轮状病毒感染发病机制的研究进展

轮状病毒(RV)是小儿腹泻病最常见病原体,RV感染不仅可导致胃肠道症状,亦可引起各种肠道外表现.RV腹泻特别是RV血症发病机制和多个因素有关,至今尚未完全明确.RV感染性腹泻可能和细胞胞间连接损害、非结构蛋白NSP4、热休克蛋白hsc70等因素有关.RV病毒血症发病机制可能和RV感染引起体内炎性介质分泌、细胞因子表达水平改变等免疫因素有关.     

轮状病毒感染发病机制的研究进展

轮状病毒(RV)是小儿腹泻病最常见病原体,RV感染不仅可导致胃肠道症状,亦可引起各种肠道外表现.RV腹泻特别是RV血症发病机制和多个因素有关,至今尚未完全明确.RV感染性腹泻可能和细胞胞间连接损害、非结构蛋白NSP4、热休克蛋白hsc70等因素有关.RV病毒血症发病机制可能和RV感染引起体内炎性介质分泌、细胞因子表达水平改变等免疫因素有关.     

轮状病毒感染引起肠道内外发病机制的研究进展

轮状病毒（RV）是一种双链RNA病毒,其基因序列已经基本查明.RV是引起婴幼儿严重腹泻最常见的病毒,除了可以引起胃肠道疾病外,也可以导致全身各个系统病变.发病机制和多个因素有关.腹泻可能是非结构蛋白-4、肠道神经系统、肠道吸收功能失调等多种机制共同作用引起.肠道外病变可能是RV在免疫功能异常（或正常）的情况下通过血液或/和淋巴途径播散所致.     

轮状病毒感染引起肠道内外发病机制的研究进展

轮状病毒(RV)是一种双链RNA病毒,其基因序列已经基本查明。RV是引起婴幼儿严重腹泻最常见的病毒,除了可以引起胃肠道疾病外,也可以导致全身各个系统病变。发病机制和多个因素有关。腹泻可能是非结构蛋白-4、肠道神经系统、肠道吸收功能失调等多种机制共同作用引起。肠道外病变可能是RV在免疫功能异常(或正常)的情况下通过血液或/和淋巴途径播散所致。     

轮状病毒感染机制新进展

轮状病毒(rotavirus,RV)是世界范围内引起婴幼儿重症腹泻的最主要病原,而对于RV腹泻至今尚无特效治疗药物.目前对于RV感染的致病机制有多种说法,但尚无确切结论.在RV感染过程中,RV病原体必须克服宿主抗病毒先天免疫反应才能在宿主细胞中成功复制,而在此过程中RV编码的蛋白起到了重要作用.该文对RV编码蛋白在RV感染机制中的作用的研究进展加以综述.     

轮状病毒感染和细胞因子相关性研究进展

轮状病毒(rotavirus,RV)是世界范围内引起婴幼儿重症腹泻的最主要病原,每年造成全世界60多万人死亡.控制和预防RV感染有赖于对其发病机制的阐明,但目前仍不十分清楚.国内外研究多集中于环境、感染、免疫等因素,其中细胞免疫反应异常尤为受到重视.已经证实有许多细胞因子参与轮状病毒炎症免疫反应,与发病及转归密切相关.本文就轮状病毒感染过程中几种焦点细胞因子的作用机制综述如下.     

人类组织血型抗原在小儿轮状病毒感染中的研究进展

轮状病毒(RV)是引起婴幼儿病毒性腹泻的主要病原体之一,RV感染宿主细胞主要依赖于病毒识别细胞表面的特异性受体并与其发生结合,因此,受体是病毒感染细胞的重要因素。近年研究发现,组织血型抗原(HBGAs)可以作为RV的结合受体被病毒蛋白VP8识别。该领域的研究不仅部分揭示HBGAs在RV感染、进化中的重要作用,也提示了不同个体对RV易感性的差异,而且对于探索RV感染的发病机制、流行病学规律和防治措施具有重要意义。文章分析RV感染与HBGAs的相关性以进一步探讨最佳疫苗的研发。     

