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Li L, Xie Z, Xu L. Current antiviral agents against human adenoviruses associated with respiratory infections. Front Pediatr 2024; 12:1456250. [PMID: 39268358 PMCID: PMC11390452 DOI: 10.3389/fped.2024.1456250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 08/16/2024] [Indexed: 09/15/2024] Open
Abstract
Human adenoviruses (HAdVs) are important pathogens responsible for respiratory infections. In children and immunocompromised patients, respiratory infections can cause considerable morbidity and mortality. Currently, there are no approved effective and safe antiviral therapeutics for the clinical treatment of HAdV infections, even those that have undergone preclinical/clinical trials. However, many compounds and molecules with anti-HAdV activity have been explored, and some candidates are undergoing clinical development. Here, we reviewed the reported in vitro and in vivo efficacies, as well as the therapeutic potential of these antiviral compounds, providing an overview and a summary of the current status of anti-HAdV drug development.
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Affiliation(s)
- Lexi Li
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhengde Xie
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Lili Xu
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
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Crawford R, Akmyradov C, Dachepally R, Prodhan P. Hospital Outcomes Among Children With Congenital Heart Disease and Adenovirus Pneumonia. Pediatr Infect Dis J 2024; 43:720-724. [PMID: 38564736 DOI: 10.1097/inf.0000000000004341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND The aim of the study is to evaluate the mortality risk factors and hospitalization outcomes of adenovirus pneumonia in pediatric patients with congenital heart disease. METHODS In this retrospective multicenter cohort study utilizing the Pediatric Health Information System database, we analyzed congenital heart disease patients with adenovirus pneumonia from January 2004 to September 2018, categorizing them into shunts, obstructive lesions, cyanotic lesions and mixing lesions. Multivariate logistic regression analysis was employed to identify mortality risk factors with 2 distinct models to mitigate collinearity issues and the Mann-Whitney U test was used to compare the hospital length of stay between survivors and nonsurvivors across these variables. RESULTS Among 381 patients with a mean age of 3.2 years (range: 0-4 years), we observed an overall mortality rate of 12.1%, with the highest mortality of 15.1% noted in patients with shunts. Model 1 identified independent factors associated with increased mortality, including age 0-30 days (OR: 8.13, 95% CI: 2.57-25.67, P < 0.005), sepsis/shock (OR: 3.34, 95% CI: 1.42-7.83, P = 0.006), acute kidney failure (OR: 4.25, 95% CI: 2.05-13.43, P = 0.0005), shunts (OR: 2.95, 95% CI: 1.14-7.67, P = 0.03) and cardiac catheterization (OR: 6.04, 95% CI: 1.46-24.94, P = 0.01), and Model 2, extracorporeal membrane oxygenation (OR: 3.26, 95% CI: 1.35-7.87, P = 0.008). Nonsurvivors had a median hospital stay of 47 days compared to 15 days for survivors. CONCLUSION The study revealed a 12.1% mortality rate in adenoviral pneumonia among children with congenital heart disease, attributed to risk factors such as neonates, sepsis, acute kidney failure, shunts, cardiac catheterization, extracorporeal membrane oxygenation use and a 3-fold longer hospital stay for nonsurvivors compared to survivors.
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MESH Headings
- Humans
- Heart Defects, Congenital/mortality
- Heart Defects, Congenital/complications
- Retrospective Studies
- Male
- Infant
- Female
- Child, Preschool
- Infant, Newborn
- Risk Factors
- Length of Stay/statistics & numerical data
- Pneumonia, Viral/mortality
- Pneumonia, Viral/therapy
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/complications
- Hospitalization/statistics & numerical data
- Adenovirus Infections, Human/epidemiology
- Adenovirus Infections, Human/mortality
- Hospital Mortality
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Affiliation(s)
- Richard Crawford
- From the Department of Cardiology, University of Oklahoma, Oklahoma
| | | | - Rashmitha Dachepally
- Department of Cardiology and Pediatric Intensive Care, University of Arkansas for Medical Sciences, Arkansas
- Department of Pediatric Critical Care, University of Nebraska Medical Center
| | - Parthak Prodhan
- Department of Cardiology and Pediatric Intensive Care, University of Arkansas for Medical Sciences, Arkansas
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Mahmood K, Ahmed W, Farooq S, Habib G, Sindhu MA, Asif A, Iftner T. Molecular characterization of human adenoviruses associated with pediatric respiratory infections in Karachi, Pakistan. BMC Infect Dis 2024; 24:538. [PMID: 38811902 PMCID: PMC11134642 DOI: 10.1186/s12879-024-09415-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
Human adenoviruses (HAdVs) are a diverse group of viruses associated with respiratory infections in humans worldwide. However, there is a lack of research on the genetic diversity and epidemiology of HAdVs in Pakistan. This study characterized HAdVs in pediatric patients with respiratory tract infections in Karachi, Pakistan, between 2022 and 2023. We analyzed 762 nasopharyngeal samples of children ≤ 5 years. DNA extraction, followed by PCR targeting E2B and hexon genes, was carried out. Data analysis was performed on SPSS 25.0, and phylogenetic analysis of hexon gene was performed on MEGA 11. HAdV was detected in 7.34% (56/762) of patients round the year, but at a significantly higher rate during the winter season. Age was insignificantly associated with HAdV incidence (p = 0.662), but more than 62.5% (35/56) of positive cases were younger than 10 months. The circulating HAdVs were identified as six different types from species B (78.57%) and C (21.42%), with the majority of isolates found to be like B3. HAdV was found to be co-infected with bocavirus (5.4%) and measles (7.14%). These findings revealed a high frequency and genetic diversity of respiratory HAdVs in Karachi, Pakistan. We conclude that periodic and continuous surveillance of adenoviruses and other respiratory pathogens is necessary to improve the prognosis and management of respiratory diseases, thereby reducing the child mortality rate in Pakistan.
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Affiliation(s)
- Khalid Mahmood
- National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
| | - Waqar Ahmed
- National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Saba Farooq
- National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Gul Habib
- Department of Microbiology, Abbottabad University of Science and Technology, Havelian, Abbottabad, 22010, Pakistan
| | - Muhammad Ashfaq Sindhu
- Department of Pediatrics, National Institute of Child Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Afshan Asif
- Department of Pediatrics, Sindh Government Children Hospital, Karachi, Pakistan
| | - Thomas Iftner
- National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
- Institute of Medical Virology and Epidemiology of Viral Diseases, University Hospital Tuebingen, Elfriede-Aulhorn-Str. 6, 72076, Tubingen, Germany
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Wu L, Lin Y, Yin J, Yang C, Jiang Y, Zhai L, Wang Y, Zhu L, Wu Q, Zhang B, Wan C, Zhao W, Yang Y, Shen C, Xiao W. Development of monoclonal antibodies targeting the conserved fragment of hexon protein to detect different serotypes of human adenovirus. Microbiol Spectr 2024; 12:e0181623. [PMID: 38385650 PMCID: PMC10986570 DOI: 10.1128/spectrum.01816-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/20/2024] [Indexed: 02/23/2024] Open
Abstract
Human adenovirus (HAdV) infects the respiratory system, thus posing a threat to health. However, immunodiagnostic reagents for human adenovirus are limited. This study aimed to develop efficient diagnostic reagents based on monoclonal antibodies for diagnosing various human adenovirus infections. Evolutionary and homology analyses of various human adenoviral antigen genes revealed highly conserved antigenic fragments. The prokaryotic expression system was applied to recombinant penton, hexon, and IVa2 conserved fragments of adenovirus, which were injected into BALB/c mice to prepare human adenovirus-specific monoclonal antibodies. Enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence assay (IFA), and Western blotting were used to determine the immune specificity of the monoclonal antibodies. Indirect ELISA showed that monoclonal antibodies 1F10, 8D3, 4A1, and 9B2 were specifically bound to HAdV-3 and HAdV-55 and revealed high sensitivity and low detection limits for various human adenoviruses. Western blotting showed that 1F10 and 8D3 specifically recognized various human adenovirus types, including HAdV-1, HAdV-2, HAdV-3, HAdV-4, HAdV-5, HAdV-7, HAdV-21, and HAdV-55, and 4A1 specifically recognized HAdV-1, HAdV-2, HAdV-3, HAdV-5, HAdV-7, HAdV-21, and HAdV-55. IFAs showed that 1F10, 8D3, and 4A1 exhibited highly selective localization to A549 cells infected with HAdV-3 and HAdV-55. Finally, two antibody pairs that could detect hexon antigens HAdV-3 and HAdV-55 at low concentrations were developed. The monoclonal antibodies developed in this study show potential for detecting human adenoviruses. IMPORTANCE In this study, we selected the three most conserved antigenic fragments of human adenovirus to prepare a murine monoclonal antibody for the first time, and human adenovirus antigenic fragments with heretofore unheard of degrees of conservatism were isolated. The three monoclonal antibodies with the ability to recognize human respiratory adenovirus over a broad spectrum were screened by hybridoma and monoclonal antibody preparation. Human adenovirus infections are serious; however, therapeutic drugs and diagnostic reagents are scarce. Thus, to reduce the serious consequences of human viral infections and adenovirus pneumonitis, early diagnosis of infection is required. The present study provides three monoclonal antibodies capable of recognizing a wide range of human adenoviruses, thereby offering guidance for subsequent research and development.
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Affiliation(s)
- Linfan Wu
- School of Public Health, Guangdong Medical University, Zhanjiang, China
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yuhao Lin
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Juzhen Yin
- Shenzhen Key Laboratory of Pathogen and Immunity, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Changbi Yang
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yushan Jiang
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Linlin Zhai
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yuelin Wang
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Li Zhu
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qinghua Wu
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Bao Zhang
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chengsong Wan
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Wei Zhao
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yang Yang
- Shenzhen Key Laboratory of Pathogen and Immunity, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Chenguang Shen
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Weiwei Xiao
- School of Public Health, Guangdong Medical University, Zhanjiang, China
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Cai S, Zhu CH, Chen FG, Liu F, Gao ML, Xiong Y. [Establishment of a risk model for severe adenovirus pneumonia and prospective study of the timing of intravenous immunoglobulin therapy in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:619-625. [PMID: 37382132 DOI: 10.7499/j.issn.1008-8830.2211069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To develop a risk prediction model for severe adenovirus pneumonia (AVP) in children, and to explore the appropriate timing for intravenous immunoglobulin (IVIG) therapy for severe AVP. METHODS Medical data of 1 046 children with AVP were retrospectively analyzed, and a risk prediction model for severe AVP was established using multivariate logistic regression. The model was validated with 102 children with AVP. Then, 75 children aged ≤14 years who were considered at risk of developing severe AVP by the model were prospectively enrolled and divided into three groups (A, B and C) in order of visit, with 25 children in each group. Group A received symptomatic supportive therapy only. With the exception of symptomatic supportive therapy, group B received IVIG treatment at a dose of 1g/(kg·d) for 2 consecutive days, before progressing to severe AVP. With the exception of symptomatic supportive therapy, group C received IVIG treatment at a dose of 1 g/(kg·d) for 2 consecutive days after progressing to severe AVP. Efficacy and related laboratory indicators were compared among the three groups after treatment. RESULTS Age<18.5 months, underlying diseases, fever duration >6.5 days, hemoglobin level <84.5 g/L, alanine transaminase level >113.5 U/L, and co-infection with bacteria were the six variables that entered into the risk prediction model for severe AVP. The model had an area under the receiver operating characteristic curve of 0.862, sensitivity of 0.878, and specificity of 0.848. The Hosmer-Lemeshow test showed good consistency between the predicted values and the actual observations (P>0.05). After treatment, group B had the shortest fever duration and hospital stay, the lowest hospitalization costs, the highest effective rate of treatment, the lowest incidence of complications, the lowest white blood cell count and interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 levels, and the highest level of tumor necrosis factor alpha (P<0.05). CONCLUSIONS The risk model for severe AVP established in this study has good value in predicting the development of severe AVP. IVIG therapy before progression to severe AVP is more effective in treating AVP in children.
