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Rhinovirus induces airway epithelial gene expression through double-stranded RNA and IFN-dependent pathways.

Rhinovirus (RV) infection is the major cause of common colds and of asthma exacerbations. Because the epithelial cell layer is the primary target of RV infection, we hypothesize that RV-induced airway disease is associated with the perturbation of airway epithelial gene expression. In this study, well differentiated primary human airway epithelial cells were infected with either RV16 (major group) or RV1B (minor group). Transcriptional gene profiles from RV-infected and mock-infected control cells were analyzed by Affymetrix Genechip, and changes of the gene expression were confirmed by real-time RT-PCR analysis. At 24 h after infection, 48 genes induced by both viruses were identified. Most of these genes are related to the IFN pathway, and have been documented to have antiviral functions. Indeed, a significant stimulation of IFN-beta secretion was detected after RV16 infection. Neutralizing antibody specific to IFN-beta and a specific inhibitor of the Janus kinase pathway both significantly blocked the induction of RV-inducible genes. Further studies demonstrated that 2-aminopurine, a specific inhibitor double-stranded RNA-dependent protein kinase, could block both IFN-beta production and RV-induced gene expression. Thus, IFN-beta-dependent pathway is a part of the double-stranded RNA-initiated pathway that is responsible for RV-induced gene expression. Consistent with its indispensable role in the induction of antiviral genes, deactivation of this signaling pathway significantly enhanced viral production. Because increase of viral yield is associated with the severity of RV-induced airway illness, the discovery of an epithelial antiviral signaling pathway in this study will contribute to our understanding of the pathogenesis of RV-induced colds and asthma exacerbations.

2-Aminopurine↗

[Intranasal application of inactivated influenza virus vaccines].

Recent concept on the common mucosal immune system gives new direction of influenza vaccine development-mucosal vaccine. Vaccines have to be administered over the mucosal surface (in case of influenza vaccine, intranasal route may be the most suited route) to assure mucosal immunity which is the first hand armament against influenza virus. This article reviews our work on intranasal administration of inactivated influenza virus HA vaccines. Since influenza vaccines are usually given to people who has some degree of immunity due to past infection or immunization, vaccines which have booster effect are preferable. In this context, intranasally administered inactivated influenza HA vaccine was more immunogenic than cold adapted reassortant live influenza virus vaccine, another candidate mucosal influenza virus vaccine, which is now under investigation in the United States.

Administration, Intranasal↗

Chronic rhinoviral infection in lung transplant recipients.

RATIONALE: Lung transplant recipients are particularly at risk of complications from rhinovirus, the most frequent respiratory virus circulating in the community. OBJECTIVES: To determine whether lung transplant recipients can be chronically infected by rhinovirus and the potential clinical impact. METHODS: We first identified an index case, in which rhinovirus was isolated repeatedly, and conducted detailed molecular analysis to determine whether this was related to a unique strain or to re-infection episodes. Transbronchial biopsies were used to assess the presence of rhinovirus in the lung parenchyma. The incidence of chronic rhinoviral infections and potential clinical impact was assessed prospectively in a cohort of 68 lung transplant recipients during 19 mo by screening of bronchoalveolar lavages. MEASUREMENTS AND MAIN RESULTS: We describe 3 lung transplant recipients with graft dysfunctions in whom rhinovirus was identified by reverse transcriptase-polymerase chain reaction in upper and lower respiratory specimens over a 12-mo period. In two cases, rhinovirus was repeatedly isolated in culture. The persistence of a unique strain in each case was confirmed by sequence analysis of the 5'NCR and VP1 gene. In the index case, rhinovirus was detected in the lower respiratory parenchyma. In the cohort of lung transplant recipients, rhinoviral infections were documented in bronchoalveolar lavage specimens of 10 recipients, and 2 presented with a persistent infection. CONCLUSIONS: Rhinoviral infection can be persistent in lung transplant recipients with graft dysfunction, and the virus can be detected in the lung parenchyma. Given the potential clinical impact, chronic rhinoviral infection needs to be considered in lung transplant recipients.

