respiratory infections.


2021 ◽  
Vol 5 (11) ◽  
pp. 749-754
Author(s):  
S.V. Nikolaeva ◽  
◽  
A.B. Turovskiy ◽  
Yu.N. Khlypovka ◽  
◽  
...  

Dysphonia is a voice disorder manifesting with hoarseness, nasality, weak voice, and vocal fatigue. Being a common complaint, dysphonia is a common cause of medical referral and disability due to absence from work. Voice disorders affect individuals of any age. Meanwhile, voice disorders are more commonly reported in patients over 65 years (29.1%) and children. Moreover, 23.4% of children may have dysphonia at a certain point — this disorder is more common in boys than in girls. There are numerous causes of dysphonia, e.g., head snd neck tumors, neurological, gastrointestinal, or lung diseases, psychological disorders, injuries, iatrogenic injuries, infections, etc. Meanwhile, acute laryngitis, a symptom of acute respiratory infections, is one of the leading causes of dysphonia. The most common causative agents of acute laryngitis are parainfluenza and influenza viruses, adenoviruses, on occasion, respiratory syncytial virus, and viral-bacterial associations. Dysphonia treatment should be complex and include systemic and topical corticosteroids, antihistamines, mucoactive medications, systemic and topical antibiotics, and combined medications (e.g., Homeovox). Clinical trials have demonstrated their efficacy in adults and children. KEYWORDS: acute laryngitis, dysphonia, hoarseness, treatment. FOR CITATION: Nikolaeva S.V., Turovskiy A.B., Khlypovka Yu.N. Dysphonia: state-of-the-art and treatment tools. Russian Medical Inquiry. 2021;5(11):749–754 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-749-754.


2020 ◽  
Vol 63 (3) ◽  
pp. 7-18
Author(s):  
Marcela Solís-Rodríguez ◽  
Ángel G. Alpuche-Solís ◽  
Rocío G. Tirado-Mendoza

In 2001 in the Netherlands, Human metapneumovirus (hMPV) was identified as a “new” etiologic agent causing acute respiratory infections in children younger than 5 years old; however, it has also been isolated in the elderly and immunocompromised people. This virus is considered the second etiological agent in acute diseases of the respiratory tract. Currently, the estimated cost of IRAs in our country is of 9,000USD per inpatient. hMPV is a member of the genus Metapneumovirus, family Pneumoviridae, and it belongs to the order Mononegavirales that is part of the negative single-stranded ribonucleic acid (RNA) virus, consisting of eight genes ordered: 3’-N-P-M-FM2-SH-G-L-5 ‘, and which encodes for 9 proteins. Of these proteins, the F fusion glycoprotein is highly conserved in the genus Metapneumovirus, and is the major antigenic determinant, and because an approved vaccine doesn’t exist, it has been used as a candidate epitope for the design of a vaccine that confers host immunity or as a therapeutic target in the creation of antiviral peptides that inhibit the fusion of the virus to its target cell and to avoid infection in subjects at high risk of contagion since there is currently none accepted by COFEPRIS as a prophylactic treatment against hMPV. Key words: hMPV; respiratory infections; epitopes; protein F;vaccines.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Zhong-Jie Li ◽  
Hai-Yang Zhang ◽  
Li-Li Ren ◽  
Qing-Bin Lu ◽  
Xiang Ren ◽  
...  

AbstractNationwide prospective surveillance of all-age patients with acute respiratory infections was conducted in China between 2009‒2019. Here we report the etiological and epidemiological features of the 231,107 eligible patients enrolled in this analysis. Children <5 years old and school-age children have the highest viral positivity rate (46.9%) and bacterial positivity rate (30.9%). Influenza virus, respiratory syncytial virus and human rhinovirus are the three leading viral pathogens with proportions of 28.5%, 16.8% and 16.7%, and Streptococcus pneumoniae, Mycoplasma pneumoniae and Klebsiella pneumoniae are the three leading bacterial pathogens (29.9%, 18.6% and 15.8%). Negative interactions between viruses and positive interactions between viral and bacterial pathogens are common. A Join-Point analysis reveals the age-specific positivity rate and how this varied for individual pathogens. These data indicate that differential priorities for diagnosis, prevention and control should be highlighted in terms of acute respiratory tract infection patients’ demography, geographic locations and season of illness in China.


2012 ◽  
Vol 20 (1) ◽  
pp. 113-114 ◽  
Author(s):  
Daniel R. Feikin ◽  
M. Kariuki Njenga ◽  
Godfrey Bigogo ◽  
Barrack Aura ◽  
Stella Gikunju ◽  
...  

ABSTRACTThe role of serology in the setting of PCR-based diagnosis of acute respiratory infections (ARIs) is unclear. We found that acute- and convalescent-phase paired-sample serologic testing increased the diagnostic yield of naso/oropharyngeal swabs for influenza virus, respiratory syncytial virus (RSV), human metapneumovirus, adenovirus, and parainfluenza viruses beyond PCR by 0.4% to 10.7%. Although still limited for clinical use, serology, along with PCR, can maximize etiologic diagnosis in epidemiologic studies.


Author(s):  
Montaha Al-Iede ◽  
Lena Sarhan ◽  
Leen Abushanab ◽  
Tamara Ayasrah ◽  
Rafaa Al Maani ◽  
...  

Background: Influenza virus and other respiratory viruses have been identified as an essential cause of acute respiratory infections (ARIs) in children worldwide. However, there are few data on its frequency and clinical presentation in Jordan. Objectives: We aimed to identify the viral etiology of acute respiratory infections and the various clinical presentations in hospitalized children, especially those with influenza viruses compared to other respiratory viruses. Methods: A retrospective study that was conducted at the Jordan university hospital. All the positive nasopharyngeal aspirates that were collected from hospitalized children aged 0-19 years from January 2017 to January 2019 were reviewed. Results: A total of 338 nasopharyngeal aspirates (NPAs) with positive viral serology results were reviewed. Among the patients younger than four years, the RSV virus was the most frequently detected. However, the Influenza B virus was the most commonly seen in patients older than 5 years, H1N1 was more frequent in autumn (29.5%), and RSV was the most frequent virus in winter. Bronchopneumonia was the most frequent diagnosis among all hospitalized patients, followed by bronchiolitis. Out of 338 patients, 50.3 % had tachypnea, 70.7% of patients were admitted to the pediatric floor, while 18.6% presented with a severe illness and required admission to the pediatric intensive care unit (PICU). Infants under the age of one were more likely to have higher co-infection rates with other viruses compared to children over five years that had influenza. Conclusion: Presentations of influenza and other respiratory viruses vary between different age groups, such as sepsis in children younger than one year.


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