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Affiliation(s)
- Sha Cai
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Chun-Hui Zhu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Fang-Gen Chen
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Fei Liu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Mei-Ling Gao
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Yan Xiong
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
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Huang S, Zhang S, Yuan L, Zhuo Z, Wu X. Severe pediatric adenoviral pneumonia combined with invasive pulmonary aspergillosis. BMC Pulm Med 2023; 23:152. [PMID: 37127631 PMCID: PMC10150341 DOI: 10.1186/s12890-023-02447-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/19/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND This study aimed to analyze the clinical characteristics of severe pediatric adenoviral pneumonia combined with invasive pulmonary aspergillosis. METHODS We retrospectively analyzed the clinical data of five children clinically diagnosed with severe adenoviral pneumonia combined with invasive pulmonary aspergillosis at Xiamen Children's Hospital. RESULTS These five children included one boy and four girls, with ages of onset ranging from 8 months and 15 days to 2 years and 2 months. All of them had fever with a mean duration of 11-35 days and cough. Pulmonary imaging was performed, which revealed solid pulmonary opacification in all five children, pleural effusion in two children, and emphysema and multiple small cavity formations in one child. Multiple microbiological tests were performed on the 5 children, and adenovirus was positive in the alveolar lavage fluid for the first time, and aspergillus culture was positive in the second test. On tracheoscopy, the bronchial mucosa was seen to be congested and edematous or pale and eroded; white moss-like material was seen adhering to the tracheal wall or even blocking the airway. The five children were treated with a combination of two or more broad-spectrum antimicrobials, glucocorticoids, and gamma globulins and underwent bronchoscopy. Voriconazole was added in the treatment regimen after the diagnosis of aspergillosis (28-34 days of treatment). Four of the children were discharged in good condition with a mean total length of hospital stay of 17-47 days. The other child leave against medical advice. Follow-up 3-5 months after discharge showed that one child had been cured; two children had developed obliterative bronchiolitis; one child had developed bronchiectasis; and the remaining child who had been discharged spontaneously was not contactable via telephone. CONCLUSIONS Immune disorders and antibiotic and steroid treatments for adenovirus infection are high-risk factors for secondary invasive pulmonary aspergillosis in children. Prolonged fever and cough are the main manifestations, but which lack specificity, and bronchoscopic mucosal-specific injury evaluation and alveolar lavage fluid culture are helpful in the diagnosis of aspergillosis. The long-term prognosis of severe pediatric adenoviral pneumonia combined with invasive pulmonary aspergillosis maybe poor.
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Affiliation(s)
- Shuihua Huang
- Department of Infection, Xiamen Children's Hospital, Xiamen Branch of Fudan University Pediatric Hospital, Xiamen, Fujian, China
| | - Shengxin Zhang
- Pediatric intensive care unit, Xiamen Children's Hospital, Xiamen Branch of Fudan University Pediatric Hospital, Xiamen, Fujian, China
| | - Lin Yuan
- Department of Infection, Xiamen Children's Hospital, Xiamen Branch of Fudan University Pediatric Hospital, Xiamen, Fujian, China.
| | - Zhiqiang Zhuo
- Department of Infection, Xiamen Children's Hospital, Xiamen Branch of Fudan University Pediatric Hospital, Xiamen, Fujian, China
| | - Xingdong Wu
- Department of Infection, Xiamen Children's Hospital, Xiamen Branch of Fudan University Pediatric Hospital, Xiamen, Fujian, China.
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Dewandel I, van Niekerk M, Ghimenton-Walters E, Palmer M, Anthony MG, McKenzie C, Croucamp R, Alter G, Demers AM, van Zyl G, Claassen M, Goussard P, Swanepoel R, Hoddinott G, Bosch C, Dunbar R, Allwood B, McCollum ED, Schaaf HS, Hesseling AC, van der Zalm MM. UMOYA: a prospective longitudinal cohort study to evaluate novel diagnostic tools and to assess long-term impact on lung health in South African children with presumptive pulmonary TB-a study protocol. BMC Pulm Med 2023; 23:97. [PMID: 36949477 PMCID: PMC10032249 DOI: 10.1186/s12890-023-02329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/17/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Despite a high paediatric tuberculosis (TB) burden globally, sensitive and specific diagnostic tools are lacking. In addition, no data exist on the impact of pulmonary TB on long-term child lung health in low- and middle-income countries. The prospective observational UMOYA study aims (1) to build a state-of-the-art clinical, radiological, and biological repository of well-characterised children with presumptive pulmonary TB as a platform for future studies to explore new emerging diagnostic tools and biomarkers for early diagnosis and treatment response; and (2) to investigate the short and long-term impact of pulmonary TB on lung health and quality of life in children. METHODS We will recruit up to 600 children (0-13 years) with presumptive pulmonary TB and 100 healthy controls. Recruitment started in November 2017 and is expected to continue until May 2023. Sputum and non-sputum-based samples are collected at enrolment and during follow-up in TB cases and symptomatic controls. TB treatment is started by routine care services. Intensive follow-up for 6 months will allow for TB cases to retrospectively be classified according to international consensus clinical case definitions for TB. Long-term follow-up, including imaging, comprehensive assessment of lung function and quality of life questionnaires, are done yearly up to 4 years after recruitment. DISCUSSION The UMOYA study will provide a unique platform to evaluate new emerging diagnostic tools and biomarkers for early diagnosis and treatment response and to investigate long-term outcomes of pulmonary TB and other respiratory events on lung health in children.
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Affiliation(s)
- Isabelle Dewandel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Margaret van Niekerk
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elisabetta Ghimenton-Walters
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Newcastle-Upon-Tyne National Health Service Hospitals Foundation Trust, Newcastle upon Tyne, UK
| | - Megan Palmer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Michaile G. Anthony
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carla McKenzie
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rolanda Croucamp
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Galit Alter
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard, Cambridge, MA USA
- Moderna Therapeutics, Cambridge, MA USA
| | - Anne-Marie Demers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Microbiology, Department of Laboratory Medicine, Centre Hospitalier Universitaire Sainte-Justine, Quebec, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Montreal, Quebec, Canada
| | - Gert van Zyl
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- National Health Laboratory Service, Tygerberg Business Unit, Cape Town, South Africa
| | - Mathilda Claassen
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Pierre Goussard
- Department of Paediatric Pulmonology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Ruan Swanepoel
- Department of Pulmonology and Lung Function, Tygerberg Hospital, Cape Town, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Corne Bosch
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rory Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Brian Allwood
- Department of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Eric D. McCollum
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Global Program in Pediatric Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - H. Simon Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anneke C. Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marieke M. van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Biškup UG, Steyer A, Lusa L, Strle F, Pokorn M, Mrvič T, Grosek Š, Petrovec M, Jevšnik Virant M. Molecular Typing of Mastadenoviruses in Simultaneously Collected Nasopharyngeal Swabs and Stool Samples from Children Hospitalized for Acute Bronchiolitis, Acute Gastroenteritis, and Febrile Seizures. Microorganisms 2023; 11:microorganisms11030780. [PMID: 36985353 PMCID: PMC10058226 DOI: 10.3390/microorganisms11030780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
This study determines and compares the frequency of human mastadenovirus (HAdV) presence in children with acute bronchiolitis (AB), acute gastroenteritis (AGE), and febrile seizures (FS), ascertains types of HAdVs associated with each individual syndrome and contrasts the findings with a control group of children. The presence of HAdVs was ascertained in simultaneously collected nasopharyngeal (NP) swabs and stool samples amplifying the hexon gene by RT-PCR; these were sequenced to determine the types of HAdVs. HAdVs were grouped into eight different genotypes. Of these, three (F40, F41, and A31) were found solely in stool samples, whereas the others (B3, C1, C2, C5, and C6) were found in both stool samples and NP swabs. The most common genotypes in NP swabs were C2 (found in children with AGE and FS) and C1 (only in children with FS), whereas in stool samples genotypes F41 (in children with AGE) and C2 (in children with AGE and FS) prevailed, and C2 was simultaneously present in both samples. HAdVs were more often detected in stool samples than in NP swabs in patients (with the highest estimated viral load in stool samples in children with AB and AGE) and healthy controls and were more common in NP swabs in children with AGE than in children with AB. In most patients, the characterized genotypes in NP swabs and stool samples were in concordance.
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Affiliation(s)
- Urška Glinšek Biškup
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Andrej Steyer
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
- National Laboratory of Health, Environment and Food, Prvomajska 1, 2000 Maribor, Slovenia
| | - Lara Lusa
- Department of Mathematics, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, 6000 Koper, Slovenia
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1104 Ljubljana, Slovenia
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1525 Ljubljana, Slovenia
| | - Marko Pokorn
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1525 Ljubljana, Slovenia
- Division of Pediatrics, Ljubljana University Medical Center, Bohoričeva 20, 1000 Ljubljana, Slovenia
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | - Tatjana Mrvič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1525 Ljubljana, Slovenia
| | - Štefan Grosek
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
- Neonatology Section, Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, Slovenia
- Department of Pediatric Intensive Therapy, Division of Pediatrics, University Medical Centre Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Monika Jevšnik Virant
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
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9
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In Vitro Antiviral and Anti-Inflammatory Activities of N-Acetylglucosamine: Development of an Alternative and Safe Approach to Fight Viral Respiratory Infections. Int J Mol Sci 2023; 24:ijms24065129. [PMID: 36982205 PMCID: PMC10049122 DOI: 10.3390/ijms24065129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Viral respiratory tract infections (RTIs) are responsible for significant morbidity and mortality worldwide. A prominent feature of severe respiratory infections, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is the cytokine release syndrome. Therefore, there is an urgent need to develop different approaches both against viral replication and against the consequent inflammation. N-acetylglucosamine (GlcNAc), a glucosamine (GlcN) derivative, has been developed as an immunomodulatory and anti-inflammatory inexpensive and non-toxic drug for non-communicable disease treatment and/or prevention. Recent studies have suggested that GlcN, due to its anti-inflammatory activity, could be potentially useful for the control of respiratory virus infections. Our present study aimed to evaluate in two different immortalized cell lines whether GlcNAc could inhibit or reduce both viral infectivity and the inflammatory response to viral infection. Two different viruses, frequent cause of upper and lower respiratory tract infections, were used: the H1N1 Influenza A virus (IAV) (as model of enveloped RNA virus) and the Human adenovirus type 2 (Adv) (as model of naked DNA virus). Two forms of GlcNAc have been considered, bulk GlcNAc and GlcNAc in nanoform to overcome the possible pharmacokinetic limitations of GlcNAc. Our study suggests that GlcNAc restricts IAV replication but not Adv infection, whereas nano-GlcNAc inhibits both viruses. Moreover, GlcNAc and mainly its nanoformulation were able to reduce the pro-inflammatory cytokine secretion stimulated by viral infection. The correlation between inflammatory and infection inhibition is discussed.
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10
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Machine learning for the identification of respiratory viral attachment machinery from sequences data. PLoS One 2023; 18:e0281642. [PMID: 36862685 PMCID: PMC9980812 DOI: 10.1371/journal.pone.0281642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 01/27/2023] [Indexed: 03/03/2023] Open
Abstract
At the outset of an emergent viral respiratory pandemic, sequence data is among the first molecular information available. As viral attachment machinery is a key target for therapeutic and prophylactic interventions, rapid identification of viral "spike" proteins from sequence can significantly accelerate the development of medical countermeasures. For six families of respiratory viruses, covering the vast majority of airborne and droplet-transmitted diseases, host cell entry is mediated by the binding of viral surface glycoproteins that interact with a host cell receptor. In this report it is shown that sequence data for an unknown virus belonging to one of the six families above provides sufficient information to identify the protein(s) responsible for viral attachment. Random forest models that take as input a set of respiratory viral sequences can classify the protein as "spike" vs. non-spike based on predicted secondary structure elements alone (with 97.3% correctly classified) or in combination with N-glycosylation related features (with 97.0% correctly classified). Models were validated through 10-fold cross-validation, bootstrapping on a class-balanced set, and an out-of-sample extra-familial validation set. Surprisingly, we showed that secondary structural elements and N-glycosylation features were sufficient for model generation. The ability to rapidly identify viral attachment machinery directly from sequence data holds the potential to accelerate the design of medical countermeasures for future pandemics. Furthermore, this approach may be extendable for the identification of other potential viral targets and for viral sequence annotation in general in the future.
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11
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Liu XP, Mao CX, Wang GS, Zhang MZ. Metagenomic next-generation sequencing for pleural effusions induced by viral pleurisy: A case report. World J Clin Cases 2023; 11:844-851. [PMID: 36818630 PMCID: PMC9928708 DOI: 10.12998/wjcc.v11.i4.844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/31/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Viral pleurisy is a viral infected disease with exudative pleural effusions. It is one of the causes for pleural effusions. Because of the difficult etiology diagnosis, clinically pleural effusions tend to be misdiagnosed as tuberculous pleurisy or idiopathic pleural effusion. Here, we report a case of pleural effusion secondary to viral pleurisy which is driven by infection with epstein-barr virus. Viral infection was identified by metagenomic next-generation sequencing (mNGS).
CASE SUMMARY A 40-year-old male with a history of dermatomyositis, rheumatoid arthritis, and secondary interstitial pneumonia was administered with long-term oral prednisone. He presented with fever and chest pain after exposure to cold, accompanied by generalized sore and weakness, night sweat, occasional cough, and few sputums. The computed tomography scan showed bilateral pleural effusions and atelectasis of the partial right lower lobe was revealed. The pleural fluids were found to be yellow and slightly turbid after pleural catheterization. Thoracoscopy showed fibrous adhesion and auto-pleurodesis. Combining the results in pleural fluid analysis and mNGS, the patient was diagnosed as viral pleuritis. After receiving Aciclovir, the symptoms and signs of the patient were relieved.
CONCLUSION Viral infection should be considered in cases of idiopathic pleural effusion unexplained by routine examination. mNGS is helpful for diagnosis.