Adolescent↗

In vitro activity of expanded-spectrum pyridazinyl oxime ethers related to pirodavir: novel capsid-binding inhibitors with potent antipicornavirus activity.

Picornaviruses (PV) include human rhinovirus (HRV), the primary cause of the common cold, and the enteroviruses (EV), which cause serious diseases such as poliomyelitis, meningoencephalitis, and systemic neonatal disease. Although no compounds for PV infections have been approved in the United States, pirodavir was one of the most promising capsid-binding compounds to show efficacy in human clinical trials for chemoprophylaxis of the common cold. Susceptibility to hydrolysis precluded its use as an oral agent. We have developed orally bioavailable pyridazinyl oxime ethers that are as potent as pirodavir. Compounds BTA39 and BTA188 inhibited a total of 56 HRV laboratory strains and three clinical isolates as determined by neutral red uptake assay. At concentrations of <100 nM, BTA39 inhibited 69% of the HRV serotypes and isolates evaluated, BTA188 inhibited 75%, and pirodavir inhibited 59% of the serotypes and isolates. The 50% inhibitory concentrations (IC(50)s) for the two compounds ranged from 0.5 nM to 6,701 nM. The compounds also inhibited EV, including coxsackie A and B viruses (IC(50) = 773 to 3,608 nM) and echoviruses (IC(50) = 193 to 5,155 nM). BTA39 only inhibited poliovirus strain WM-1 at 204 nM, and BTA188 only inhibited poliovirus strain Chat at 82 nM. EV 71 was inhibited by BTA39 and BTA188, with IC(50)s of 1 and 82 nM, respectively. Both compounds were relatively nontoxic in actively growing cells (50% cytotoxic doses, >/=4,588 nM). These data suggest that these oxime ethers warrant further investigation as potential agents for treating selected PV infections.

Animals↗

Human major group rhinoviruses downmodulate the accessory function of monocytes by inducing IL-10.

Human rhinoviruses (HRVs) are the predominant cause of the common cold. Although this disease is per se rather harmless, HRV infection is considered to set the stage for more dangerous pathogens in vivo. Here we demonstrate that HRV-14, a member of the major group HRV family, can efficiently inhibit antigen-induced T-cell proliferation and T-cell responses to allogeneic monocytes. HRV-14 triggered a significant downregulation of MHC class II molecules on monocytes. Moreover, supernatants from monocytes cultured in the presence of HRV-14 strongly reduced the allogeneic T-cell stimulatory property of untreated monocytes and monocyte-derived dendritic cells (md-DCs), whereas Epstein Barr virus-transformed B-lymphoblastoid cells were not sensitive. Analysis of the supernatant revealed that HRV-14 induced the production of significant amounts of the immunosuppressive cytokine IL-10. The important T-cell stimulatory cytokine IL-12 or the proinflammatory cytokines IL-1beta or TNF-alpha were not detected or were only minimally detected. Finally, monocytes pretreated with HRV-14 were greatly inhibited in their production of IL-12 upon stimulation with IFN-gamma/LPS. These observations suggest that altered cytokine production in mononuclear phagocytes upon interaction with HRV downmodulates appropriate immune responses during the viral infection.

Antigens, CD↗

Necrotizing lymphadenitis: a review of clinicopathological, immunohistochemical and ultrastructural studies.

