Impaired interferon status in children with acute respiratory infection and its correction with bifidumbacterin-forte

The state of interferon status was studied in 46 hospitalized children: 33 patients with complicated forms of acute respiratory virus infection (ARVI), such as pneumonia, bronchitis, etc., and 13 patients with vegetovascular dystonia (used as a comparison group). The study revealed that in patients with acute infections of the upper and lower respiratory tract considerable changes in their interferon system were registered. Children with ARVI were treated with Bifidumbacterin forte, a probiotic preparation, in large doses. Bifidumbacterin forte was found to produce a regulatory effect on the interferon system by enhancing the induction of alpha- and gamma-interferon and decreasing the production of serum interferon. The experience of using Bifidumbacterin forte in large doses proved that the preparation was well tolerated and could be used for the correction of interferon status.     

Prevalence and structure of acute respiratory virus infections

Information on epidemiology of acute respiratory virus infections (ARVI) is reviewed and analyzed. In addition to influenza viruses, the role of respiratory syncytial viruses (RSV), rhino- and adenoviruses, as well as other viruses, in the development of respiratory diseases, especially in newborns, young children and elderly persons, is emphasized. A high proportion of RSV in the etiology the severe forms of ARVI and in the development of intrauterine infection is pointed out. The conclusion has been made that the identification of the causative agents of ARVI with the use of modern methods makes it possible to determine the real role of each of the pathogens in the formation of the severe forms of diseases, as well as the expediency of vaccinal prophylaxis.     

Opportunistic microorganisms in respiratory tract diseases in patients of the Moscow Province region

The respiratory tract microflora in patients with inflammatory processes of the upper and lower respiratory tracts in the Moscow Province region has been studied. Changes in the microflora were found to occur in patients with pyoinflammatory diseases (PID) of the upper and lower respiratory tracts have been found to occur. Gram-positive cocci, mainly staphylococci and streptococci, were shown to play the leading etiological role in the development of PID. As revealed in this study, the microorganisms detected in the inflammations of the upper and lower respiratory tracts are coagulase-negative staphylococci, mainly S. epidermidis, as well as enterococci and streptococci belonging to the group viridans.     

Evaluation of amyxin effect in prophylaxis of acute respiratory viral infections

The results of the evaluation of the oral inductor of endogenic interferon (amyxin), manufactured in Russia are presented. The use of amyxin was found to produce a drop in morbidity in acute respiratory virus infections (ARVI) among medical workers 3.4 times, i.e. the preparation exhibited a pronounced prophylactic effect with respect to ARVI. The use of the preparation was accompanied by a decrease in the number of manifest forms of ARVI. Persons given the preparation often had ARVI in a mild or asymptomatic form.     

Preventive measure of massive spreading of influenza and acute respiratory viral infections

Influenza and acute respiratory viral infections (ARVI) continue to be one of the most actual medical and social-economic problem. But problem of high incidence of ARVI often regarded as problem of influenza only. Information about methods of prognosis of massive spreading of ARVI complex and universal system of their prophylaxis including influenza is presented in the article.     

Acute respiratory viral infections and bronchial asthma. Cellular and molecular aspects of the problem

In this review information on relationships between acute respiratory viral infections (ARVI) and attacks of bronchial asthma is presented. The mechanisms of the appearance of virus induced attacks and bronchial hyperreactiveness have been analyzed. The role of the immune response of the body as well as anti-inflammatory and chemotaxic cytokines in the development of bronchial obstruction and hyperreactiveness has been substantiated. The conclusion on the role of ARVI especially induced by respiratory syncytial virus and rhinoviruses, in the development of immune response facilitating allergic sensitization and provoking attacks of bronchial asthma has been made.     

Characteristics of acute respiratory viral infections in children under conditions of technogenic environmental pollution

The results of observations on children with acute virus respiratory infections (ARVI) and who had long been residents of zones with different levels of technogenic pollution of the atmospheric air are presented. The technogenic pollution of the environment has been found to exert influence on the spread and clinical course of ARVI in children, this influence being the more pronounced, the higher is the level of xenobiotics in the atmospheric air. The severity of the disease is noted to depend on the development of a number of syndromes, aggravating the course of ARVI, such as the neurotoxic and bronchoobstructive syndromes. Bronchical and ENT lesions are the most frequent complication of the main disease. The child population residing under the conditions of high technogenic environmental pollution should be regarded as a group of risk subject to the aggravated course of ARVI, and the examination of sick children should be made with due regard to this circumstance.     