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Affiliation(s)
- Xue-Ping Liu
- Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Chen-Xue Mao
- Department of Laboratory Diagnosis, Chongqing KingMed Center for Clinical Laboratory Co., Ltd, Chongqing 400050, China
| | - Guan-Song Wang
- Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Ming-Zhou Zhang
- Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
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12
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Pneumonia in Children During the 2019 Outbreak in Xiamen, China. Pediatr Infect Dis J 2023; 42:87-93. [PMID: 36638390 DOI: 10.1097/inf.0000000000003749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND To understand the regional epidemiology and clinical characteristics of adenovirus pneumonia in hospitalized children during the 2019 outbreak of respiratory adenoviruses in China. METHODS We analyzed the epidemiologic trend of adenovirus in children hospitalized for acute lower respiratory tract infections in Xiamen in 2019. Adenovirus was identified using direct fluorescent antibody detection. During the peak seasons of adenovirus epidemic, 170 adenovirus-positive specimens were obtained for molecular typing, and the clinical data were collected. RESULTS Among the 9890 children hospitalized for acute lower respiratory tract infection, 609 (6.2%) were tested positive for adenovirus. The detection rate of adenovirus was significantly higher in boys than in grils (9.5% vs. 4.6%, P < 0.05). Adenovirus activity increased markedly between April and August with the prevalence of 7.3%-12.4%. During the outbreak season, type 7 accounted for 70.6%, followed by type 3 (28.8%) and type 4 (0.6%). Of the 155 cases of adenovirus pneumonia, the median age was 3.0 years (range: 4 month to 9 years), 153 (98.7%) had fever with a mean fever duration of 9.04 ± 5.52 days, 28 (16.5%) had wheezing, 93 (60%) showed segmental or lobar consolidation with atelectasis and 13 (8.4%) showed pleural effusion. Forty-six (29.6%) cases developed severe pneumonia, 7 (4.1%) required mechanical ventilation and 2 (1.2%) died. Younger age, longer duration of fever and higher fever spike were more frequently seen in severe cases (P < 0.05). Twenty-five (16.2%) had C-reactive protein ≥ 40 mg/L, and 91 (58.7%) had procalcitonin ≥ 0.25 mg/L. CONCLUSIONS Adenovirus types 7 and 3 caused the outbreak of adenovirus pneumonia in community children during late spring to summer in 2019 in Xiamen. The majority of adenovirus pneumonia resembles bacterial pneumonia. The incidence of severe pneumonia was high when type 7 predominantly prevailed. Adenovirus type 7 was more common in severe cases than in nonsevere cases.
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13
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Shi T, Chen C, Fan H, Yu M, Li M, Yang D, Huang L, Nie Z, Lu G. Impact of extracorporeal membrane oxygenation in immunocompetent children with severe adenovirus pneumonia. BMC Pulm Med 2023; 23:41. [PMID: 36717803 PMCID: PMC9885392 DOI: 10.1186/s12890-022-02284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 12/12/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Severe adenovirus (Adv.) pneumonia can cause significant mortality in young children. There has been no worldwide consensus on the impact of extracorporeal membrane oxygenation (ECMO) in immunocompetent children with severe Adv. pneumonia. This study aimed to assess the impact of ECMO in immunocompetent children with severe Adv. pneumonia. METHODS This study evaluated the medical records of 168 hospitalized children with severe Adv. pneumonia at the Guangzhou Women and Children's Medical Center between 2019 and 2020.Nineteen patients in the ECMO group and 149 patients in the non-ECMO group were enrolled. RESULTS Between these two groups, there were no differences in host factors such as sex, age (all P > 0.05). Significant differences were observed in shortness of breath/increased work of breathing; cyanosis; seizures; tachycardia; the partial pressure of oxygen in arterial blood (PO2); the ratio of PaO2 to the fraction concentration of oxygen in inspired air (FiO2; P/F); white blood cell, lymphocyte, monocytes, lactate dehydrogenase (LDH), serum albumin, and procalcitonin levels; and, pulmonary consolidation (all P < 0.05). There were significant differences in the parameters of mechanical ventilation (MV) therapy and complications such as respiratory failure, acute respiratory distress syndrome, septic shock, length of hospitalization, and death (all P < 0.05). The maximum axillary temperatures, respiratory rates, heart rates and LDH levels after receiving ECMO were significantly lower than those before ECMO (all P < 0.05). Additionally, SPO2, PO2, and P/F were significantly higher than those before ECMO (all P < 0.05). In MV therapy, FiO2, PIP, and PEEP were significantly lower than those before ECMO (all P < 0.05). CONCLUSIONS In our study, the clinical conditions of the patients in the ECMO group were much more severe than those in the non-ECMO group. Our study showed that ECMO might be beneficial for the patients with severe Adv. pneumonia.
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Affiliation(s)
- Tingting Shi
- grid.410737.60000 0000 8653 1072Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120 Guangdong China
| | - Chen Chen
- grid.410737.60000 0000 8653 1072Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120 Guangdong China ,grid.410737.60000 0000 8653 1072Pediatric Intensive Care Unit, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Huifeng Fan
- grid.410737.60000 0000 8653 1072Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120 Guangdong China
| | - Minghua Yu
- grid.410737.60000 0000 8653 1072Department of Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Ming Li
- grid.410737.60000 0000 8653 1072Pediatric Intensive Care Unit, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Diyuan Yang
- grid.410737.60000 0000 8653 1072Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120 Guangdong China
| | - Li Huang
- grid.410737.60000 0000 8653 1072Pediatric Intensive Care Unit, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhiqiang Nie
- grid.413405.70000 0004 1808 0686Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Gen Lu
- grid.410737.60000 0000 8653 1072Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120 Guangdong China
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14
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Yang Y, Huang J, Yan H, Li X, Zang P, Zhang X, Xiao Z, Lu X. Decreased NK cells in cases of severe adenovirus pneumonia with liver dysfunction in pediatric intensive care unit: Evidence from 330 patients. Allergol Immunopathol (Madr) 2023; 51:42-48. [PMID: 37169559 DOI: 10.15586/aei.v51i3.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Although the human adenovirus infection is common, adenovirus infection with liver dysfunction is rare. METHODS To retrospectively analyze and compare the clinical characteristics and outcomes of pediatric patients diagnosed with severe adenovirus pneumonia with and without liver dysfunction, who were admitted to the pediatric intensive care unit of Hunan Children's Hospital (South China University) between January 2018 and June 2022. RESULTS Of the 330 severe adenovirus pneumonia cases analyzed (mean age, 19.88 ± 18.26 months), 102 were girls and 228 were boys. They were divided into two groups: those with liver dysfunction (n = 54) and without liver dysfunction (n = 276). Comparison analysis showed no significant between-group differences in body mass index and levels of white blood cells, neutrophils, platelets, albumin, total bilirubin, direct bilirubin, indirect bilirubin, creatine kinase, procalcitonin, creatinine, and urea nitrogen. However, the levels of alanine aminotransferase (175.99 U/L vs 30.55 U/L) and aspartate transaminase (215.96 U/L vs 74.30 U/L) were significantly higher in patients with liver dysfunction compared to those without liver dysfunction. Further analysis showed that pediatric patients with liver dysfunction had a significantly lower percentage of natural killer (NK) cells (6.93% vs 8.71%) and higher mortality rate (22% vs 9%) than those without liver dysfunction. CONCLUSION A decrease in serum NK cell levels in pediatric patients with severe adenovirus pneumonia could serve as a marker for monitoring the onset or progression of hepatic damage.
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Affiliation(s)
- Yufan Yang
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China
| | - Jiaotian Huang
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China
| | - Haipeng Yan
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China
| | - Xun Li
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China
| | - Ping Zang
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China
| | - Xinping Zhang
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China
| | - Zhenghui Xiao
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China;
| | - Xiulan Lu
- Department of Pediatric Intensive Care Unit of Hunan Children's Hospital, Changsha, Hunan, China;
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15
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Deyab N, Ekram B, Badr KR, Abd El-Hady BM, Allam NK. Antiviral Electrospun Polyamide Three-Layered Mask Filter Containing Metal Oxide Nanoparticles and Black Seed Oil. ACS OMEGA 2022; 7:44438-44447. [PMID: 36506173 PMCID: PMC9730509 DOI: 10.1021/acsomega.2c06611] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
Upon the tremendous spread of coronavirus, there is a need to develop biodegradable, multifunctional, antiviral masks that can be safely used without polluting the environment as conventional surgical masks do. In this study, a three-layered mask filter is designed and fabricated. The first two layers contain electrospun polyamide with dispersed nanoparticles (NPs) of TiO2 and ZnO prepared via breakdown anodization. The third layer is composed of Nigella sativa oil (black seed oil) electrospun with polyamide and blended with chitosan to form an effective antiviral three-layered mask filter. The morphological characterization revealed the nanoscale features of the fabricated nanofibers with the ZnO and TiO2 NPs being embedded in the polymeric matrix. The specimens showed good wettability, which is necessary for virus attachment and its subsequent decay. The assembled mask has shown very good mechanical properties. The cytotoxicity results revealed that the proposed mask filter has less cytotoxic effect on the A549 cell line than the commercial KN95 mask filter with maintaining a cell viability of 65.3%. The antiviral activity test showed a variable virucidal effect against human adenovirus on A549 cells. The proposed mask showed the highest effect on the virus followed by PA-ZnO and PA-TiO2 films, which supports the assumption that the used NPs may have broad and promising effects on viruses when combined with the electrospun films.
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Affiliation(s)
- Nourhan
M. Deyab
- Physical
Chemistry Department, Advanced Materials Technology and Mineral Resources
Research Institute, National Research Centre, Dokki, 12622Cairo, Egypt
| | - Basma Ekram
- Polymers
and Pigments Department, Chemical Industries Research Institute, National Research Centre, Dokki, 12622Cairo, Egypt
| | - Kareem R. Badr
- Environmental
Virology Laboratory, Water 593 Pollution Research Department, Environment
and Climate Change Research Institute, National
Research Centre, Dokki, 12622Cairo, Egypt
| | - Bothaina M. Abd El-Hady
- Polymers
and Pigments Department, Chemical Industries Research Institute, National Research Centre, Dokki, 12622Cairo, Egypt
| | - Nageh K. Allam
- Energy
Materials Laboratory, Physics Department, School of Sciences and Engineering, The American University in Cairo, New Cairo11835, Egypt
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Shi T, Bai J, Yang D, Huang L, Fan HF, Zhang DW, Liu T, Lu G. Identification of candidate biomarkers for severe adenovirus community-acquired pneumonia by proteomic approach. Heliyon 2022; 8:e10807. [PMID: 36217477 PMCID: PMC9547224 DOI: 10.1016/j.heliyon.2022.e10807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/19/2022] [Accepted: 09/23/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Worldwide, Human adenoviruses (ADV) cause a significant portion of childhood mortality. The severity of ADV Community-acquired Pneumonia (CAP) can be assessed by clinical features, but the rapid and accurate diagnostic biomarkers are still lacking. Candidate biomarkers for severe ADV CAP are to be screened and the different protein expression levels associated with pediatric ADV CAP may help assess the severity of ADV CAP for the pediatricians to make early intervention. Methods In our study, serum samples from healthy controls, patients with ADV CAP, streptococcus pneumonia (SP) and respiratory syncytial virus (RSV) infection were collected. Differently expressed proteins (DEPs) were detected by iTRAQ-based mass spectrometry. Gene Ontology and Pathway Enrichment analysis of DEPs were performed by Cytoscape. The protein interaction network for the identified proteins was constructed by String. Results The results showed that 119 DEPs in mild ADV CAP and 148 DEPs in severe ADV CAP were identified, compared with healthy children. Four proteins (Protein S100-A9 (S100A9), Protein S100-A8 (S100A8), Leucine aminopeptidase III (LAP3), and Apolipoprotein A-IV(APOA4)) were validated by Western blot, and results indicated that the expression levels of these four proteins were consistent with the proteomic analysis. LAP3 was the most significantly up-regulated protein in severe ADV CAP compared to mild group. In addition, LAP3 was the most significantly up-regulated protein in severe ADV CAP comparing with SP CAP infection and RSV CAP infection. Conclusion Our findings identified LAP3 protein as a potential diagnostic biomarker which can assess the severity of ADV CAP.
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Zheng N, Wang Y, Rong H, Wang K, Huang X. Human Adenovirus Associated Hepatic Injury. Front Public Health 2022; 10:878161. [PMID: 35570934 PMCID: PMC9095934 DOI: 10.3389/fpubh.2022.878161] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/16/2022] [Indexed: 01/08/2023] Open
Abstract
Human adenovirus (HAdV) is a common virus, but the infections it causes are relatively uncommon. At the same time, the methods for the detection of HAdV are varied, among which viral culture is still the gold standard. HAdV infection is usually self-limited but can also cause clinically symptomatic in lots of organs and tissues, of which human adenovirus pneumonia is the most common. In contrast, human adenovirus hepatitis is rarely reported. However, HAdV hepatitis has a high fatality rate once it occurs, especially in immunocompromised patients. Although human adenovirus hepatitis has some pathological and imaging features, its clinical symptoms are not typical. Therefore, HAdV hepatitis is not easy to be found in the clinic. There are kinds of treatments to treat this disease, but few are absolutely effective. In view of the above reasons, HAdV hepatitis is a disease that is difficult to be found in time. We reviewed and summarized the previously reported cases, hoping to bring some relatively common characteristics to clinicians, so as to facilitate early detection, early diagnosis, and early treatment of patients.
