沈阳地区婴幼儿RSV感染的病原学调查研究

查明冬春季沈阳地区婴幼儿RSV感染流行情况.采用APAAP法和IFA法对65例临床诊断为急性病毒性下呼吸道感染的婴幼儿进行了检查.在RSV感染的高发季节由RSV引起婴幼儿的急性下呼吸道感染的阳性率为44.60%(29/65),0～6个月婴幼儿感染率最高,为74.07%(20/27),并有明显的喘息倾向.以上结果表明RSV仍是引起婴幼儿急性下呼吸道感染,特别是肺炎和毛细支气管炎的重要病原体,沈阳地区仍有流行.为防止和控制RSV的流行及为RSV的防治提供了依据.     

人呼吸道合胞病毒感染的预防和治疗研究进展

呼吸道合胞病毒（respiratory syncytial virus, RSV）会引起呼吸道和肺部感染,尤其是婴幼儿和老人,容易出现严重感染。尽管RSV感染对医疗保健产生了全球性影响,目前仍以支持性的治疗为主。在过去的几十年中,随着对RSV发病机制和免疫病理学的了解不断加深,RSV的预防策略取得了重大进步。自1966年RSV疫苗首次试验以来已经过去50多年,目前有两种RSV疫苗获批上市。综述了当前RSV感染的治疗方案（包括RSV特异性和非特异性）以及RSV疫苗的研发进展,以期为RSV的治疗及疫苗的研发提供参考。     

急性下呼吸道感染患儿中RSV的分离鉴定及分析

目的对2015年兰州单中心急性下呼吸道感染患儿中呼吸道合胞病毒(respiratory syncytial virus,RSV)进行分离鉴定及分析。方法收集临床急性下呼吸道感染患儿痰分泌物226份,在HEP-2细胞中连续盲传培养3代,收获的培养物用半巢式RT-PCR进行检测,选取强阳性样品进行测序以确定其型别,并对其流行病学特征进行分析。结果 226份样品中RSV阳性样本为76份(阳性率为34%)。RSV阳性患儿中,男女性别比为3∶1;年龄分布6月龄患儿占45%,6月龄~2岁占35%,2~5岁的占20%。冬季为发病高峰。76例RSV阳性患儿中,临床诊断依次为毛细支气管炎31例(40.79%)、喘息性支气管炎21例(27.36%)、支气管肺炎20例(26.32%)和支气管哮喘4例(5.26%)。40份强阳性RSV样品经测序确定为B亚型。结论 RSV是引起婴幼儿急性下呼吸道感染的重要病原之一,2015年RSV的流行株主要为B亚型。     

单克隆抗体在呼吸道合胞病毒感染诊断和防治中的应用

呼吸道合胞病毒 (RSV)是世界范围内婴幼儿下呼吸道感染的重要病原 ,目前尚无成熟疫苗应用于临床。展开对RSV被动免疫的研究显得尤为重要。单克隆抗体成为深入研究和防治RSV感染的有力武器。本文综述了单克隆抗体在RSV感染的诊断、预防和治疗中的应用     

280例呼吸道感染儿童呼吸道病毒病原学检出情况及流行规律分析

目的:了解呼吸道感染儿童呼吸道病毒病原学检出情况及其流行规律,为儿童呼吸道感染的预防、诊断及治疗提供病原学依据。方法:选取2016年1月-2017年12月期间中国人民解放军中部战区总医院收治的280例呼吸道感染患儿为研究对象,分析患儿呼吸道分泌物中呼吸道病毒的检出情况,并分析呼吸道感染儿童呼吸道病毒感染与年龄、季节、疾病类型的关系。结果:280例呼吸道感染患儿中共检出98份阳性标本,阳性率为35.00%,其中有2份标本中检出2种病毒感染,混合感染阳性率为0.71%;在所有病毒类型中,呼吸道合胞病毒(RSV)病毒感染阳性率最高。1岁患儿的病毒感染阳性率最高,与其他年龄段病毒感染阳性率比较差异有统计学意义(P0.05)。呼吸道感染患儿春季、冬季的病毒感染阳性率明显高于夏季、秋季(P0.05)。不同呼吸道感染疾病类型患儿病毒感染阳性率比较差异有统计学意义(P0.05),以喘息性肺炎、毛细支气管炎、肺炎患儿病毒感染阳性率较高。结论:RSV是呼吸道感染儿童呼吸道病毒感染的主要致病病原体,1岁的婴幼儿较易感染,春季、冬季为其高发季节,且以肺炎、毛细支气管炎、喘息性肺炎患儿的病毒感染阳性率较高。     