Etiological structure of acute respiratory viral infections in children hospitalized in 1981-1999

The role of influenza and parainfluenza viruses, respiratory syncytial viruses and adenoviruses in the etiological structure of morbidity in acute respiratory virus infections (ARVI) in children hospitalized during the 19 year period is analyzed. As the result of examination of 56,287 patients by direct immunofluorescent test, respiratory viruses were detected in 21% of cases. The seasonal character, periodicity and level of ARVI morbidity were established. According to medical records, in the 1990s ARVI took a more severe course in children than that observed in the 1980s. In addition, the data on morbidity among children regarding rotavirus infection and ARVI were found to be similar.     

The upper and lower respiratory tracts differ in their requirement of IFN-gamma and IL-4 in controlling respiratory mycoplasma infection and disease

The purpose of this study is to evaluate the significance of IFN-gamma and IL-4 production in controlling mycoplasma infection and the pathogenesis of disease in the upper and lower respiratory tract. By using IFN-gamma knockout and IL-4 knockout BALB/c mice, we were able to study the contribution of these cytokines in the development of pathogenesis and/or protection in response to mycoplasma respiratory infection, in both the upper and lower respiratory tracts. The loss of either IFN-gamma or IL-4 does not affect disease pathogenesis or mycoplasma organism numbers in the upper respiratory tract. However, in the absence of IL-4, the nasal passages developed a compensatory immune response, characterized by higher numbers of macrophages and CD8(+) T cells, which may be masking detrimental effects due to IL-4 deficiency. This is in contrast to the lower respiratory tract, where the loss of IFN-gamma, but not IL-4, leads to higher mycoplasma numbers and increased disease severity. The loss of IFN-gamma impacted the innate immune system's ability to effectively clear mycoplasma, as the number of organisms was higher by day 3 postinfection. This higher organism burden most likely impacted disease pathogenesis; however, the development of Th2 cell-mediated adaptive immune response most likely contributed to lesion severity at later time points during infection. Our studies demonstrate that the upper and lower respiratory tracts are separate and distinct in their cytokine requirements for generating immunity against mycoplasma infection.     

The comprehensive differentiated protection against influenza and acute respiratory diseases of medical workers in industrial enterprises]

Acute diseases of the respiratory organs rank first among temporary invalidity causes (30.5%). For the first time workers of a health center of an industrial enterprise were protected from influenza and ARVI during an epidemic outbreak of influenza A by specific and nonspecific protection means with due consideration for the subject's health status and will. Comprehensive differentiated protection from influenza and ARVI proved highly effective, its index reaching 2.5 and the invalidity periods being shorter by 2.4-4 days.     

Recombinant respiratory syncytial virus that does not express the NS1 or M2-2 protein is highly attenuated and immunogenic in chimpanzees

Mutant recombinant respiratory syncytial viruses (RSV) which cannot express the NS1 and M2-2 proteins, designated rA2DeltaNS1 and rA2DeltaM2-2, respectively, were evaluated as live-attenuated RSV vaccines. The rA2DeltaNS1 virus contains a large deletion that should have the advantageous property of genetic stability during replication in vitro and in vivo. In vitro, rA2DeltaNS1 replicated approximately 10-fold less well than wild-type recombinant RSV (rA2), while rA2DeltaM2-2 had delayed growth kinetics but reached a final titer similar to that of rA2. Each virus was administered to the respiratory tracts of RSV-seronegative chimpanzees to assess replication, immunogenicity, and protective efficacy. The rA2DeltaNS1 and rA2DeltaM2-2 viruses were 2,200- to 55,000-fold restricted in replication in the upper and lower respiratory tracts but induced a level of RSV-neutralizing antibody in serum that was only slightly reduced compared to the level induced by wild-type RSV. The replication of wild-type RSV in immunized chimpanzees after challenge was reduced more than 10,000-fold at each site. Importantly, rA2DeltaNS1 and rA2DeltaM2-2 were 10-fold more restricted in replication in the upper respiratory tract than was the cpts248/404 virus, a vaccine candidate that retained mild reactogenicity in the upper respiratory tracts of 1-month-old infants. Thus, either rA2DeltaNS1 or rA2DeltaM2-2 might be appropriately attenuated for this age group, which is the major target population for an RSV vaccine. In addition, these results show that neither NS1 nor M2-2 is essential for RSV replication in vivo, although each is important for efficient replication.     