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Affiliation(s)
- Nan Zheng
- Department of Infectious Diseases, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Wang
- Department of Infectious Diseases, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hechen Rong
- Department of Infectious Diseases, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Kun Wang
- Department of Gastroenterology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoping Huang
- Department of Infectious Diseases, First Affiliated Hospital of Soochow University, Suzhou, China
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18
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Lin TY, Tsai YS, Shen CF. Type 3 adenovirus respiratory infection complicated with catastrophic bronchiole damage and related barotrauma. Pediatr Neonatol 2022; 63:319-321. [PMID: 35246370 DOI: 10.1016/j.pedneo.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/12/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022] Open
Affiliation(s)
- Ting-Yu Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Shan Tsai
- Department of Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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19
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Spencer JA, Shutt DP, Moser SK, Clegg H, Wearing HJ, Mukundan H, Manore CA. Distinguishing viruses responsible for influenza-like illness. J Theor Biol 2022; 545:111145. [PMID: 35490763 DOI: 10.1016/j.jtbi.2022.111145] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
The many respiratory viruses that cause influenza-like illness (ILI) are reported and tracked as one entity, defined by the CDC as a group of symptoms that include a fever of 100 degrees Fahrenheit, a cough, and/or a sore throat. In the United States alone, ILI impacts 9-49 million people every year. While tracking ILI as a single clinical syndrome is informative in many respects, the underlying viruses differ in parameters and outbreak properties. Most existing models treat either a single respiratory virus or ILI as a whole. However, there is a need for models capable of comparing several individual viruses that cause respiratory illness, including ILI. To address this need, here we present a flexible model and simulations of epidemics for influenza, RSV, rhinovirus, seasonal coronavirus, adenovirus, and SARS/MERS, parameterized by a systematic literature review and accompanied by a global sensitivity analysis. We find that for these biological causes of ILI, their parameter values, timing, prevalence, and proportional contributions differ substantially. These results demonstrate that distinguishing the viruses that cause ILI will be an important aspect of future work on diagnostics, mitigation, modeling, and preparation for future pandemics.
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Affiliation(s)
- Julie A Spencer
- A-1 Information Systems and Modeling, Los Alamos National Laboratory, NM87545, USA.
| | - Deborah P Shutt
- A-1 Information Systems and Modeling, Los Alamos National Laboratory, NM87545, USA
| | - S Kane Moser
- B-10 Biosecurity and Public Health, Los Alamos National Laboratory, NM87545, USA
| | - Hannah Clegg
- A-1 Information Systems and Modeling, Los Alamos National Laboratory, NM87545, USA
| | - Helen J Wearing
- Department of Biology, University of New Mexico, NM87131, USA; Department of Mathematics and Statistics, University of New Mexico, NM87102, USA
| | - Harshini Mukundan
- C-PCS Physical Chemistry and Applied Spectroscopy, Los Alamos National Laboratory, NM87545, USA
| | - Carrie A Manore
- T-6 Theoretical Biology and Biophysics, Los Alamos National Laboratory, NM87545, USA
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20
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Mycoplasma pneumoniae and Adenovirus Coinfection Cause Pediatric Severe Community-Acquired Pneumonia. Microbiol Spectr 2022; 10:e0002622. [PMID: 35311565 PMCID: PMC9045297 DOI: 10.1128/spectrum.00026-22] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Consolidation is one complication of pediatric severe community-acquired pneumonia (SCAP) that can respond poorly to conservative medical treatment. We investigated the pathogens that cause pediatric SCAP including cases with persistent consolidation that need bronchoscopy intervention. Alveolar lavage fluid (ALF) samples collected from cases admitted to Children’s Hospital of Fudan University with SCAP during January 2019 to March in 2019 were retrospectively tested by the RespiFinder 2SMART multiplex PCR (multi-PCR) assay targeting 22 respiratory pathogens. A total of 90 cases and 91 samples were enrolled; 80.0% (72/90) of the cases had pulmonary consolidation and/or atelectasis. All samples were positive with targeted pathogens tested by multi-PCR, and 92.3% (84/91) of the samples were co-detected with pathogens. Mycoplasma pneumoniae (MP) and adenovirus (ADV) as the two dominant pathogens, with the positive rates of 96.7% (88/91) and 79.1% (72/91), respectively. Most of the samples were positive with MP and ADV simultaneously. As a control, 78.0% (71/91) of the samples were positive by conventional tests (CT), in which MP had the detection rate of 63.9% (55/86) by a traditional real-time PCR assay, while ADV were positive in 13.1% (12/91) of the samples by a direct immunofluorescence assay (DFA). In cases with persistent pulmonary consolidation, the positive rates of pathogens by multi-PCR and CT were 100% (72/72) and 81.9% (59/72), respectively. There were no significant differences of MP or ADV positive rates between cases with and without pulmonary consolidation. MP and ADV most prevalent in pediatric SCAP cases required fiberscope intervention, and presented with coinfections dominantly. IMPORTANCE Pathogens that cause pediatric severe community-acquired pneumonia (SCAP) requiring bronchoscopy intervention are understudied. Through this study, we explore the etiology of SCAP form alveolar lavage fluid (ALF) samples by the RespiFinder 2SMART multi-PCR assay. It is observed that high mixed detection rates of Mycoplasma pneumoniae and adenovirus in ALF samples collected from hospitalized SCAP children experienced bronchoscopy intervention. Eighty percent of the cases had pulmonary consolidation and/or atelectasis. The presence of possible coinfection of these two pathogens might contribute to poor clinical anti-infection response. The results of this study might be helpful for the selection of clinical strategies for the empirical treatment of such pediatric SCAP cases.
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Calzado-Dacasin C, Foronda JL, Arguelles VL, Daga CM, Quimpo MT, Lupisan S, Dapat C, Saito M, Okamoto M, Albano PM, Oshitani H. Serotype Identification of Human Adenoviruses Associated with Influenza-Like Illnesses in the Philippines from 2006-2012 by Microneutralization and Molecular Techniques. Int J Infect Dis 2022; 117:326-333. [PMID: 35150916 DOI: 10.1016/j.ijid.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Human adenoviruses (HAdV) are known to cause a wide range of diseases including acute respiratory infections, conjunctivitis, and acute gastroenteritis. In this study, we aimed to determine the serotypes of HAdV in patients with influenza-like illness (ILI) in the Philippines from 2006-2012 and to describe the demographic and epidemiological characteristics of patients who tested positive for HAdV. METHODS Between 2006 and 2012, the Philippine National Influenza Centre detected HAdV in 1294 samples of patients with ILI. Serotype determination was done in select samples using microneutralization, polymerase chain reaction (PCR), and sequencing methods. RESULTS A total of 8 serotypes were identified (HAdV 1-7 and 11), with HAdV-2 (27.8%), and HAdV-3 (27.8%) being the most prevalent. The majority of HAdV infections were found in children below 5 years of age (79.9%). CONCLUSIONS The identification of HAdV circulating serotypes may serve as guide for designing disease intervention and control strategies and will provide important information regarding the contribution of this virus to respiratory infections, particularly in children, which remain a public health burden in the Philippines.
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Affiliation(s)
- Catherine Calzado-Dacasin
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines; Graduate School, University of Santo Tomas, Manila, Philippines.
| | - Janiza Lianne Foronda
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Vina Lea Arguelles
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Chona Mae Daga
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Marie Therese Quimpo
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Socorro Lupisan
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Clyde Dapat
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mariko Saito
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan; RITM-Tohoku Collaborating Research Center on Emerging and Re-emerging Infectious Diseases, Muntinlupa, Philippines
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan; RITM-Tohoku Collaborating Research Center on Emerging and Re-emerging Infectious Diseases, Muntinlupa, Philippines
| | - Pia Marie Albano
- Graduate School, University of Santo Tomas, Manila, Philippines; Department of Biological Sciences, College of Science, University of Santo Tomas, Manila, Philippines
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan; RITM-Tohoku Collaborating Research Center on Emerging and Re-emerging Infectious Diseases, Muntinlupa, Philippines
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22
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Rajbanshi A, Giri P, Laha S, Poddar S. Epidemiology, clinical presentation, and respiratory sequelae of severe adenoviral pneumonia in children admitted in a tertiary care pediatric intensive care unit from Eastern India: A single-center observational study. JOURNAL OF PEDIATRIC CRITICAL CARE 2022. [DOI: 10.4103/jpcc.jpcc_84_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Lynch JP, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment. Semin Respir Crit Care Med 2021; 42:800-821. [PMID: 34918322 DOI: 10.1055/s-0041-1733802] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The vast majority of cases are self-limited. However, the clinical spectrum is broad and fatalities may occur. Dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 100 genotypes and 52 serotypes of AdV have been identified and classified into seven species designated HAdV-A through -G. Different types display different tissue tropisms that correlate with clinical manifestations of infection. The predominant types circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been done. Cidofovir has been the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States but currently are not available to civilians.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Adriana E Kajon
- Infectious Disease Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico
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24
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Jayaweera JAAS, Morel AJ, Abeykoon AMSB, Pitchai FNN, Kothalawela HS, Peiris JSM, Noordeen F. Viral burden and diversity in acute respiratory tract infections in hospitalized children in wet and dry zones of Sri Lanka. PLoS One 2021; 16:e0259443. [PMID: 34919553 PMCID: PMC8682885 DOI: 10.1371/journal.pone.0259443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 10/19/2021] [Indexed: 11/21/2022] Open
Abstract
The present study was done to identify the viral diversity, seasonality and burden associated with childhood acute respiratory tract infection (ARTI) in Sri Lanka. Nasopharyngeal aspirates (NPA) of hospitalized children (1 month-5 years) with ARTI were collected in 2 centers (wet and dry zones) from March 2013 to August 2014. Respiratory viral antigen detection by immunofluorescence assay (IFA) was used to identify the infecting viruses. IFA negative 100 NPA samples were tested for human metapeumovirus (hMPV), human bocavirus and corona viruses by polymerase chain reaction. Of the 443 and 418 NPAs, 37.2% and 39.4% were positive for any of the 8 different respiratory viruses tested from two centers studied. Viral co-infection was detected with respiratory syncytial virus (RSV) in both centers. Peak viral detection was noted in the wet zone from May-July 2013 and 2014 and in the dry zone from December-January 2014 suggesting a local seasonality for viral ARTI. RSV showed a clear seasonality with a direct correlation of monthly RSV infections with rainy days in the wet zone and an inverse correlation with temperature in both centers. The case fatality rate was 2.7% for RSV associated ARTI. The overall disability adjusted life years was 335.9 and for RSV associated ARTI it was 241.8. RSV was the commonly detected respiratory virus with an annual seasonality and distribution in rainy seasons in the dry and wet zones of Sri Lanka. Identifying the virus and seasonality will contribute to employ preventive measures and reduce the empirical use of antibiotics in resource limited settings.
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Affiliation(s)
- J. A. A. S. Jayaweera
- Department of Microbiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - A. J. Morel
- Teaching Hospital, Gampola, Gampola, Sri Lanka
| | - A. M. S. B. Abeykoon
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - F. N. N. Pitchai
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - H. S. Kothalawela
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - J. S. M. Peiris
- School of Public Health, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - F. Noordeen
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Xie LY, Zeng SZ, Yu T, Hu X, Wang T, Yang L, Zhong LL, Li JS, Duan ZJ, Zhang B. Viral loads in nasopharyngeal aspirates and tracheal aspirates among children hospitalized with invasive ventilation for human adenovirus pneumonia. Virol J 2021; 18:238. [PMID: 34847913 PMCID: PMC8638111 DOI: 10.1186/s12985-021-01711-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose To evaluate viral loads in children with human adenovirus (HAdV) pneumonia at different stages of disease and compare the viral load between upper and lower respiratory tract samples. Methods We prospectively enrolled children who required invasive ventilation for HAdV pneumonia. Nasopharyngeal aspirate (NPA) and tracheal aspirate (TA) samples were collected throughout the entire period of invasive ventilation. Viral detection and quantification were performed using quantitative real-time polymerase chain reaction. Results Ninety-four children were enrolled. The median age of the children was 12.0 months (IQR: 11.0–24.0), and > ninety percent of patients were aged between 6 and 59 months. Seven hundred and nine paired NPA-TA samples were collected. The median viral loads of the NPA and TA samples were 7.31 log10 and 7.50 log10 copies/mL, respectively. Viral loads generally decreased steadily over time. The median viral load after 1, 2, 3, and > 3 weeks of the disease course was 8.65, 7.70, 6.69, and 5.09 log10 copies/mL, respectively, in NPA samples and 8.67, 7.79, 7.08, and 5.53 log10 copies/mL, respectively, in TA samples. Viral load showed a significant negative correlation with time since symptom onset in both NPA samples (Spearman r = − 0.607, P = 0.000) and TA samples (Spearman r = − 0.544, P = 0.000). The predicted duration of HAdV shedding was 60.17 days in the NPA group and 65.81 days in the TA group. Viral loads in NPA and TA from the same subjects correlated well with each other (R2 = 0.694). HAdV loads in NPA and TA were most comparable during the early phase of infection (95% limits of agreement, − 1.36 to 1.30 log10 copies/mL, R2 = 0.746). Variation increased during the late phase of infection (i.e., in follow-up samples), with viral loads remaining significantly higher in TA than NPA. Conclusions In children with HAdV pneumonia, viral loads in both NPA and TA steadily decreased during the course of the disease, and the predicted duration of viral shedding was more than 2 months. The HAdV DNA load of NPA is highly correlated with that of TA, especially in the initial phase of infection.