136例急性呼吸道感染患儿病原菌特点及鼻咽分泌物中呼吸道合胞病毒和人偏肺病毒基因分析

目的分析136例急性呼吸道感染患儿的病原菌特点,并对患儿鼻咽分泌物中呼吸道合胞病毒(RSV)、人偏肺病毒(hMPV)进行检测,为后续研究提供参考。方法选择2017年1月至2019年4月我院收治的136例急性呼吸道感染患儿为研究对象,分析患儿呼吸道感染病原菌分布、耐药性,并对不同性别、年龄和感染部位患儿鼻咽分泌物中hMPV和RSV基因进行检测。结果136例急性呼吸道感染患儿共检出病原菌164株,其中革兰阴性菌占70.73%(116/164),革兰阳性菌占25.00%(41/164),真菌占4.27%(7/164);以铜绿假单胞菌(26.22%)、肺炎克雷伯菌(17.07%)、大肠埃希菌(15.24%)、金黄色葡萄球菌(12.20%)为主。药敏试验显示,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌均对哌拉西林/他唑巴坦、头孢哌哃/舒巴坦、亚胺培南、左氧氟沙星、阿米卡星的耐药性较低(耐药率<50.0%)。金黄色葡萄球菌对万古霉素、呋喃妥因的耐药率为0.00%,对克林霉素、利福平的耐药率低于50.00%。136例患儿共检出hMPV 21例(15.44%),RSV 33例(24.26%)。不同性别患儿hMPV、RSV检出情况差异无统计学意义(均P>0.05)。1~2岁患儿hMPV检出率最高,0~5岁患儿RSV检出率较高。喘息性支气管炎、毛细支气管炎患儿hMPV检出率均较高,支气管肺炎、毛细支气管炎患儿RSV检出率均较高。结论急性呼吸道感染患儿病原菌以革兰阴性菌为主,应结合病原菌的药敏试验结果为患儿选择更有针对性的药物进行治疗。此外,应重视患儿RSV、hMPV感染情况,采取科学有效的方式对急性呼吸道感染进行预防和治疗。     

呼吸道合胞病毒被动免疫制剂研究进展

呼吸道合胞病毒(RSV)是造成世界范围内婴幼儿下呼吸道病毒性感染的主要原因之一,目前尚未研制出有效的疫苗,也没有特异性的治疗方法。被动免疫制剂能够有效预防RSV感染。静注RSV免疫球蛋白(RSV-IVIG)降低RSV易感儿童住院率,但其应用存在一定的局限性;抗RSVF蛋白的单抗Palivizumab是美国FDA批准的第一种用于传染病的人源化单克隆抗体,能够有效预防RSV感染、安全性高;其优化后的单抗Motavizumab亲和力和效力更强于Palivizumab。本文对RSV被动免疫制剂的研究进行了综述。     