轮状病毒NSP4与轮状病毒腹泻的相关研究新进展

轮状病毒 (rotavirus ,RV)是婴幼儿腹泻的最主要病原。尽管对其流行病学及防治进行了深入研究 ,但RV腹泻的发病机制尚未阐明。近年来 ,RV非结构蛋白NSP4在病毒致病性中的重要作用得到了一致重视。本文就NSP4蛋白的分子结构及其在RV腹泻发病机制中的作用、NSP4基因变异与RV腹泻临床症状严重程度的相关性、NSP4与RV腹泻的防治进行简要综述     

轮状病毒NSP4与轮状病毒腹泻的相关研究新进展

轮状病毒(rotavirus，RV)是婴幼儿腹泻的最主要病原。尽管对其流行病学及防治进行了深入研究，但RV腹泻的发病机制尚未阐明。近年来，RV非结构蛋白NSP4在病毒致病性中的重要作用得到了一致重视。本文就NSP4蛋白的分子结构及其在RV腹泻发病机制中的作用、NSP4基因变异与RV腹泻临床症状严重程度的相关性、NSP4与RV腹泻的防治进行简要综述。     

毛细支气管炎与哮喘的关系

毛细支气管炎是引起2岁以下婴幼儿喘息发作的主要病因,多由病毒感染引起,其中呼吸道合胞病毒（RSV）和鼻病毒（RV）是最常见的病原体。近年来,研究发现生后早期RSV和RV感染诱发的毛细支气管可能与患儿日后反复喘息发作甚至发展为哮喘密切相关。该文拟对RSV和RV感染后诱发的毛细支气管炎与日后反复喘息发作及发展为哮喘的关系、病毒感染后对肺功能的长期影响、发展为哮喘可能的发病机制和危险因素及预防策略等方面问题进行介绍。     

Rotavirus in infant-toddler day care centers: epidemiology relevant to disease control strategies

A 15-month prospective longitudinal study of diarrhea and rotavirus (RV) infection was conducted concurrently in infants and toddlers in day care centers (DCCs) and in a large pediatric clinic in Houston. The mean number of children in the DCCs was 223; the diarrhea rate during the first 12 months was 2.62 episodes per child-year. Rotavirus accounted for approximately 10% of the total episodes of diarrhea in the pediatric clinic and DCC populations, but 50% during the winter months. The occurrence of RV in the DCCs paralleled that seen in the pediatric clinic. The annual rate of RV infection in DCCs was 0.55 episodes per child-year, with diarrhea occurring in only 40% of the episodes (0.22 episodes per child-year). There were 45 diarrhea outbreaks in DCCs, for a mean of 3.8 per center per year; nine of these outbreaks were associated with RV. Polyacrylamide gel electrophoresis of RNA genome patterns of RV strains from eight of these outbreaks showed that in seven outbreaks a single strain was identified in children in that DCC, whereas multiple strains were identified simultaneously in the community. The age distributions of symptomatic and asymptomatic RV infections in DCC study children were not significantly different. In symptomatic RV-infected children in DCCs, 42% had RV identified in stool specimens within 2 days before diarrhea occurred. Thirty-eight DCC children had more than one episode of RV infection, but only five had two symptomatic RV infections. Diarrhea caused by RV is common in children in DCCs, often occurs in outbreaks due to the same strain, and parallels disease in the community; asymptomatic RV infection is also common in children in DCCs.     

