Respiratory viruses are responsible of acute respiratory infections that affect worldwide population causing morbi-mortality and children younger than 5 years are the most affected population. Cytokines can modulate the immune response but little is known about their levels in nasal mucosa and less if these would correlate with symptoms severity. One hundred twenty-one pediatric patients with clinically diagnosed acute respiratory infections were sequentially enrolled in the Department of Pediatrics of the University Hospital. Throat swabs were performed and nucleic acid was isolated to viral detection by Luminex xTAG RVP kit and qRT-PCR. Nasal lavage were performed in each patients to evaluate cytokines levels by multiplex immunoassay. Disease severity was evaluated according to clinical characteristics on the day of enrollment. The most frequently found viral respiratory infections were hRV, RSV, and hMPV. hMPV load correlated with disease severity (P<0.05). Pro-inflammatory, Th1, Th2 and Th17 cytokines were detected in nasal lavage in those patients, however only pro-inflammatory cytokines were found higher in severe disease. Pro-inflammatory, Th1/Th2/Th17 cytokines correlated with symptoms, mainly with fever (P<0.05). Our findings show that disease severity correlates with viral load and cytokines in nasal lavage may regulate local immune response against respiratory virus.
Septic arthritis is considered the fastest joint destructive disease and a medical emergency. The most common etiological agents are bacteria; Staphylococcus aureus is the main cause of infection. The etiological agent and the host immune response might determine the clinical presentation and the evolution of the disease. Depending on these factors, septic arthritis might be responsible for many complications, including even death. Understanding the immunopathogenesis responsible for the clinical presentation and creating awareness of its importance may help in the medical education, research approaches, and attention of physicians treating this disease. Evidence indicates that bacteria-specific factors such as adhesins, amino acids, toxins, and superantigens are responsible for joint colonization. However, a dual role with a "double-edged sword effect" of the immune system might be responsible for septic arthritis's severe consequences. Due to immune system redundancy, there might not be a specific component responsible for the disastrous complications. However, cells as neutrophils, macrophages, T helper cells, and their cytokines might be playing an important role. Physical complications have been well studied. However, little research has been done regarding the possible psychological effects on these patients due to the morbidities, which clearly affect the outcome of the patients. This report aims to review the available literature on joint infections focusing on the most common etiological agents, the immune response, and the impact this disease can create in the patients.
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