稳定性改善的呼吸道合胞病毒融合糖蛋白疫苗的设计和特性鉴定

呼吸道合胞病毒(RSV)感染是幼儿和老年人下呼吸道感染的主要原因。目前,还没有能用的上市疫苗并且治疗这种疾病的选择相当有限。感染性RSV颗粒用I型病毒融合蛋白(F)糖蛋白修饰,其在结构上从亚稳态的融合前形态重排成高度稳定的融合后形态。在自然感染RSV的人群中,中和抗体主要识别病毒融合前构象。因此,基因工程制备的其融合前构象稳定的经RSV F蛋白一直是开发RSV F疫苗抗原的有前景的方向。在4 ℃或更高温度下长期稳定性是RSV F亚单位疫苗抗原的理想属性。     

冬季急性下呼吸道感染住院儿童病原学分析及临床流行病学特点

目的了解冬季儿童急性下呼吸道感染病原谱及临床流行病学特征,为临床抗感染及病原检测提供依据。方法对我院2006年12月～2007年2月急性下呼吸道感染住院患儿采用一次性无菌吸痰管经鼻腔插入7～8cm,达到咽部以下负压吸取1～2ml深部鼻咽分泌液送细菌培养,并对呼吸道合胞病毒(RSV),腺病毒(ADV),A、B型流感病毒(IFV),1、2及3型副流感病毒(PIV)等7种常见呼吸道病毒抗原进行检测及运用荧光定量聚合酶链反应(PCR)技术检测标本中支原体和衣原体DNA。结果①381份下呼吸道感染儿童痰标本中细菌培养阳性81份,病毒检测阳性133份,支原体和衣原体阳性分别12份与6份,混合感染标本44份,总标本病原学检出率为50.66%(193/381)。②RSV阳性标本112份,为最重要的感染病原,连续3个月RSV检出率均在30%左右,6月龄以下儿童占61.61%,2岁以下儿童占86.61%,阳性标本中78.57%的患儿有喘息表现。③大肠埃希菌(16株)、肺炎链球菌(14株)、肺炎克雷伯菌及金黄色葡萄球菌(各10株)、卡他莫拉菌布兰汉亚种(8株)、流感嗜血杆菌和副流感嗜血杆菌(各6株)表现为主要的致病菌。结论RSV感然仍为儿童冬季急性下呼吸道感染最主要的病原,尤其在2岁以下儿童,且易表现为喘息发作。仍有40%以上感染病原未明,儿童急性下呼吸道感染病原谱需进一步完善。     

呼吸道合胞病毒疫苗及其抗体制剂的研究进展

呼吸道合胞病毒(respiratory syncytial virus,RSV)感染是一个全球性的健康问题,目前临床上仍缺乏特异的治疗手段。接种疫苗主动免疫预防或使用抗体制剂被动免疫预防是避免重症感染和减少死亡的重要措施。针对不同的人群,须研制不同类型的RSV疫苗：减毒活疫苗对婴儿来说,可能是最佳选择;亚单位疫苗有引起增强型呼吸道疾病的风险,不适合RSV血清学阴性的婴幼儿接种,主要适用于老年人和孕妇。研发安全且有效的RSV疫苗难度大,虽然已有30余种RSV疫苗进入临床研究阶段,并显示出应用潜力,其中F纳米颗粒疫苗已率先进入III期临床试验,但在老年人和孕妇中未达预期效果。在RSV流行季节前,使用特异性抗体制剂也是预防高危人群严重RSV感染性疾病的有效手段。长效单克隆抗体MEDI8897比帕利珠单抗更具成本效益,已进入III期临床试验,且获得优先研发资格。多克隆免疫球蛋白RI-002已在免疫缺陷人群中显示出较好的预防效果,具有进一步研发的现实意义。本综述针对近年来RSV疫苗及其抗体的研究进展进行阐述,期望为RSV的预防提供参考。     

Resveratrol chemosensitizes breast cancer cells to melphalan by cell cycle arrest