Distinct mechanisms for cross-protection of the upper versus lower respiratory tract through intestinal priming

A main feature of the common mucosal immune system is that lymphocytes primed in one mucosal inductive site may home to distant mucosal effector sites. However, the mechanisms responsible for such cross-protection remain elusive. To address these we have used a model of local mucosal infection of mice with reovirus. In immunocompetent mice local duodenal priming protected against subsequent respiratory challenge. In the upper respiratory tract this protection appeared to be mainly mediated by specific IgA- and IgG2a-producing B cells, whereas ex vivo active effector memory CTL were found in the lower respiratory tract. In accordance with these findings, clearance of reovirus from the lower respiratory tract, but not from the upper respiratory tract, of infected SCID mice upon transfer of gut-primed lymphocytes depended on the presence of T cells. Taken together this study reveals that intestinal priming leads to protection of both the upper and lower respiratory tracts, however through distinct mechanisms. We suggest that cross-protection in the common mucosal immune system is mediated by trafficking of B cells and effector memory CTL.     

The role of Streptococcus pneumoniae virulence factors in host respiratory colonization and disease

Streptococcus pneumoniae is a Gram-positive bacterial pathogen that colonizes the mucosal surfaces of the host nasopharynx and upper airway. Through a combination of virulence-factor activity and an ability to evade the early components of the host immune response, this organism can spread from the upper respiratory tract to the sterile regions of the lower respiratory tract, which leads to pneumonia. In this Review, we describe how S. pneumoniae uses its armamentarium of virulence factors to colonize the upper and lower respiratory tracts of the host and cause disease.     

Epidemiological and economic effectiveness of immunization of adult and children against influenza and acute respiratory viral infections with the vaccine Grippol

Materials on the characterization of the vaccine Grippol, indications for its use and the results of mass use are presented. Analysis of the morbidity level in influenza and acute respiratory viral infections (ARVI) among the vaccinated persons are indicative of considerably decreased level. The coefficient of the epidemiological effectiveness of Grippol in the immunization of children has proved to be 75-95%. The conclusion has been made that the vaccine Grippol is sufficiently effective and safe for use by Russian public health service.     

Rhinovirus genome variation during chronic upper and lower respiratory tract infections

Routine screening of lung transplant recipients and hospital patients for respiratory virus infections allowed to identify human rhinovirus (HRV) in the upper and lower respiratory tracts, including immunocompromised hosts chronically infected with the same strain over weeks or months. Phylogenetic analysis of 144 HRV-positive samples showed no apparent correlation between a given viral genotype or species and their ability to invade the lower respiratory tract or lead to protracted infection. By contrast, protracted infections were found almost exclusively in immunocompromised patients, thus suggesting that host factors rather than the virus genotype modulate disease outcome, in particular the immune response. Complete genome sequencing of five chronic cases to study rhinovirus genome adaptation showed that the calculated mutation frequency was in the range observed during acute human infections. Analysis of mutation hot spot regions between specimens collected at different times or in different body sites revealed that non-synonymous changes were mostly concentrated in the viral capsid genes VP1, VP2 and VP3, independent of the HRV type. In an immunosuppressed lung transplant recipient infected with the same HRV strain for more than two years, both classical and ultra-deep sequencing of samples collected at different time points in the upper and lower respiratory tracts showed that these virus populations were phylogenetically indistinguishable over the course of infection, except for the last month. Specific signatures were found in the last two lower respiratory tract populations, including changes in the 5'UTR polypyrimidine tract and the VP2 immunogenic site 2. These results highlight for the first time the ability of a given rhinovirus to evolve in the course of a natural infection in immunocompromised patients and complement data obtained from previous experimental inoculation studies in immunocompetent volunteers.     

Leptospirotic etiology in pulmonary and upper respiratory tract pathology

A number of 3,200 febrile patients who presented upon admission to hospital primary pulmonary or upper respiratory tract impairment either as single forms of manifestation or associated to other syndromes were tested. The cases were screened by the rapid slide agglutination reaction with heat inactivated Patoc antigen and leptospirotic etiology was confirmed by the ultramicroscopic agglutination reaction with 18 live circulating pathogenic antigens. 64 leptospirosis cases with pulmonary impairment were confirmed and in 52 cases the upper respiratory tract was involved. Particular aspects of leptospirosis with pulmonary impairment: 71.8% of cases had a clinical diagnosis of interstitial pneumonia; 89% of cases presented important chest x-ray modifications; in an approximately equal number of cases the pulmonary involvement was the single manifestation or was associated with other syndromes; icterohaemorrhagiae, wolffi and pomona were the frequently encountered infecting serotypes. Particular aspects for leptospirosis involving the upper respiratory tract: 84.6% of cases had a clinical diagnosis of acute rhino-pharyngotracheitis; in 86.5% of cases the upper respiratory tract impairment was the single feature; the infecting serotypes were in decreasing order of frequency as follows: icterohaemorrhagiae, pomona, wolffi, canicola, grippotyphosa.     