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Affiliation(s)
- Le-Yun Xie
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Sai-Zhen Zeng
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China. .,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China.
| | - Tian Yu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Xian Hu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Tao Wang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Le Yang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Li-Li Zhong
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Jin-Song Li
- MOH Key Laboratory for Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, 100052, China
| | - Zhao-Jun Duan
- MOH Key Laboratory for Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, 100052, China
| | - Bing Zhang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China. .,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China.
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Laya BF, Concepcion NDP, Garcia-Peña P, Naidoo J, Kritsaneepaiboon S, Lee EY. Pediatric Lower Respiratory Tract Infections: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:15-40. [PMID: 34836562 DOI: 10.1016/j.rcl.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Lower respiratory tract infection (LRTI) remains a major cause of morbidity and mortality in children. Various organisms cause LRTI, including viruses, bacteria, fungi, and parasites, among others. Infections caused by 2 or more organisms also occur, sometimes enhancing the severity of the infection. Medical imaging helps confirm a diagnosis but also plays a role in the evaluation of acute and chronic sequelae. Medical imaging tests help evaluate underlying pathology in pediatric patients with recurrent or long-standing symptoms as well as the immunocompromised.
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Affiliation(s)
- Bernard F Laya
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines.
| | - Nathan David P Concepcion
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines
| | - Pilar Garcia-Peña
- Autonomous University of Barcelona (AUB), University Hospital Materno-Infantil Vall d'Hebron, Pso. Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jaishree Naidoo
- Paeds Diagnostic Imaging and Envisionit Deep AI, 2nd Floor, One-on Jameson Building, 1 Jameson Avenue, Melrose Estate, Johannesburg, 2196, South Africa
| | - Supika Kritsaneepaiboon
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Kanjanavanich Road, Hat Yai, 90110, Thailand
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
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Retrospective Study of an Adenovirus Pneumonia Outbreak in Shenzhen in 2017. Virol Sin 2021; 36:555-558. [PMID: 34046814 PMCID: PMC8158460 DOI: 10.1007/s12250-021-00393-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/21/2021] [Indexed: 12/17/2022] Open
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Zhu Y, Li W, Yang B, Qian R, Wu F, He X, Zhu Q, Liu J, Ni Y, Wang J, Mao S. Epidemiological and virological characteristics of respiratory tract infections in children during COVID-19 outbreak. BMC Pediatr 2021; 21:195. [PMID: 33888063 PMCID: PMC8060686 DOI: 10.1186/s12887-021-02654-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/08/2021] [Indexed: 12/21/2022] Open
Abstract
Background To investigate the impact of protective measures and isolation on respiratory tract infections in children during the COVID-19 outbreak. Methods We extracted data on outpatient visits and respiratory infection visits, and tests of respiratory viruses (adenovirus (ADV), influenza A (FluA), influenza B (FluB) and respiratory syncytial virus (RSV)) from electronic healthcare records in Children’s Hospital, Zhejiang University School of Medicine during the COVID-19 outbreak (January–April, 2020), compared with those in 2018 and 2019 during the same periods. Results We found that outpatient visits in January, 2020 was comparable with those in 2018 and 2019, but decreased by 59.9% (288,003 vs. 717,983) and 57.4% (288,003 vs. 676,704), respectively during the period of February-April, 2020, as compared with the same periods in 2018 and 2019. The total number of respiratory tract infections from January to April 2020 decreased by 65.7% (119,532 vs.348,762) and 59.0% (119,532 vs.291,557), respectively compared with the same periods in 2018 and 2019. The proportion of respiratory tract infections during the outbreak also dropped compared with the same periods in 2018 and 2019 (P<0.001). We also found significantly decreased number of completed tests for respiratory viruses and positive cases of ADV, FluA, FluB, and RSV during February-April, 2020. Conclusions In this study, we found that outpatient visits and respiratory tract infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent respiratory virus infections in children.
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Affiliation(s)
- Yueling Zhu
- Department of Traditional Chinese Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Binbin Yang
- Department of General Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Ruiying Qian
- Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng road, Zhejiang Province, 310052, Hangzhou, PR China
| | - Fang Wu
- Department of Traditional Chinese Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Xue He
- Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Qinheng Zhu
- Department of Public Health, Zhejiang University School of Medicine, 310058, Hangzhou, Zhejiang Province, PR China
| | - Jinling Liu
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Yan Ni
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 310052, Hangzhou, Zhejiang Province, PR China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, , 310058, Hangzhou, Zhejiang Province, PR China
| | - Shanshan Mao
- Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng road, Zhejiang Province, 310052, Hangzhou, PR China.
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Yu X, Ma Y, Gao Y, You H. Epidemiology of Adenovirus Pneumonia and Risk Factors for Bronchiolitis Obliterans in Children During an Outbreak in Jilin, China. Front Pediatr 2021; 9:722885. [PMID: 34650942 PMCID: PMC8506152 DOI: 10.3389/fped.2021.722885] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/02/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Jilin Province, located in northeastern China, recently experienced a human adenovirus (HAdV) epidemic. Few studies involving hospitalized pediatric patients with pneumonia caused by HAdV in our region exist. HAdV pneumonia can lead to severe long-term respiratory sequelae, such as post-infectious bronchiolitis obliterans (PIBO), which has a poor prognosis and greatly influences the quality of life of pediatric patients. However, studies on the risk factors for PIBO are limited. Objective: To describe the HAdV pneumonia prevalence and determine potential risk factors for PIBO development among hospitalized children in Jilin Province, China. Methods: The data of 187 children with HAdV pneumonia (10 months-12 years old) admitted to the First Hospital of Jilin University during an outbreak between October 2018 and January 2020 were retrospectively studied. We analyzed the epidemiological characteristics of HAdV pneumonia, focusing on severe HAdV pneumonia (66 cases). The risk factors for BO development were determined by comparing the demographic and clinical data of the BO and non-BO groups. Results: The largest number of HAdV pneumonia cases occurred in January 2019 (severe n = 18, general n = 21), followed by December 2018 (severe n = 14, general n = 11), June 2019 (general n = 17), July 2019 (general, n = 14), and May 2019 (general, n = 13). In total, 91.98% of the children with HAdV pneumonia were <6 years old (172/187), and 50% of the pediatric patients with severe HAdV pneumonia were <2 years old (33/66). We found that 30.3% of the severe cohort developed BO (20/66), and the strongest independent risk factors for PIBO were persistent wheezing (OR 181.776, 95% CI, 3.385-9,761.543) and acute respiratory failure (OR 51.288, 95% CI, 1.858-1,415.441) during a severe pneumonia episode. Conclusions: The largest number of HAdV pneumonia cases, especially severe cases, occurred in winter in Northeast China, followed by summer. The majority of children admitted with HAdV pneumonia were <6 years old, and half of severe HAdV pneumonia patients were <2 years old. Children who had persistent wheezing or acute respiratory failure during the acute phase of severe HAdV pneumonia were prone to the development of BO.
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Affiliation(s)
- Xiuhua Yu
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Yucong Ma
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Yang Gao
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Hailong You
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
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30
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Zhang S, Zhan L, Zhu Y, Sun H, Xu X. Tumor Necrosis Factor Alpha Gene Polymorphisms Increase Susceptibility to Adenovirus Infection in Children and Are Correlated with Severity of Adenovirus-Associated Pneumonia. Genet Test Mol Biomarkers 2020; 24:761-770. [PMID: 33270503 DOI: 10.1089/gtmb.2020.0122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective: To study the relationships between single nucleotide polymorphisms (SNPs) in the intron of the tumor necrosis factor α (TNFα) gene and the susceptibility and severity of disease associated with adenovirus infection in children. Methods: Four polymorphic loci of the TNFα gene (rs3093661, rs1800610, rs3093662, and rs3093664) were characterized allelically and genotypically in 320 children with adenovirus-associated pneumonia (AP) and compared with 320 healthy controls. Enzyme-linked immunosorbent assays (ELISAs) were used to detect the plasma TNFα protein levels in all subjects. Results: The TNFα gene rs3093661 locus A allele, the rs1800610 locus A allele, the rs3093662 locus G allele, and the rs3093664 locus G allele were identified as susceptibility alleles for development of AP, and they were also positively correlated with the severity of AP. In children who had the GGAA haplotype, AP susceptibility was significantly reduced (0.28-fold) (95% confidence interval, CI: 0.20-0.40, p < 0.001). Conversely, among the subjects with the AGGG haplotype, their AP susceptibility risk was significantly increased (2.76-fold) (95% CI: 1.77-4.29, p < 0.001); and in the subjects with the AP GGGG haplotype their AP susceptibility risk was significantly increased (2.49-fold) (95% CI: 1.67-3.72, p < 0.001). The TNFα rs3093661, rs1800610, rs3093662, and rs3093664 SNPs were significantly correlated with plasma TNFα levels (p < 0.05). Conclusion: The TNFα gene rs3093661, rs1800610, rs3093662, and rs3093664 loci are associated with AP susceptibility and severity. This relationship might be due to the effect on TNFα levels found in the plasma. Clinical Trial Registration number: LL20190723.
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Affiliation(s)
- Shouyuan Zhang
- Department of Pediatrics, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital/Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Lu Zhan
- Department of Pediatrics, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital/Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Yanyan Zhu
- Department of Pediatrics, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Hong Sun
- Department of Pediatrics, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital/Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Xiujuan Xu
- Department of Pediatrics, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
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van der Zalm MM, Walters E, Claassen M, Palmer M, Seddon JA, Demers AM, Shaw ML, McCollum ED, van Zyl GU, Hesseling AC. High burden of viral respiratory co-infections in a cohort of children with suspected pulmonary tuberculosis. BMC Infect Dis 2020; 20:924. [PMID: 33276721 PMCID: PMC7716283 DOI: 10.1186/s12879-020-05653-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Background The presentation of pulmonary tuberculosis (PTB) in young children is often clinically indistinguishable from other common respiratory illnesses, which are frequently infections of viral aetiology. As little is known about the role of viruses in children with PTB, we investigated the prevalence of respiratory viruses in children with suspected PTB at presentation and follow-up. Methods In an observational cohort study, children < 13 years were routinely investigated for suspected PTB in Cape Town, South Africa between December 2015 and September 2017 and followed up for 24 weeks. Nasopharyngeal aspirates (NPAs) were tested for respiratory viruses using multiplex PCR at enrolment, week 4 and 8. Results Seventy-three children were enrolled [median age 22.0 months; (interquartile range 10.0–48.0); 56.2% male and 17.8% HIV-infected. Anti-tuberculosis treatment was initiated in 54.8%; of these 50.0% had bacteriologically confirmed TB. At enrolment, ≥1 virus were detected in 95.9% (70/73) children; most commonly human rhinovirus (HRV) (74.0%). HRV was more frequently detected in TB cases (85%) compared to ill controls (60.6%) (p = 0.02). Multiple viruses were detected in 71.2% of all children; 80% of TB cases and 60.6% of ill controls (p = 0.07). At follow-up, ≥1 respiratory virus was detected in 92.2% (47/51) at week 4, and 94.2% (49/52) at week 8. Conclusions We found a high prevalence of viral respiratory co-infections in children investigated for PTB, irrespective of final PTB diagnosis, which remained high during follow up. Future work should include investigating the whole respiratory ecosystem in combination with pathogen- specific immune responses.
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Affiliation(s)
- M M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - E Walters
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Paediatrics, Great North Children's Hospital, Newcastle-Upon-Tyne Health Trust, Newcastle upon Tyne, UK
| | - M Claassen
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - M Palmer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - J A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Infectious Diseases, Imperial College London, London, UK
| | - A M Demers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - M L Shaw
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, School of Medicine, Johns Hopkins University, Baltimore, USA.,Global Program in Respiratory Sciences, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA.,Health Systems Program, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - G U van Zyl
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Vanderburg S, Wijayaratne G, Danthanarayana N, Jayamaha J, Piyasiri B, Halloluwa C, Sheng T, Amarasena S, Kurukulasooriya R, Nicholson BP, Peiris JSM, Gray GC, Gunasena S, Nagahawatte A, Bodinayake CK, Woods CW, Devasiri V, Tillekeratne LG. Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study. BMJ Open 2020; 10:e040612. [PMID: 33158834 PMCID: PMC7651749 DOI: 10.1136/bmjopen-2020-040612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018. DESIGN Prospective, cross-sectional study. SETTING 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka. PARTICIPANTS 410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018. RESULTS We found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality. CONCLUSIONS This is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.