Melphalan (MEL) is a chemotherapeutic agent used in breast cancer therapy; however, MEL's side effects limit its clinical applications. In the last 20 years, resveratrol (RSV), a polyphenol found in grape skins, has been proposed to reduce the risk of cancer development. The aim of this study was to investigate whether RSV would be able to enhance the antitumor effects of MEL in MCF-7 and MDA-MB-231 cells. RSV potentiated the cytotoxic effects of MEL in human breast cancer cells. This finding was related to the ability of RSV to sensitize MCF-7 cells to MEL-induced apoptosis. The sensitization by RSV involved the enhancement of p53 levels, the decrease of procaspase 8 and the activation of caspases 7 and 9. Another proposed mechanism for the chemosensitization effect of MCF-7 cells to MEL by RSV was the cell cycle arrest in the S phase. The treatment with RSV or MEL increased the levels of p-Chk2. The increase became pronounced in the combined treatments of the compounds. The expression of cyclin A was decreased by treatment with RSV and by the combination of RSV with MEL. While the levels of cyclin dependent kinase 2 (CDK2) remained unchanged by treatments, its active form (Thr(160) -phosphorylated CDK2) was decreased by treatment with RSV and by the combination of RSV with MEL. The activity of CDK7, kinase that phosphorylates CDK2 at Thr(160), was inhibited by RSV and by the combination of RSV with MEL. These results indicate that RSV could be used as an adjuvant agent during breast cancer therapy with MEL.     

Neutralizing anti-F glycoprotein and anti-substance P antibody treatment effectively reduces infection and inflammation associated with respiratory syncytial virus infection

Respiratory syncytial virus (RSV) is the most important virus mediating lower respiratory tract illness in infants and young children. RSV infection is associated with pulmonary inflammation and increased levels of substance P (SP), making the airways and leukocytes that express SP receptors susceptible to the proinflammatory effects of this peptide. This study examines combining neutralizing anti-F glycoprotein and anti-SP antibody treatment of RSV-infected BALB/c mice to inhibit RSV replication and inflammation associated with infection. BALB/c mice were prophylactically treated with antibody prior to RSV infection or were therapeutically treated at day 2 or 6 post-RSV infection. Prophylactic or therapeutic treatment with anti-SP antibodies promptly reduced pulmonary inflammatory cell infiltration and decreased the number of cells expressing proinflammatory cytokines, while anti-F antibody treatment reduced virus titers. The results suggest that combined anti-viral and anti-SP antibody treatment may be effective in treating RSV disease.     

Combination Therapy Using Monoclonal Antibodies against Respiratory Syncytial Virus (RSV) G Glycoprotein Protects from RSV Disease in BALB/c Mice

Therapeutic options to control respiratory syncytial virus (RSV) are limited, thus development of new therapeutics is high priority. Previous studies with a monoclonal antibody (mAb) reactive to an epitope proximal to the central conserved region (CCR) of RSV G protein (mAb 131-2G) showed therapeutic efficacy for reducing pulmonary inflammation RSV infection in BALB/c mice. Here, we show a protective effect in RSV-infected mice therapeutically treated with a mAb (130-6D) reactive to an epitope within the CCR of G protein, while treatment with a mAb specific for a carboxyl G protein epitope had no effect. Combined treatment with mAbs 130-6D and 131-2G significantly decreased RSV-associated pulmonary inflammation compared to either antibody alone. The results suggest that anti-RSV G protein mAbs that react at or near the CCR and can block RSV G protein-mediated activities are effective at preventing RSV disease and may be an effective strategy for RSV therapeutic treatment.     