Venezuelan equine encephalitis virus replicon particles encoding respiratory syncytial virus surface glycoproteins induce protective mucosal responses in mice and cotton rats

Respiratory syncytial virus (RSV) is an important viral pathogen that causes severe lower respiratory tract infection in infants, the elderly, and immunocompromised individuals. There are no licensed RSV vaccines to date. To prevent RSV infection, immune responses in both the upper and lower respiratory tracts are required. Previously, immunization with Venezuelan equine encephalitis virus replicon particles (VRPs) demonstrated effectiveness in inducing mucosal protection against various pathogens. In this study, we developed VRPs encoding RSV fusion (F) or attachment (G) glycoproteins and evaluated the immunogenicity and efficacy of these vaccine candidates in mice and cotton rats. VRPs, when administered intranasally, induced surface glycoprotein-specific virus neutralizing antibodies in serum and immunoglobulin A (IgA) antibodies in secretions at the respiratory mucosa. In addition, fusion protein-encoding VRPs induced gamma interferon (IFN-γ)-secreting T cells in the lungs and spleen, as measured by reaction with an H-2K^d-restricted CD8⁺ T-cell epitope. In animals vaccinated with F protein VRPs, challenge virus replication was reduced below the level of detection in both the upper and lower respiratory tracts following intranasal RSV challenge, while in those vaccinated with G protein VRPs, challenge virus was detected in the upper but not the lower respiratory tract. Close examination of histopathology of the lungs of vaccinated animals following RSV challenge revealed no enhanced inflammation. Immunization with VRPs induced balanced Th1/Th2 immune responses, as measured by the cytokine profile in the lungs and antibody isotype of the humoral immune response. These results represent an important first step toward the use of VRPs encoding RSV proteins as a prophylactic vaccine for RSV.     

Bacterial adherence to the upper respiratory tract of ferrets infected with influenza A virus

A ferret model was used to study bacterial adherence in animals with influenza. Ferrets were inoculated intranasally with influenza A3/Hong Kong/1/68 virus. Antiviral serum antibodies were apparent by Day 5. On Days 3, 5, 7, 9, and 11, three virus-inoculated and two uninoculated controls were anesthetized, exsanguinated, and decapitated, and the lower jaw was removed. Each animal was inoculated intranasally with a 1-ml suspension containing 20 mg (dry wt) of either 3H-labeled Staphylococcus aureus or 3H-labeled group B Streptococcus type Ia and incubated for 45 min at ambient temperature. In animals challenged with staphylococci, 80% of the original inoculum remained free in suspension; of the remaining 20%, the distribution in the upper respiratory tracts of virus-infected and control animals was significantly different. Of the staphylococci remaining in the nasopharynx of control animals, 74% was present in mucinous plugs, 11% was bound to host cells present in washes of the nasal cavity, and 15% was released by protease treatment of the nasopharynx. Of the staphylococci remaining in the upper respiratory tract of virus-infected ferrets, 36% was recovered in plugs, 24% was bound to cells in nasal washes, and 40% was released by enzyme treatment. Overall, adherence-positive staphylococci represented 64% of recoverable bacteria in virus-infected ferrets versus 26% in controls. Adherence was increased twofold (Days 5 and 7) to threefold (Days 3, 9, and 11) in virus-infected ferrets compared to uninfected controls. In contrast, only 7% of the original streptococcal inoculum was recovered from virus-infected and uninfected control animals and virus infection did not enhance streptococcal adherence except for an approximately threefold increase that was seen on Day 11.     

Comparison of Influenza Outbreaks in the Republic of Kazakhstan and Russia Induced by 2009 Yearly New Variant of А(H1N1) Influenza Virus

The aim of the work is the comparison of the epidemiology of influenza and acute respiratory virus infections (ARVI) in the Republic of Kazakhstan with the corresponding influenza epidemic in Russia induced by influenza pandemic virus A/California/07/2009 in 2009.Data on influenza and ARVI from the Republic of Kazakhstan and Federal Center of influenza was collected and investigated over the course of several weeks from hospitalized patients with the same diagnosis among all population and in age groups on ...