Exacerbation of asthma and airway infection: is the virus the villain?

Costa, Lusmaia Damaceno Camargo; Costa, Paulo Sucasas; Camargos, Paulo Augusto Moreira

doi:10.1016/j.jpedp.2014.07.002

Cited by 16 publications

(21 citation statements)

References 62 publications

(83 reference statements)

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“…While severe bacterial pneumonia following influenza infection has been well described, associations are less clear among infections caused by viruses common in young children; secondary infections due to other viruses are less well understood and has been reviewed by others [86]. Although assessing the overall contribution of bacteria to disease severity is complicated by the presence of many confounding factors in clinical studies, understanding the role of viral/bacterial co-infections in defining the outcome of paediatric ARI may potentially reveal novel treatment and prevention strategies, improving patient outcomes [33,[86][87][88][89][90][91][92][93][94][95].…”

Section: Co-infectionsmentioning

confidence: 99%

The human viral challenge model: accelerating the evaluation of respiratory antivirals, vaccines and novel diagnostics

et al. 2018

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The Human Viral Challenge (HVC) model has, for many decades, helped in the understanding of respiratory viruses and their role in disease pathogenesis. In a controlled setting using small numbers of volunteers removed from community exposure to other infections, this experimental model enables proof of concept work to be undertaken on novel therapeutics, including vaccines, immunomodulators and antivirals, as well as new diagnostics.Crucially, unlike conventional phase 1 studies, challenge studies include evaluable efficacy endpoints that then guide decisions on how to optimise subsequent field studies, as recommended by the FDA and thus licensing studies that follow. Such a strategy optimises the benefit of the studies and identifies possible threats early on, minimising the risk to subsequent volunteers but also maximising the benefit of scarce resources available to the research group investing in the research. Inspired by the principles of the 3Rs (Replacement, Reduction and Refinement) now commonly applied in the preclinical phase, HVC studies allow refinement and reduction of the subsequent development phase, accelerating progress towards further statistically powered phase 2b studies. The breadth of data generated from challenge studies allows for exploration of a wide range of variables and endpoints that can then be taken through to pivotal phase 3 studies.We describe the disease burden for acute respiratory viral infections for which current conventional development strategies have failed to produce therapeutics that meet clinical need. The Authors describe the HVC model’s utility in increasing scientific understanding and in progressing promising therapeutics through development.The contribution of the model to the elucidation of the virus-host interaction, both regarding viral pathogenicity and the body’s immunological response is discussed, along with its utility to assist in the development of novel diagnostics.Future applications of the model are also explored.Electronic supplementary materialThe online version of this article (10.1186/s12931-018-0784-1) contains supplementary material, which is available to authorized users.

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Section: Co-infectionsmentioning

confidence: 99%

The human viral challenge model: accelerating the evaluation of respiratory antivirals, vaccines and novel diagnostics

et al. 2018

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“…Besides this, 10%-50% of children affected with ARI develop secondary bacterial infections, namely, acute otitis media, sinusitis, or pneumonia [4]. Moreover, viruses are the most common pathogen associated with severe respiratory diseases (e.g., bronchiolitis), exacerbation of asthma, or pneumonia in early life and are leading cause of hospitalization in children under two [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Viral Agents Causing Acute Respiratory Infections in Children under Five: A Study from Eastern India

Mishra

Nayak

Das

et al. 2016

International Journal of Pediatrics

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Background. Acute respiratory infections (ARIs) are important cause of mortality and morbidity in children under five in developing country. Methods. This observational study was conducted over two-year period in a tertiary care teaching hospital of Eastern India. Nasal and throat swabs were collected, transported to the laboratory at 2–8°C in viral transport media, and then processed for detection of viruses using mono/multiplex real-time polymerase chain reaction. Results. A total of 300 children aged 2–60 months with ARIs were included. The most common age group affected with LRI was 2–12 mo and with URI was >12–60 mo. Viruses were detected in 248 cases. In URI, 77 were positive for single virus and 19 were positive for more than one virus; in LRI, 113 were positive for single virus and 12 were positive for more than one virus. The most common viruses isolated from URI cases were rhinovirus and adenovirus. The most common viruses isolated from LRI cases were respiratory syncytial virus and influenza virus. Most cases occurred in the months of January, December, and August. Conclusion. Viruses constitute a significant cause of ARI in children under five. RSV, ADV, RV, and IFV were the most prevalent viruses isolated.

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“…Effects of pollutants such as cigarettes are generally neglected in the existence of allergens and viruses. 28 When a comparison was made between children hospitalised for community acquired pneumonia, duration of hospitalisation of children with two or more smoking family members in the house was longer, and that their intensive-care needs were greater. 29 Previous studies reported that ETS for Gambian and Alaskan children and smoking of the mother for Finnish children are related with invasive pneumococcal disease.…”

Section: Discussionmentioning

confidence: 99%