Resveratrol Induces Pro-oxidant Effects and Time-Dependent Resistance to Cytotoxicity in Activated Hepatic Stellate Cells

Resveratrol (RSV) is known for its antioxidant properties; however, this compound has been proposed to have cytotoxic and pro-oxidant effects depending on its concentration and time of exposure. We previously reported the cell cycle arrest effect of low doses of RSV in GRX cells, an activated hepatic stellate cell model. Here, we evaluated the effects of RSV treatment (0.1–50 μM) for 24 and 120 h on GRX viability and oxidative status. Only treatment with 50 μM of RSV reduced the amount of live cells. However, even low doses of RSV induced an increased reactive species production at both treatment times. While being diminished within 24 h, RSV induced an increase in the SOD activity in 120 h. The cellular damage was substantially increased at 24 h in the 50 μM RSV-treated group, as indicated by the high lipoperoxidation, which may be related to the significant cell death and low proliferation. Paradoxically, this cellular damage and lipoperoxidation were considerably reduced in this group after 120 h of treatment while the surviving cells proliferated. In conclusion, RSV induced a dose-dependent pro-oxidant effect in GRX cells. The highest RSV dose induced oxidative-related damage, drastically reducing cell viability; but this cytotoxicity seems to be attenuated during 120 h of treatment.     

TARGETED THERAPY OF RESPIRATORY SYNCYTIAL VIRUS BY 2-5A ANTISENSE

Respiratory syncytial virus is a leading cause of respiratory disease in infants, young children, immunocompromized patients, and the elderly. Previous work has shown that RNase L, an antiviral enzyme of the interferon system, can be recruited to cleave RSV genomic RNA by attaching tetrameric 2′-5′-linked oligoadenylates (2 5A) to an antisense oligonucleotide complementary to repetitive intergenic sequences within the RSV genome (2 5A antisense). RBI034, a 2′-O-methyl RNA-modified analogue of the 2 5A anti-RSV compound, was found to have enhanced antiviral activity in cell culture studies while also cleaving RSV genomic RNA in an RNase L· and sequence-specific manner. RBI034′s efficacy in suppressing RSV replication in cell culture is 50 to 100 times better than ribavirin, the only approved drug for RSV infection. Here we show that the activity of 2 5A antisense compound can be further enhanced by a combination treatment with interferon or ribavirin. The anti-RSV activity resulting from combination treatment is more potent than either treatment alone. We also demonstrate that RBI034 is effective against RSV in three different species: mice, cotton rats, and African green monkeys.     

The effects of resveratrol on cyclooxygenase-1 and -2, nuclear factor kappa beta, matrix metalloproteinase-9, and sirtuin 1 mRNA expression in hearts of streptozotocin-induced diabetic rats

Resveratrol (RSV) has a beneficial role in the prevention of diabetes and alleviates some diabetic complications, such as cardiomyopathy. We investigated cyclooxygenase-1 (COX-1), COX-2, nuclear factor κB (NF-κB), matrix metalloproteinase-9 (MMP-9), and sirtuin 1 (SIRT1) mRNA expression levels in heart tissue after RSV treatment in streptozotocin (STZ)-induced diabetic rats. After induction of chronic diabetes with STZ, 10 mg RSV/kg per day was administered to DM and DM+RSV groups for four weeks. At the end of the experiment, all rats were sacrificed and heart tissues were stored at -80°C; mRNA expression levels of COX-1, COX-2, NF-κB, MMP-9, and SIRT1 genes were analyzed with quantitative real-time PCR. We did not find any significant effect of RSV on MMP-9, COX-1, COX-2, or NF-κB mRNA levels among the groups. However, SIRT1 mRNA levels decreased in the DM group compared to controls and increased in the DM+RSV group when compared to the DM group. SIRT1 is activated by RSV treatment in diabetic heart tissue. Activation of SIRT1 by RSV may lead to a new therapeutic approach for diabetic heart tissue. We conclude that RSV treatment can alleviate heart dysfunction by inhibiton of inflammatory gene expression such as SIRT1.     