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Affiliation(s)
- Sky Vanderburg
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | | | | | - Jude Jayamaha
- Medical Research Institute Sri Lanka, Colombo, Sri Lanka
| | | | | | - Tianchen Sheng
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | | | | | | | - Gregory C Gray
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | - Ajith Nagahawatte
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Champica K Bodinayake
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Christopher W Woods
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | - L Gayani Tillekeratne
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
- Duke Global Health Institute, Durham, North Carolina, USA
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Spaeder MC, Stewart C, Sharron MP, Noether JR, Martinez-Schlurman N, Kavanagh RP, Signoff JK, McCrory MC, Eidman DB, Subbaswamy AV, Shea PL, Harwayne-Gidansky I, Ninmer EK, Sheram ML, Watson CM. Adenoviral Respiratory Infection-Associated Mortality in Children: A Retrospective Case Series. J Pediatr Intensive Care 2020; 11:13-18. [DOI: 10.1055/s-0040-1718868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/19/2020] [Indexed: 12/22/2022] Open
Abstract
AbstractViral respiratory infections are a leading cause of illness and hospitalization in young children worldwide. Case fatality rates in pediatric patients with adenoviral lower respiratory tract infection requiring intensive care unit (ICU) admission have been reported between 7 and 22%. We investigated the demographics and clinical characteristics in pediatric mortalities associated with adenoviral respiratory infection at 12 academic children's hospitals in the United States. There were 107 mortality cases included in our study, 73% of which had a chronic medical condition. The most common chronic medical condition was immunocompromised state in 37 cases (35%). The incidences of pediatric acute respiratory distress syndrome (78%) and multiple organ dysfunction syndrome (94%) were profound. Immunocompetent cases were more likely to receive mechanical ventilation within the first hour of ICU admission (60 vs. 14%, p < 0.001) and extracorporeal membrane oxygenation (27 vs. 5%, p = 0.009), and less likely to receive continuous renal replacement therapy (20 vs. 49%, p = 0.002) or have renal dysfunction (54 vs. 78%, p = 0.014) as compared with immunocompromised cases. Immunocompromised cases were more likely to have bacteremia (57 vs. 16%, p < 0.001) and adenoviremia (51 vs. 17%, p < 0.001) and be treated with antiviral medications (81 vs. 26%, p < 0.001). We observed a high burden of nonrespiratory organ system dysfunction in a cohort of pediatric case fatalities with adenoviral respiratory infection. The majority of cases had a chronic medical condition associated with an increased risk of complications from viral respiratory illness, most notably immunocompromised state. Important treatment differences were noted between immunocompromised and immunocompetent cases.
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Affiliation(s)
- Michael C. Spaeder
- Division of Pediatric Critical Care, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Claire Stewart
- Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States
| | - Matthew P. Sharron
- Division of Critical Care Medicine, Children's National Hospital, Washington, District of Columbia, United States
| | - Julia R. Noether
- Division of Pediatric Critical Care, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, United States
| | - Natalia Martinez-Schlurman
- Division of Pediatric Critical Care, University of Florida School of Medicine, Gainesville, Florida, United States
| | - Robert P. Kavanagh
- Division of Pediatric Critical Care, Pennsylvania State University School of Medicine, Hershey, Pennsylvania, United States
| | - Jessica K. Signoff
- Division of Pediatric Critical Care, University of California at Davis School of Medicine, Sacramento, California, United States
| | - Michael C. McCrory
- Pediatric Critical Care, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
| | - Daniel B. Eidman
- Pediatric Critical Care, Yale University School of Medicine, New Haven, Connecticut, United States
| | - Anjali V. Subbaswamy
- Division of Pediatric Critical Care, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
| | - Paul L. Shea
- Division of Pediatric Critical Care, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States
| | - Ilana Harwayne-Gidansky
- Division of Pediatric Critical Care, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
| | - Emily K. Ninmer
- Division of Pediatric Critical Care, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Mary Lynn Sheram
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, United States
| | - Christopher M. Watson
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, United States
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Epidemiology of Adenovirus Infections and Outcomes of Cidofovir Treatment in Severely Ill Children. Pediatr Infect Dis J 2020; 39:907-913. [PMID: 32404785 DOI: 10.1097/inf.0000000000002726] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND An increase in human adenovirus (HAdV) infections among hospitalized children in Singapore was observed since 2013. Young age (<2 years) and significant comorbidities have been associated with severe HAdV infections which can result in significant morbidity and mortality. Cidofovir (CDV) has been used to treat severe HAdV infections despite limited data and efficacy. METHODS This is a retrospective, observational review of infants and children 1 month to 17 years of age with laboratory-confirmed severe HAdV infection, admitted to a pediatric tertiary care hospital in Singapore between January 2013 and September 2017. Severe infection was defined as requiring intensive care unit or high dependency care at any point during hospital admission. Clinical characteristics, potential risk factors for mortality, as well as the outcome of cases treated with CDV were examined. RESULTS A total of 1167 children were admitted for HAdV infection, of which 85 (7.3%) were severe. For severe infections, the median age was 1.5 years (interquartile range: 0.72-3.2 years). The majority had comorbidities (69.4%) and presented with pneumonia (32.9%). Genotypes HAdV-7 (29.4%) and HAdV-3 (27.0%) were the most common HAdV genotypes identified. Thirteen (15.3%) patients died. Patients who died had a higher proportion of existing neurologic comorbidity (46.2% vs. 13.9%; P = 0.014) and presentation with pneumonia (69.2% vs. 26.4%; P = 0.008) compared with survivors. Patients who presented with pneumonia had a higher risk of 30-day mortality (odds ratio 4.3, 95% confidence interval: 1.0-28.6; P < 0.05). CDV was administered to 17 (20%) children for mainly viremia (47.1%) and/or pneumonia (41.2%). Mortality rate was 41.2% for severe HAdV cases treated with CDV. A significant proportion of patients who died when compared with recovered patients presented with pneumonia (6 of 7, 85.7% vs 1 of 10, 10%; P = 0.004). All 8 patients who had viremia received CDV and survived. CONCLUSIONS Mortality can be high in pediatric patients with severe HAdV infections. HAdV-7 and HAdV-3 were the most common genotypes identified in our cohort with severe HAdV infection. Pneumonia is a potential risk factor for mortality in severe HAdV infections in our cohort. Early CDV administration may be considered in patients with severe HAdV infection and existing comorbidities but more studies are required.
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Adenovirus Infections in Immunocompetent Children. Curr Infect Dis Rep 2020. [DOI: 10.1007/s11908-020-00736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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36
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Evaluation of Risk Factors for Exacerbations in Children with Adenoviral Pneumonia. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4878635. [PMID: 32802848 PMCID: PMC7415082 DOI: 10.1155/2020/4878635] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/17/2020] [Accepted: 07/10/2020] [Indexed: 12/18/2022]
Abstract
Purpose The aim of this work was to analyze clinical features and laboratory findings of children with adenovirus pneumonia and guide clinical diagnosis, treatment, and assessment of disease severity. Material and Methods. Retrospective analysis of clinical data of 285 children with adenoviral pneumonia who were hospitalized in Wuhan Children's Hospital from December 2018 to October 2019. According to the assessment criteria for severe pneumonia, it was divided into the severe group (92 cases) and the nonsevere group (193 cases). Collected clinical manifestations, complications, and laboratory test indicators in two groups of children and conducted all statistical analyses. Results The risk of fever and wheezing was significantly higher in the severe group than in the nonsevere group. The difference was statistically significant (P < 0.05). The risk of complications in the severe group was significantly higher than that in the nonsevere group. The difference was statistically significant (P < 0.05). The levels of AST, LDH-L, PCT, ferritin, and D-dimer in the severe group were significantly higher than those in the nonsevere group. The difference was statistically significant (P < 0.05). Conclusion Children with severe adenovirus pneumonia have severe clinical manifestations and many complications. AST, LDH-L, PCT, ferritin, and D-dimer levels have important clinical implications for assessing disease severity.
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Lu G, Peng X, Li R, Liu Y, Wu Z, Wang X, Zhang D, Zhao J, Sun Y, Zhang L, Yang P, Wang Q. An outbreak of acute respiratory infection at a training base in Beijing, China due to human adenovirus type B55. BMC Infect Dis 2020; 20:537. [PMID: 32703176 PMCID: PMC7376533 DOI: 10.1186/s12879-020-05258-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/14/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Twelve students experienced symptoms of acute respiratory infection (ARI) at a training base in Beijing from August 26 to August 30, 2015. We investigated the cause of this ARI outbreak. METHODS In partnership with the local center for disease control, we collected a total of twelve pharyngeal swab specimens as well as demographic information for the affected patients. We used multiplex real-time PCR to screen for sixteen common respiratory viruses in these samples. To isolate HAdV, we inoculated Hep-2 cells with the human adenovirus (HAdV)-positive samples and then carried out sequencing and phylogenetic analysis of the hexon, fiber, and penton genes of the isolated adenoviruses. In addition, we analyzed the entire genome of one strain isolated from the index case to identify single-nucleotide substitutions. RESULTS We identified ten HAdV-positive students using multiplex real-time PCR. None of the students were co-infected with other viruses. We successfully isolated seven HAdV strains from the pharyngeal swab specimens. The coding sequences of the hexon, fiber, and penton genes of these seven HAdV strains were identical, suggesting that they represented seven strains from a single virus clone. One HAdV isolate obtained from the index case, BJDX-01-2015, was selected for whole genome analysis. From this isolate, we obtained a 34,774-nucleotide sequence. The genome of BJDX-01-2015 clustered with HAdV-B55 in phylogenetic analyses and had 99.97% identity with human adenovirus 55 isolate HAdV-B/CHN/BJ01/2011/55 (GenBank accession no. JX491639). CONCLUSIONS We identified HAdV-B55 as the strain associated with the August 2015 ARI outbreak at a training base in Beijing. This was the first reported outbreak in Beijing due to HAdV-B55. Continuous surveillance of respiratory adenoviruses is urgently needed to understand the epidemiological and evolutionary features of HAdV-B55, and an epidemiological modeling approach may provide further insights into this emerging public health threat. Furthermore, the clinical laboratory data from this outbreak provides important reference for the clinical diagnosis and may ultimately aid in informing the development of strategies to control and prevent respiratory tract infections caused by HAdV-B55.
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Affiliation(s)
- Guilan Lu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Xiaomin Peng
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Renqing Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Yimeng Liu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Zhanguo Wu
- Daxing District Center for Disease Prevention and Control, Beijing, 102600, China
| | - Xifeng Wang
- Daxing District Center for Disease Prevention and Control, Beijing, 102600, China
| | - Daitao Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Jiachen Zhao
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Ying Sun
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Li Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Peng Yang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, 16# He Ping Li Middle Street, Dongcheng District, Beijing, 100013, China.
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Yang DY, Lu BT, Shi TT, Fan HF, Zhang DW, Huang L, Lu G. Total and double-stranded DNA-specific immunoglobulin E in bronchoalveolar lavage fluid of children with human adenovirus pneumonia. J Infect Chemother 2020; 26:986-991. [PMID: 32473848 DOI: 10.1016/j.jiac.2020.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/12/2020] [Accepted: 04/26/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Some antibodies and autoreactive antibodies are associated with the severity of infectious diseases. The roles of humoral responses to lung inflammation in children with human adenovirus (HAdVs) pneumonia remain unknown. PATIENTS AND METHODS A retrospective study was done to compare plasma immunoglobulin E (IgE) levels between HAdVs pneumonia patients and healthy children by searching the electronic medical record system of Guangzhou Women and Children's Medical Center. Then, a prospective study was performed for children with HAdVs pneumonia who needed flexible bronchoscopy for examination and treatment purposes during July 2017 to July 2019. We examined the IgE and autoreactive IgE levels in plasma and bronchoalveolar lavage fluid (BALF) of these children to explore their role in HAdVs pneumonia. RESULTS A significantly higher level of IgE was found in plasma from children hospitalized with HAdVs pneumonia compared with that from healthy children in the same age range. Furthermore, the levels of IgE, double-stranded DNA (dsDNA), and double-stranded DNA-specific immunoglobulin E (dsDNA-IgE) in BALF were increased compared to plasma in children with HAdVs pneumonia. The levels of IgE, dsDNA, and dsDNA-IgE in BALF were significantly higher in the severe group compared to the non-severe group. The ability of IgE in BALF to recognize dsDNA was verified by the ELISPOT test. CONCLUSIONS Our findings indicate that IgE and dsDNA-IgE in BALF may contribute to lung injury caused by HAdVs, especially in severe cases. Elevated dsDNA-IgE may serve as an indicator of severity in children with HAdVs pneumonia.
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Affiliation(s)
- Di-Yuan Yang
- Department of Respiration, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bing-Tai Lu
- Guangzhou Institute of Paediatrics, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ting-Ting Shi
- Department of Respiration, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hui-Feng Fan
- Department of Respiration, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dong-Wei Zhang
- Department of Respiration, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Li Huang
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Gen Lu
- Department of Respiration, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China.