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目的了解婴幼儿急性腹泻的病原构成,为本地区临床合理有效地控制小儿急性腹泻提供病原依据。方法对2009年1-12月福州儿童医院消化专科收治的459例急性腹泻患儿的粪便标本进行细菌培养,采用免疫胶体金法检测轮状病毒(RV)抗原;抽取其中218例,再应用ELISA法检测RV抗原,逆转录聚合酶链式反应(RT-PCR)法检测诺如病毒(NV)核酸。结果 459例患儿细菌感染35例(7.6%),真菌感染5例(1.1%),检出RV阳性117例(25.5%)。218例中RV阳性69例(31.7%),NV阳性61例(28.0%),上述二种病毒混合感染14例(6.4%)。两种病毒感染阳性率男女性别差异无统计学意义(P>0.05),不同年龄组间RV及NV阳性率差异有统计学意义(P<0.05),均以2岁以下患儿为主。RV、NV均有明显的季节特征,RV以10-12月份为发病高峰,NV以7~9月份为发病高峰分布,差异均有统计学意义(P<0.05)。结论小儿感染性腹泻病原类型复杂多样,在临床诊治中应重视病原学检测。     

Rotavirus infections in childhood: studies using a molecular biology method (gene electrophoresis)

During a 15-month period all children below 16 years admitted to the Children's Hospital in St. Gallen with acute diarrheal disease were studied for rotavirus (RV) infection. Stool samples from control patients without gastrointestinal disease were investigated for RV shedding in order to detect RV carriers or asymptomatically infected children. RV was detected by electrophoresis of RV genomic dsRNA in 154 children. 119 (58%) of 205 patients hospitalized because of diarrhea were RV associated, 25 children became symptomatically ill during their hospitalization, and in 10 (1%) of 954 control patients RV could be found. During the winter 1983/1984 two epidemic peaks of RV associated diarrhea were noted, whereas in the summer period RV related disease occurred only sporadically. The peak incidence of RV infection was in the age group between 10 and 12 months. After the 3rd year of life RV infection only rarely required hospitalization. During this study period 8 different genomic RNA patterns of RV were found. The number of patients within these 8 RV types, however, is too small to allow definite correlations between epidemiological or clinical features and selected electrophorotypes. The possibility to perform refined epidemiological and clinical analyses of RV infection by genomic dsRNA electrophoresis offers important advantages when compared to other RV detection systems. In addition, this method has proven to be fast, simple and reliable.     

Prospective study of rotavirus infection in a maternity unit. Demonstration of a nosocomial infection

Eighty-eight children born at the maternity hospital in Saint-Germain-en-Laye between May 24 and June 7, 1983 were followed clinically, with a special supervision concerning stools, weight curves and the way of feeding. Stool samplings looking for Rotavirus were performed in all the children and their mothers, at the 3rd and 6th days of life. No mother was found with Rotavirus infection. In neonates, Rotavirus excretion was significantly related to a slow down in weight curves and the occurrence of diarrhea. All rotaviruses had the same electrophoretype. Breast-feeding had an undeniable protective effect.     

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??Objective To explore the epidemiological features of NV and RV infection and to investigate the clinical features and prognosis of NV infection. Methods Stool specimens??without pus??mucus or blood?? were collected from children less than 3 years old with acute diarrhea within 7 days admitted from November 2012 to October 2013 in Beijing Children’s Hospital??Capital Medical University. Stool specimens were screened for NV and RV using immunochromatographic test??ICG??. History was investigated and the severity was evaluated by Vesikari scale. Follow-ups were conducted via phone calls. The epidemiological features?? clinical manifestations and prognosis of children infected with NV were analyzed and compared with those infected with RV. Results Among the total 942 samples??RV was detected in 329??34.9%?? samples??while NV was detected in 137??14.5%?? samples. Rate of co-infection was 9.7%??91/942??. The seasonal distribution of RV detection showed a peak of incidence from September to February the following year??but NV detection showed sporadic distribution. The times and duration of diarrhea and vomiting were similar in two kinds of infection??but fever??vomiting??severe diarrhea??with fatigue??sleepiness or lethargy?? were significantly more common in RV infection??P??0.05??. NV infection had a higher incidence of respiratory symptoms??such as cough and rhinorrhea. Mean Vesikari severity score was ??8.98±2.94?? in NV infection??remarkably lower than??10.45±3.04??in RV infection??P??0.05??. Most patients recovered in??7 days??but NV infection was likely to have longer duration. Conclusion RV is still the leading cause of acute viral diarrhea??and NV is also a significant cause. NV infection occurs year-round??while RV infection shows a peak in autumn and winter. Fever??vomiting and severe diarrhea with dehydration are more common in RV infection. NV infection has a higher rate of respiratory symptoms and longer recovery period.     