Resveratrol Ameliorates Renal Damage,Increases Expression of Heme Oxygenase-1, and Has Anti-Complement,Anti-Oxidative,and Anti-Apoptotic Effects in a Murine Model of Membranous Nephropathy

BackgroundIdiopathic membranous nephropathy (MN) is an autoimmune-mediated glomerulonephritis and a common cause of nephrotic syndrome in adults. There are limited available treatments for MN. We assessed the efficacy of resveratrol (RSV) therapy for treatment of MN in a murine model of this disease.MethodsMurine MN was experimentally induced by daily subcutaneous administration of cationic bovine serum albumin, with phosphate-buffered saline used in control mice. MN mice were untreated or given RSV. Disease severity and pathogenesis was assessed by determination of metabolic and histopathology profiles, lymphocyte subsets, immunoglobulin production, oxidative stress, apoptosis, and production of heme oxygenase-1 (HO1).ResultsMN mice given RSV had significantly reduced proteinuria and a marked amelioration of glomerular lesions. RSV also significantly attenuated immunofluorescent staining of C3, although there were no changes of serum immunoglobulin levels or immunocomplex deposition in the kidneys. RSV treatment of MN mice also reduced the production of reactive oxygen species (ROS), reduced cell apoptosis, and upregulated heme oxygenase 1 (HO1). Inhibition of HO1 with tin protoporphyrin IX partially reversed the renoprotective effects of RSV. The HO1 induced by RSV maybe via Nrf2 signaling.ConclusionOur results show that RSV increased the expression of HO1 and ameliorated the effects of membranous nephropathy in a mouse model due to its anti-complement, anti-oxidative, and anti-apoptotic effects. RSV appears to have potential as a treatment for MN.     

Targeted therapy of respiratory syncytial virus by 2-5A antisense

Respiratory syncytial virus is a leading cause of respiratory disease in infants, young children, immunocompromized patients, and the elderly. Previous work has shown that RNase L, an antiviral enzyme of the interferon system, can be recruited to cleave RSVgenomic RNA by attaching tetrameric 2' 5'-linked oligoadenylates (2 5A) to an antisense oligonucleotide complementary to repetitive intergenic sequences within the RSV genome (2 5A antisense). RBI034, a 2'-O-methyl RNA-modified analogue of the 2 5A anti-RSV compound, was found to have enhanced antiviral activity in cell culture studies while also cleaving RSV genomic RNA in an RNase L- and sequence-specific manner. RBI034s efficacy in suppressing RSV replication in cell culture is 50 to 100 times better than ribavirin, the only approved drug for RSV infection. Here we show that the activity of 2 SA antisense compound can be further enhanced by a combination treatment with interferon or ribavirin. The anti-RSV activity resulting from combination treatment is more potent than either treatment alone. We also demonstrate that RBI034 is effective against RSV in three different species: mice, cotton rats, and African green monkeys.     

Protective effect of resveratrol against pembrolizumab-induced hepatotoxicity and neurotoxicity in male rats

The present study investigates the effects of resveratrol (RSV) on brain and liver tissues in rats with pembrolizumab (PEMB)-induced toxicity. Obtained for the study were 28 male Sprague-Dawley rats (3–4 months old) which were divided into four groups: Group 1: Control. Group 2: Administered PEMB at 5 mg/kg/day i.p. for a week. Group 3: Administered RSV orally at the dose of 20 mg/kg/day for 30 days by gavage. Group 4: Administered PEMB and RSV at 20 and 5 mg/kg/day RSV, respectively, for 30 days. The results of this study revealed that PEMB leads to a significant increase in thiobarbituric acid reactive substance (TBARS) levels and a significant decrease in glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD) activities, and glutathione (GSH) levels in the liver and brain tissues. The decreased SOD, CAT, GPx activities, and GSH levels increased significantly following RSV treatment in Group 4. The PEMB treatment showed histopathological alterations associated with strong positive cysteinyl aspartic acid-protease-3 (caspase-3) immunoreactivity, while RSV treatment reduced both the expression of caspase-3 protein and the histopathological changes. RSV administration prevents the biochemical, immunological, and histological alterations induced by PEMB. It can be suggested that the lower caspase-3 immunoreactivity in the PEMB + RSV group than in the PEMB group led to an inhibition of RSV on apoptosis.