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Alcamo AM, Wolf MS, Alessi LJ, Chong HJ, Green M, Williams JV, Simon DW. Successful Use of Cidofovir in an Immunocompetent Child With Severe Adenoviral Sepsis. Pediatrics 2020; 145:peds.2019-1632. [PMID: 31826930 PMCID: PMC6939840 DOI: 10.1542/peds.2019-1632] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2019] [Indexed: 01/22/2023] Open
Abstract
Adenovirus infection is common in childhood and is generally associated with self-limited disease. Cidofovir, a viral DNA polymerase inhibitor, is used to treat adenovirus infection in select populations but is not often recommended for immunocompetent patients because of limited antiviral activity and nephrotoxicity. Here, we report a case of fulminant adenovirus infection associated with lymphopenia and multiple organ failure requiring extracorporeal membrane oxygenation support in a previously healthy child. After 1 week of supportive therapy, the patient had persistent organ failure and continued to have adenoviremia of >560 000 copies per mL. Weekly doses of cidofovir with concurrent probenecid for renal protection was initiated. Adenovirus blood load declined after the first cidofovir dose, becoming undetectable after 3 doses. The patient was successfully decannulated from extracorporeal membrane oxygenation, extubated, and eventually discharged at his functional baseline without need for ongoing respiratory support. Lymphopenia improved after viremia resolved, and a subsequent immunologic workup revealed no evidence of primary immunodeficiency. The viral isolate was genotyped as adenovirus type 7. This case reveals the successful use of cidofovir for management of severe adenovirus infection in a previously healthy child. To date, there are no universally accepted recommendations for the use of cidofovir in this population. Further study is warranted to determine the potential role of cidofovir in treating severe adenovirus infections in immunocompetent children.
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Affiliation(s)
- Alicia M. Alcamo
- Departments of Critical Care Medicine and,Contributed equally as co-first authors
| | - Michael S. Wolf
- Departments of Critical Care Medicine and,Contributed equally as co-first authors
| | | | - Hey J. Chong
- Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael Green
- Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John V. Williams
- Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Chen X, Lv J, Qin L, Zou C, Tang L. Severe Adenovirus Pneumonia Requiring Extracorporeal Membrane Oxygenation Support in Immunocompetent Children. Front Pediatr 2020; 8:162. [PMID: 32351920 PMCID: PMC7174628 DOI: 10.3389/fped.2020.00162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: To highlight severe adenovirus pneumonia in immunocompetent patients by analysis of severe adenovirus pneumonia associated with acute respiratory distress syndrome in whom extracorporeal membrane oxygenation (ECMO) support is required. Methods:Pediatric patients with adenovirus pneumonia and ECMO supports in our hospital from February 2018 to May 2019 were retrospectively analyzed, and having 100 common adenovirus pneumonia children as a control. Results:A total of 8 patients, including 4 boys (50.0%), were enrolled. They were previously immunocompetent with a median age of 31 months. They were admitted as persistent fever and cough for more than one week. Median time prior to development of respiratory failure requiring intubation and invasive mechanical ventilation was 5 days. Venoarterial ECMO support as rescue ventilation was instituted after a median time of 24.5 h of conventional mechanical ventilator support. The median duration on ECMO support was 9 days and mechanical ventilation was 14 days, respectively. Six patients (75%) were recovered and 2 (25%) died. Median length of stay in ICU and hospital were 27.5 days and 47.5 days, respectively. Conclusion:The promising outcomes of our cases suggested that ECMO support for rescue ventilation may be considered when symptoms deteriorated in adenovirus pneumonia patients, and may improve outcome. However, sequelae of adenovirus pneumonia and ECMO-related complications should also be taken into account.
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Affiliation(s)
- Xuefei Chen
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jianhai Lv
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Pediatrics, Shangyu People's Hospital, Shaoxing, China
| | - Lu Qin
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Chaochun Zou
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lanfang Tang
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Jung J, Seo E, Yoo RN, Sung H, Lee J. Clinical significance of viral-bacterial codetection among young children with respiratory tract infections: Findings of RSV, influenza, adenoviral infections. Medicine (Baltimore) 2020; 99:e18504. [PMID: 31914021 PMCID: PMC6959858 DOI: 10.1097/md.0000000000018504] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We aimed to evaluate the clinical significance of bacterial coexistence and the coinfection dynamics between bacteria and respiratory viruses among young children. We retrospectively analyzed clinical data from children aged < 5 years hospitalized with a community-acquired single respiratory viral infection of influenza, adenovirus, or RSV during 2 recent consecutive influenza seasons. Remnant respiratory specimens were used for bacterial PCR targeting Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.A total of 102 children were included; median age was 0.8 years and 44.1% had underlying comorbidities. Overall, 6.8% (7/102) of cases were classified as severe diseases requiring intensive care unit admission and/or mechanical ventilation and ranged from 8.8% for a patient with RSV and 7.6% for those with adenovirus to 0% for those with influenza viruses. The overall viral-bacterial codetection rate was 59.8% (61/102); M catarrhalis was the most frequent (33.3%), followed by H influenzae (31.4%). Influenza cases showed higher bacterial codetection rates (80.0%; 8/10) compared with those with adenoviruses (69.2%; 9/13) and RSV (55.7%; 44/79). S pneumoniae and H influenzae codetections were associated with reduced severity (aOR, 0.24; 95% CI, 0.07-0.89), and reduced risk of wheezing (aOR, 0.36; 95% CI, 0.13-0.98), respectively.We observed the interactions between respiratory viruses and bacteria and the clinical significance of viral-bacterial coexistence in upper airway on disease severity. Future study will be necessary to elucidate the active interactions between different viruses and bacteria and give clues to risk stratified strategy in the management of respiratory infections among young children.
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Affiliation(s)
- Jiwon Jung
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Euri Seo
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul
- Department of Pediatrics, Dongkuk University Ilsan Hospital, Ilsan
| | - Ree Nar Yoo
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Hungseop Sung
- Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jina Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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Whittaker E, López-Varela E, Broderick C, Seddon JA. Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children. Front Pediatr 2019; 7:233. [PMID: 31294001 PMCID: PMC6603259 DOI: 10.3389/fped.2019.00233] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 05/22/2019] [Indexed: 12/21/2022] Open
Abstract
Millions of children are exposed to tuberculosis (TB) each year, many of which become infected with Mycobacterium tuberculosis. Most children can immunologically contain or eradicate the organism without pathology developing. However, in a minority, the organism overcomes the immunological constraints, proliferates and causes TB disease. Each year a million children develop TB disease, with a quarter dying. While it is known that young children and those with immunodeficiencies are at increased risk of progression from TB infection to TB disease, our understanding of risk factors for this transition is limited. The most immunologically disruptive process that can happen during childhood is infection with another pathogen and yet the impact of co-infections on TB risk is poorly investigated. Many diseases have overlapping geographical distributions to TB and affect similar patient populations. It is therefore likely that infection with viruses, bacteria, fungi and protozoa may impact on the risk of developing TB disease following exposure and infection, although disentangling correlation and causation is challenging. As vaccinations also disrupt immunological pathways, these may also impact on TB risk. In this article we describe the pediatric immune response to M. tuberculosis and then review the existing evidence of the impact of co-infection with other pathogens, as well as vaccination, on the host response to M. tuberculosis. We focus on the impact of other organisms on the risk of TB disease in children, in particularly evaluating if co-infections drive host immune responses in an age-dependent way. We finally propose priorities for future research in this field. An improved understanding of the impact of co-infections on TB could assist in TB control strategies, vaccine development (for TB vaccines or vaccines for other organisms), TB treatment approaches and TB diagnostics.
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Affiliation(s)
- Elizabeth Whittaker
- Department of Paediatrics, Imperial College London, London, United Kingdom
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, St. Mary's Campus, London, United Kingdom
| | - Elisa López-Varela
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Claire Broderick
- Department of Paediatrics, Imperial College London, London, United Kingdom
| | - James A. Seddon
- Department of Paediatrics, Imperial College London, London, United Kingdom
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, St. Mary's Campus, London, United Kingdom
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Yao LH, Wang C, Wei TL, Wang H, Ma FL, Zheng LS. Human adenovirus among hospitalized children with respiratory tract infections in Beijing, China, 2017-2018. Virol J 2019; 16:78. [PMID: 31196108 PMCID: PMC6567909 DOI: 10.1186/s12985-019-1185-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/24/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Human adenoviruses (HAdVs) cause a wide range of diseases. However, the genotype diversity and epidemiological information relating to HAdVs among hospitalized children with respiratory tract infections (RTIs) is limited. Here, we describe the epidemiology and genotype distribution of HAdVs associated with RTIs in Beijing, China. METHODS Nasopharyngeal aspirates (NPA) were collected from hospitalized children with RTIs from April 2017 to March 2018. HAdVs were detected by a TaqMan-based quantitative real-time polymerase chain reaction (qPCR) assay, and the hexon gene was used for phylogenetic analysis. Epidemiological data were analyzed using statistical product and service solutions (SPSS) 21.0 software. RESULTS HAdV was detected in 72 (5.64%) of the 1276 NPA specimens, with most (86.11%, 62/72) HAdV-positives cases detected among children < 6 years of age. HAdV-B3 (56.06%, 37/66) and HAdV-C2 (19.70%, 13/66) were the most frequent. Of the 72 HAdV-infected cases, 27 (37.50%) were co-infected with other respiratory viruses, most commonly parainfluenza virus (12.50%, 9/72) and rhinovirus (9.72%, 7/72). The log number of viral load ranged from 3.30 to 9.14 copies per mL of NPA, with no significant difference between the HAdV mono- and co-infection groups. The main clinical symptoms in the HAdV-infected patients were fever and cough, and 62 (86.11%, 62/72) were diagnosed with pneumonia. Additionally, HAdVs were detected throughout the year with a higher prevalence in summer. CONCLUSIONS HAdV prevalence is related to age and season. HAdV-B and HAdV-C circulated simultaneously among the hospitalized children with RTIs in Beijing, and HAdV-B type 3 and HAdV-C type 2 were the most frequent.
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Affiliation(s)
- Li-Hong Yao
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, 100 Ying-Xin St., Xi-Cheng District, Beijing, 100052, China
| | - Chao Wang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, 100 Ying-Xin St., Xi-Cheng District, Beijing, 100052, China
| | - Tian-Li Wei
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Hao Wang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, 100 Ying-Xin St., Xi-Cheng District, Beijing, 100052, China
| | - Fen-Lian Ma
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, 100 Ying-Xin St., Xi-Cheng District, Beijing, 100052, China.
| | - Li-Shu Zheng
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, 100 Ying-Xin St., Xi-Cheng District, Beijing, 100052, China.
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Gong T, Wang HG, Shi Y, Zhou J, Xiao F, Liu SW, Li JX, Xu G, Zhang YN, Liu XQ, Xiong Y. The Epidemic Genotypes of Human Adenovirus in Outpatient Children with Adenoviral Conjunctivitis from 2011 to 2012 in Jiangxi, China. Intervirology 2019; 62:30-36. [PMID: 31117098 DOI: 10.1159/000499963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/20/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human adenoviruses (HAdV) are a common cause of viral conjunctivitis, making surveillance of them from sporadic cases of conjunctivitis important. METHODS To acquire a better understanding of the epidemic genotypes of HAdV in outpatient children with adenoviral conjunctivitis in Jiangxi Province, China (2011-2012), 179 samples from cases with a high suspicion of HAdV were analyzed by PCR. Samples confirmed to be HAdV-positive by PCR were cultured in Hep-2 cells to isolate the viruses, which were then identified through hexon gene sequencing. RESULTS The adenoviral conjunctivitis positivity rate was 74.86% (134/179), from which 71.64% (96/134) were infections in boys, and 92.54% (124/134) were infections in children under 5 years of age. Sixty-nine HAdV strains were isolated from the positive samples and 69 sequences were obtained. Phylogenetic analysis indicated that 33 strains (47.82%) clustered with HAdV-B7, 21 (30.43%) with HAdV-B3, 6 (8.70%) with HAdV-B55, 6 (8.70%) with HAdV-E4, 1 with HAdV-B21 (1.45%), 1 with HAdV-D37 (1.45%), and 1 with HAdV-D64 (1.45%). CONCLUSIONS This is the first identification of HAdV-B55 relating to adenoviral conjunctivitis in China. These findings provide a firm basis for future surveillance of adenoviral conjunctivitis in China or other East Asian regions.