诺如病毒和轮状病毒感染致小儿急性腹泻942例调查与临床分析

目的 与轮状病毒（RV）感染对比,了解诺如病毒（NV）感染的流行病学特点、临床特点及预后。方法 2012年11月至2013年10月,首都医科大学附属北京儿童医院选取3岁以下腹泻7 d以内婴幼儿的新鲜大便标本,筛选出无黏液、脓血的标本,应用胶体金免疫层析法检测NV及RV抗原。询问病史,依据Vesikari评分对腹泻严重程度进行评估,通过电话随访了解患儿预后。经统计分析,对NV及RV感染的流行病学特点、临床特点、预后进行对比研究。结果 共入组942例,RV感染329例（34.9%）,NV感染137例（14.5%）,混合感染91例（9.7%）。RV感染存在明显的季节性,9月至次年2月为高发期;NV感染则全年散发。NV及RV感染在腹泻次数、腹泻持续时间、呕吐持续时间上均无统计学差异,但RV感染中,发热、呕吐、严重腹泻（伴有乏力、嗜睡、精神弱等症状）的比例明显高于NV感染（P＜0.05 ）,而流涕、咳嗽症状在NV感染更常见。NV感染Vesikari评分均值为（8.98±2.94）分,低于RV［（10.45±3.04）分,P＜0.05）］。NV及RV感染多7 d以内好转,但NV感染易出现病程迁延。结论 RV仍为婴幼儿急性腹泻的主要病原,但NV感染检出率亦较高;NV感染呈全年散发,RV感染仍呈秋冬季节高发;RV感染出现发热、呕吐、严重腹泻较NV常见,而NV感染多伴呼吸道症状且病程易迁延。     

Prevalence and factors associated with rotavirus infection among children admitted with acute diarrhea in Uganda

Background  

Rotavirus remains the commonest cause of severe dehydrating diarrhea among children worldwide. Children in developing countries die more because of several factors including poorer access to hydration therapy and greater prevalence of malnutrition. Hitherto, the magnitude of rotavirus disease in Uganda has remained unknown. This study was therefore done to determine the prevalence and factors associated with rotavirus infection among children aged 3-59 months admitted with acute diarrhea to paediatric emergency ward of Mulago Hospital, Uganda     

Characterization of clinical and immune response in a rotavirus diarrhea model in suckling Lewis rats

Group A rotaviruses (RVs) are the leading pathogens causing diarrhea in children and animals. The present study was designed to establish an experimental model of RV infection and immune response in suckling rats. Wistar (W) and Lewis (L) suckling rats were inoculated orally with two different doses of a simian RV SA-11 strain. RV infection was evaluated by growth rate and clinical indexes. Virus-shedding and serum anti-RV antibodies were measured by enzyme-linked immunosorbent assay (ELISA). Mucosal interferon-gamma (IFN gamma), specific splenocyte proliferation, and spleen and intestinal intraepithelial lymphocyte (IEL) phenotype were analyzed. No diarrhea was observed in any inoculated Ws. All Ls developed acute moderate diarrhea, and a high score and incidence of diarrhea were found in rats infected with higher titers of RV. Specific humoral and cell systemic immune response was confirmed by splenocyte proliferation and by the presence of serum anti-RV antibodies. Moreover, RV infection induced changes in IEL composition, which showed an increase in the proportion of innate immune cells with respect to cells involved in acquired immunity. This acute moderate diarrhea process constitutes a good experimental model that also provides some immune biomarkers that may allow establishing modulation by drugs or diet components.