T-helper 2 mechanisms involved in human rhinovirus infections and asthma

Influenza virus: Genomic insights, evolution, and its clinical presentation

Influenza viruses belong to the family Orthomyxoviridae and have been a concern for public health due to frequent epidemics and sporadic waves of pandemics. According to WHO, seasonal strains of the influenza A virus (IAV) infect 3 to 5 million people every year and result in 0.29-0.65 million deaths globally. Among all proteins of IAV, the hemagglutinin (HA) and neuraminidase (NA) have high mutation rates and have been reported to undergo antigenic drift and shift leading to novel strains. Hence continuous revision in drugs and vaccines regime is an economic burden as these reassortments can cause high morbidity among the immunologically naive population. Infection rates are higher among older age groups, infants and patients reported with other respiratory distress. Routine diagnostic tests include reverse transcription polymerase chain reaction (RT-PCR), viral culture, and immunofluorescence assays; however, the diagnosis may be hindered due to the resemblance of the clinical presentation of other respiratory viruses with influenza viruses. Here we present a comprehensive review which sheds light on the genomic structure, evolution, pathogenicity and clinical presentation of influenza virus that can help to distinguish it from other respiratory viruses. A detailed analysis will ultimately pave the way for the development of more effective antiviral drugs and a universal vaccine.

Application of quantitative real-time PCR for identifying respiratory tract pathogens in outpatients with RTIs

Introduction

Respiratory tract infections (RTIs) caused by various pathogens, including viruses, bacteria, and fungi, pose significant public health challenges worldwide. Understanding the etiology and epidemiology of RTIs is necessary for clinical management, rational drug use, formulation of preventive measures, and vaccine development.

Methods

Quantitative real-time PCR was used to detect and analyze respiratory pathogens in outpatients at a hospital in Suzhou, including FluA, FluB, RSV, ADV, HRV, MP, and SARS-CoV-2.

Results

Among the 27,031 respiratory and throat swab samples, the positive rate of virus detection accounts for 25.6%. MP, SARS-CoV-2, and FluA, in particular, showed high positive rates among children, adolescents, and adults. The highest infection rates of RSV, HRV, and ADV were found in patients under 5 years old. High rates of FluA and FluB were observed in patients aged 5-17 and 18-44 years. However, the highest rate of SARS-CoV-2 infection was primarily observed in older adults. Seasonally, the infection rates of SARS-CoV-2 and FluA were highest in spring, FluB, RSV, and ADV in winter, HRV in autumn, and MP in summer and autumn.

Conclusion

By analyzing the results of respiratory virus nucleic acid detection, we can gain a better understanding of the infection status of common respiratory viruses, providing a basis for clinical diagnosis and treatment.

The impact of tezepelumab therapy on perceived asthma triggers: a multicenter real-life study

OBJECTIVE

Asthma exacerbations are often triggered by factors such as respiratory infections, allergens, exercise, and airway irritants, significantly affecting patients' respiratory symptoms and quality of life. Effective management of triggers is crucial in severe asthma care. Tezepelumab, an anti-thymic stromal lymphopoietin (TSLP) monoclonal antibody, can effectively reduce severe asthma exacerbations and symptoms burden. However, its impact on patients' perception of trigger-related symptoms remains underexplored.

METHODS

We conducted an observational, multicenter study involving 30 severe asthma patients starting tezepelumab 210 mg every 4 wk. Asthma triggers were assessed with the Asthma Triggers Inventory (ATI), while respiratory symptoms and HRQoL were evaluated using the Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), and Asthma Quality of Life Questionnaire (AQLQ). Data were collected at baseline (T0) and after 3 months of treatment (T3).

RESULTS

At T3, patients demonstrated a significant reduction in the impact of asthma triggers as well as improvements in the perception of triggers effects on HRQoL. Specific improvements were observed in the "air pollution/irritants" and "infection" domains of the ATI. Correlation analysis revealed a significant association between ATI and AQLQ changes over time.

CONCLUSION

Tezepelumab positively impacts patients' perception of asthma triggers and their HRQoL, supporting its role in managing triggers hypersensitivity as a treatable trait in severe asthma. Further research is warranted to investigate underlying mechanisms and long-term effects.

Advances in the Relationship between Respiratory Viruses and Asthma

Several studies have reported that viral infection is closely associated with the onset, progression, and exacerbation of asthma. The purpose of this review is to summarize the role that viral infections have in the pathogenesis of asthma onset and exacerbations, as well as discuss interrelated protective and risk factors of asthma and current treatment options. Furthermore, we present current knowledge of the innate immunological pathways driving host defense, including changes in the epithelial barrier. In addition, we highlight the importance of the genetics and epigenetics of asthma and virus susceptibility. Moreover, the involvement of virus etiology from bronchiolitis and childhood wheezing to asthma is described. The characterization and mechanisms of action of the respiratory viruses most frequently related to asthma are mentioned.

EV-D68 virus-like particle vaccines elicit cross-clade neutralizing antibodies that inhibit infection and block dissemination

Enterovirus D68 (EV-D68) causes severe respiratory illness in children and can result in a debilitating paralytic disease known as acute flaccid myelitis. No treatment or vaccine for EV-D68 infection is available. Here, we demonstrate that virus-like particle (VLP) vaccines elicit a protective neutralizing antibody against homologous and heterologous EV-D68 subclades. VLP based on a B1 subclade 2014 outbreak strain elicited comparable B1 EV-D68 neutralizing activity as an inactivated viral particle vaccine in mice. Both immunogens elicited weaker cross-neutralization against heterologous viruses. A B3 VLP vaccine elicited more robust neutralization of B3 subclade viruses with improved cross-neutralization. A balanced CD4⁺ T helper response was achieved using a carbomer-based adjuvant, Adjuplex. Nonhuman primates immunized with this B3 VLP Adjuplex formulation generated robust neutralizing antibodies against homologous and heterologous subclade viruses. Our results suggest that both vaccine strain and adjuvant selection are critical elements for improving the breadth of protective immunity against EV-D68.

Heparin, Low Molecular Weight Heparin, and Non-Anticoagulant Derivatives for the Treatment of Inflammatory Lung Disease

Unfractionated heparin has multiple pharmacological activities beyond anticoagulation. These anti-inflammatory, anti-microbial, and mucoactive activities are shared in part by low molecular weight and non-anticoagulant heparin derivatives. Anti-inflammatory activities include inhibition of chemokine activity and cytokine synthesis, inhibitory effects on the mechanisms of adhesion and diapedesis involved in neutrophil recruitment, inhibition of heparanase activity, inhibition of the proteases of the coagulation and complement cascades, inhibition of neutrophil elastase activity, neutralisation of toxic basic histones, and inhibition of HMGB1 activity. This review considers the potential for heparin and its derivatives to treat inflammatory lung disease, including COVID-19, ALI, ARDS, cystic fibrosis, asthma, and COPD via the inhaled route.