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Affiliation(s)
- Tian Gong
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Hua-Gui Wang
- Jiangsu Macro and Micro Test Med-Tech Co., Ltd., Nantong, China.,Beijing Macro and Micro Test Biotech Co., Ltd., Beijing, China
| | - Yong Shi
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Jun Zhou
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Fang Xiao
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Shi-Wen Liu
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Jian-Xiong Li
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Gang Xu
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Yan-Ni Zhang
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Xiao-Qing Liu
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Ying Xiong
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China,
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45
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Bullard BL, Corder BN, Weaver EA. A Single-Cycle Adenovirus Type 7 Vaccine for Prevention of Acute Respiratory Disease. Viruses 2019; 11:E413. [PMID: 31058858 PMCID: PMC6563269 DOI: 10.3390/v11050413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 11/23/2022] Open
Abstract
Adenovirus type 7 (Ad7) infection is associated with acute respiratory disease (ARD), especially in military recruits living in close quarters. Recently, several outbreaks of Ad7 infections have occurred in civilian populations, with some cases leading to death. However, the current Ad7 vaccine is licensed for use only in military recruits because it utilizes an orally delivered wild type virus which is shed in the stool for 28 days after immunization. This poses a safety risk due to the possibility of virus spread to vulnerable populations. To address the need for a safer Ad7 vaccine for use in civilian populations, we developed a single-cycle Ad7 virus (scAd7). This scAd7 virus is deleted for the Ad7 fiber protein, so that viruses produced outside of complementing cells lines lack this essential structural protein and have severely reduced infectivity. In vitro studies in noncomplementing A549 cells showed that the scAd7 virus has genomic DNA replication kinetics and Ad7 hexon expression similar to a replication-competent virus; however, virus progeny produced after infection has impaired infectivity. Therefore, this scAd7 virus combines the safety advantages of a replication-defective virus with the increased Ad7 gene expression of a replication-competent virus. Due to these advantages, we believe that scAd7 viruses should be further studied as an alternative, safer Adenovirus 7 vaccine.
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Affiliation(s)
- Brianna L Bullard
- School of Biological Sciences, Nebraska Center for Virology, University of Nebraska, Lincoln, NE 68503, USA.
| | - Brigette N Corder
- School of Biological Sciences, Nebraska Center for Virology, University of Nebraska, Lincoln, NE 68503, USA.
| | - Eric A Weaver
- School of Biological Sciences, Nebraska Center for Virology, University of Nebraska, Lincoln, NE 68503, USA.
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46
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Abstract
Currently, 88 different Human Adenovirus (HAdV) types are grouped into seven HAdV species A to G. Most types (57) belong to species HAdV-D. Recombination between capsid genes (hexon, penton and fiber) is the main factor contributing to the diversity in species HAdV-D. Noteworthy, species HAdV-C contains so far only five types, although species HAdV-C is highly prevalent and clinically significant in immunosuppressed patients. Therefore, the evolution of species HAdV-C was studied by generating 51 complete genome sequences from circulating strains. Clustering of the whole genome HAdV-C sequences confirmed classical typing results (fifteen HAdV-C1, thirty HAdV-C2, four HAdV-C5, two HAdV-C6). However, two HAdV-C2 strains had a novel penton base sequence and thus were re-labeled as the novel type HAdV-C89. Fiber and early gene region 3 (E3) sequences clustered always with the corresponding prototype sequence but clustering of the E4 region indicated recombination events in 26 out of the 51 sequenced specimens. Recombination of the E1 gene region was detected in 16 circulating strains. As early gene region sequences are not considered in the type definition of HAdVs, evolution of HAdV-C remains on the subtype level. Nonetheless, recombination of the E1 and E4 gene regions may influence the virulence of HAdV-C strains.
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47
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Fu Y, Tang Z, Ye Z, Mo S, Tian X, Ni K, Ren L, Liu E, Zang N. Human adenovirus type 7 infection causes a more severe disease than type 3. BMC Infect Dis 2019; 19:36. [PMID: 30626350 PMCID: PMC6327436 DOI: 10.1186/s12879-018-3651-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 12/21/2018] [Indexed: 12/21/2022] Open
Abstract
Background Human adenovirus type 3 (HAdV-3) and 7 (HAdV-7) cause significant morbidity and develop severe complications and long-term pulmonary sequelae in children. However, epidemiologic reports have suggested that nearly all highly severe or fatal adenoviral diseases in children are associated with HAdV-7 rather than HAdV-3. Here, we conduct in-depth investigations to confirm and extend these findings through a comprehensive series of assays in vitro and in vivo as well as clinical correlates. Methods A total of 8248 nasopharyngeal aspirate (NPA) samples were collected from hospitalized children with acute respiratory infections in Children’s Hospital of Chongqing Medical University from June 2009 to May 2015. Among 289 samples that tested positive for HAdVs, clinical data of 258 cases of HAdV-3 (127) and HAdV-7 (131) infections were analyzed. All HAdV-positive samples were classified by sequencing the hexon and fiber genes, and compared with clinical data and virological assays. We also performed in vitro assays of virus quantification, viral growth kinetics, competitive fitness, cytotoxicity and C3a assay of the two strains. Mouse adenovirus model was used to evaluate acute inflammatory responses. Results Clinical characteristics revealed that HAdV-7 infection caused more severe pneumonia, toxic encephalopathy, respiratory failure, longer mean hospitalization, significantly lower white blood cell (WBC) and platelet counts, compared to those of HAdV-3. In cell culture, HAdV-7 replicated at a higher level than HAdV-3, and viral fitness showed significant differences as well. HAdV-7 also exhibited higher C3a production and cytotoxic effects, and HAdV-7-infected mice showed aggravated pathology and higher pulmonary virus loads, compared to HAdV-3-infected mice. Macrophages in BALF remained markedly high during infection, with concomitant increase in pro-inflammatory cytokines (TNF-α, IL-1β, IFN-γ, and IL-6), compared HAdV-3 infection. Conclusions These results document that HAdV-7 replicates more robustly than HAdV-3, and promotes an exacerbated cytokine response, causing a more severe airway inflammation. The findings merit further mechanistic studies that offer the pediatricians an informed decision to proceed with early diagnosis and treatment of HAdV-7 infection.
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Affiliation(s)
- Yangxi Fu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Zhengzhen Tang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Zhixu Ye
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Shi Mo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Xingui Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510180, China
| | - Ke Ni
- Institute of Biology, Westlake institute for Advanced Study, Hangzhou, 310024, Zhejiang, China
| | - Luo Ren
- Pediatric Research Institute of Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 400014, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Na Zang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
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Ye X, Xiao L, Zheng X, Wang J, Shu T, Feng Y, Liu X, Su W, Wang Q, Li C, Chen L, Feng L. Seroprevalence of Neutralizing Antibodies to Human Adenovirus Type 4 and 7 in Healthy Populations From Southern China. Front Microbiol 2018; 9:3040. [PMID: 30619131 PMCID: PMC6295555 DOI: 10.3389/fmicb.2018.03040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/26/2018] [Indexed: 12/22/2022] Open
Abstract
Human adenoviruses type 4 (HAdV4) and 7 (HAdV7) are two major respiratory pathogens and sporadically cause outbreaks of acute respiratory diseases. The neutralizing antibody (nAb) response to these two adenoviruses in civilian populations, which is important for dissecting previous circulations and predicting potential outbreaks, remains largely unknown. In this study, we generated replication-competent HAdV4 and HAdV7 reporter viruses expressing secreted-alkaline-phosphatase (SEAP), and established neutralization assays to investigate the seroprevalence of pre-existing nAb in healthy volunteers from Hunan Province, southern China. The seropositivity rates are 58.4 and 63.8% for anti-HAdV4 nAb and anti-HAdV7 nAb, respectively. High nAb titers (> 1000) were frequently detected in HAdV4-seropositive individuals, whereas most HAdV7-seropositive volunteers had moderate nAb titers (201-1000). The seropositivity rates of anti-HAdV4 nAb and anti-HAdV7 nAb increase with age, with individuals younger than 20 exhibiting the lowest seropositivity rates. Both seropositivity rates and nAb titers are comparable between different sex groups. Notably, HAdV4-seropositive individuals tend to be HAdV7-seropositive and vice versa. Because HAdV4 antisera showed no neutralizing activity to HAdV7 whereas HAdV7 antisera cannot neutralize HAdV4, a subgroup of individuals might be susceptible to infection by HAdV4 and HAdV7 and thus generate nAb to both of them. These results revealed the continuous circulation of HAdV4 and HAdV7 and the lack of protective immunity in more than 35% of people, which emphasized the surveillance of these two HAdVs and the development of prophylactic vaccines.
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Affiliation(s)
- Xianmiao Ye
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Lijun Xiao
- Center for Disease Control and Prevention of Chenzhou, Chenzhou, China
| | - Xuehua Zheng
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Jinlin Wang
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Tao Shu
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Ying Feng
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinglong Liu
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Wan Su
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,School of Biomedical Sciences, Huaqiao University, Quanzhou, China
| | - Qian Wang
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Chufang Li
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ling Chen
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liqiang Feng
- State Key Laboratories of Respiratory Diseases, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
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49
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Wang B, Li J, Wu S, Chen Y, Zhang Z, Zhai Y, Guo Q, Zhang J, Song X, Zhao Z, Hou L, Chen W. Seroepidemiological investigation of HAdV-4 infection among healthy adults in China and in Sierra Leone, West Africa. Emerg Microbes Infect 2018; 7:200. [PMID: 30514848 PMCID: PMC6279822 DOI: 10.1038/s41426-018-0206-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/31/2018] [Accepted: 11/11/2018] [Indexed: 12/31/2022]
Abstract
An apparent increase in the frequency of human adenovirus type 4 (HAdV-4) infections among general populations has been observed over the past 10 years. However, available epidemiological data that may reflect previous viral circulation and assist in predicting potential outbreaks are sparse, particularly in mainland China and Africa. In this study, a convenient neutralization assay for use in the surveillance of historical HAdV-4 infections was established based on a recombinant luciferase-expressing virus. Subsequently, the neutralizing antibodies (nAbs) of 1013 healthy adult serum samples from China and Sierra Leone were evaluated. Our results showed that over 50% of the participants from China and nearly 70% of donors from Sierra Leone had detectable nAbs against HAdV-4 despite the few infection cases officially reported in these regions. Furthermore, the prevalence of nAbs to HAdV-4 is lower than that to HAdV-5, and both varied by geographic location. In addition, the seropositive rates of both HAdV-4 and HAdV-5 nAbs increased with age. However, the nAbs stimulated by HAdV-4 remained stable at low (≤200) levels among the different age groups, whereas moderate (201–1000) or high (>1000) nAb levels were produced by HAdV-5 and tended to decrease with age. These results elucidate the human humoral immune response against HAdV-4 and revealed that this virus may be an underestimated causative agent of respiratory disease among adults in China and West Africa, demonstrating the importance of HAdV-4 surveillance and providing useful insights for the future development of HAdV-4-based vaccines.
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Affiliation(s)
- Busen Wang
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Jianhua Li
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Shipo Wu
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Yi Chen
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Zhe Zhang
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Yanfang Zhai
- Key Laboratory of Cell Proliferation and Differentiation of the Ministry of Education, School of Life Sciences, Peking University, 5 Yiheyuan Road, Beijing, 100871, China
| | - Qiang Guo
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Jinlong Zhang
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Xiaohong Song
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Zhenghao Zhao
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China
| | - Lihua Hou
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China.
| | - Wei Chen
- Beijing Institute of Biotechnology, 20 East Street, Beijing, 100071, China.
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Xie L, Zhang B, Xiao N, Zhang F, Zhao X, Liu Q, Xie Z, Gao H, Duan Z, Zhong L. Epidemiology of human adenovirus infection in children hospitalized with lower respiratory tract infections in Hunan, China. J Med Virol 2018; 91:392-400. [PMID: 30286268 PMCID: PMC7159165 DOI: 10.1002/jmv.25333] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/02/2018] [Indexed: 12/18/2022]
Abstract
To investigate the current genotypes of circulating human adenovirus (HAdV) strains, we molecularly genotyped HAdV in the nasopharyngeal aspirates (NPAs) of patients with acute lower respiratory tract infections (ALRTIs) and attempted to determine their associations with clinical symptoms. A total of 4751 NPA samples were collected from 4751 patients admitted to Hunan Provincial People's Hospital from September 2007 to March 2014, of which 447 (9.4%) samples were HAdV positive. Fourteen different HAdV types were identified; HAdV types 1 to 7 (HAdV 1‐7) were identified in 95.7% of the 447 NPA samples with HAdV‐7 and HAdV‐3 being the most prevalent. In addition, 93.3% (417 of 447) of patients were younger than 5 years. The incidence of HAdV infection peaked in summer. Different HAdV types showed a predilection for different age groups and different seasonal distribution patterns. Coinfection of HAdVs and other respiratory viruses was detected in 63.3% (283 of 447) of the HAdV‐positive samples. The most common clinical diagnosis was pneumonia and the most common symptoms were fever and cough. In comparison with children infected with HAdV‐3 alone, those infected with HAdV‐7 alone had an increased frequency of severe pneumonia involvement (11.6% vs 32.4%; P = 0.031), higher intensive care unit admission rates (7.0% vs 26.5%; P = 0.019), and a longer length of hospital stay (P = 0.03). Mixed infections in younger children were associated with a longer hospital stay (P = 0.023). Our results demonstrate the recent changes in the trends of circulating HAdV genotypes associated with ALRTIs in Hunan China.
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Affiliation(s)
- Leyun Xie
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Bing Zhang
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Niguang Xiao
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Fei Zhang
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Xin Zhao
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Qin Liu
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Zhiping Xie
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Hanchun Gao
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Zhaojun Duan
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Lili Zhong
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
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