Necrotizing lymphadenitis (NEL) has been reported to be a reactive process described under differing terminology by Fujimoto et al. (1972), Kikuchi (1972), Wakasa et al. (1973) and other Japanese pathologists. Recently, this type of lymphadenitis has also been reported in America and Europe. In Japan, NEL is observed more frequently in the northern area, however, no characteristic seasonal occurrence has been noted. The disease affects young females more than males, particularly from the third and fourth decades onwards. Common cold-like symptoms, lymphadenopathy of the cervical region and leukopenia are characteristic clinical findings in the early stages. Morphological features of the involved lymph nodes include the presence of numerous immunoblasts, histiocytes and macrophages, the latter with phagocytized nuclear debris derived from degenerated lymphocytes. However, granulocytes are generally absent. Tubular inclusions are observed ultrastructurally. Immunohistochemical studies of peripheral blood using monoclonal antibodies have revealed that the helper/suppressor (Leu 3a/2a) ratio increases gradually with the clinical course because of a decrease in Leu 2a + cells. The pathogenesis of NEL is uncertain, but it has been speculated that there is cytolytic infection of lymphocytes by a virus or other organism, accompanied by secondary blastic transformation of suppressor T-lymphocytes.

Diagnosis, Differential↗

Prophylactic activity of intranasal enviroxime against experimentally induced rhinovirus type 39 infection.

Intranasal administration of enviroxime by aerosol spray was associated with drug levels in nasal secretions that 1 h later averaged 750-fold higher than those inhibitory for rhinoviruses in vitro (0.2 microgram/ml). However, administration of intranasal enviroxime (one spray per nostril, five times per day) to susceptible volunteers, beginning 1 day before and continuing for 4 days after virus exposure, did not significantly reduce infection or illness due to experimentally induced rhinovirus type 39 infection. The combined results of two separate trials yielded an infection rate of 100% for 21 placebo-treated and 89% for 19 enviroxime-treated subjects. Approximately one-half of the volunteers in each group had seroconversion to the challenge virus. Overall, 52% of the placebo-treated and 53% of the enviroxime-treated subjects developed colds. No significant differences in symptom scores, nasal mucus weights, or numbers of nasal tissues used were observed between the two groups. Two-thirds of the enviroxime-treated volunteers noted intranasal irritation immediately after sprays, as compared with only one-third of the placebo-treated subjects.

Administration, Oral↗

Bacterial meningitis in Malawian adults: pneumococcal disease is common, severe, and seasonal.

We prospectively collected laboratory details and outcome data on all patients with laboratory-confirmed cases of meningitis that presented to our unit in Blantyre, Malawi, from 1 April 1998 through 31 March 1999. There were 502 patients with cases of meningitis; the most common causative organisms were Cryptococcus neoformans and Streptococcus pneumoniae. This pattern probably reflects the local human immunodeficiency virus (HIV) seroprevalence (31%) and is different from the pattern in 1974, when Neisseria meningitidis was the most common isolate. There has been an 8-fold increase in the number of meningitis cases per year since 1974, and a doubling of the percentage of medical admissions due to meningitis. The inpatient mortality rate among patients with cases of pneumococcal meningitis was 61%, and in the group as a whole was 41%. Despite the HIV-related pattern of infecting pathogens among these cases of meningitis and the increased incidence of the condition, there was evidence that the typical seasonal pattern of pneumococcal meningitis, which peaks in the cold, dry season, was preserved.

Adult↗

Viral upper respiratory tract infections in young children with emphasis on acute otitis media.

Viral upper respiratory infection is the most common reason for seeking medical care for children. Recurrent viral respiratory infections and subsequent complications (e.g. acute otitis media (AOM)) are a burden for children, their families and society. Over the past decade, our knowledge on the significance of respiratory viruses has broadened remarkably. Viruses cause large variety of respiratory diseases and cause alone diseases, which previously have been assumed to be bacterial only (e.g. AOM and pneumonia). Methods for detection analysis of respiratory viruses are developing making both the diagnosis and epidemiological investigations of respiratory infections easier. Accurate diagnosis of respiratory infections and awareness of possible viral etiology could reduce the use of antibiotics. Etiologic studies of viral infections are becoming increasingly important, with the emergence of new antiviral drugs and vaccines.

Acute Disease↗

[An acute syndrome of opsoclonus and body tremulousness. A case report of benign encephalitis].

A 30-year-old woman was admitted to our hospital in May 1977, suffering from oscillation, body tremulousness and astasia-abasia. Two months prior to admission she had caught a common cold and felt paresthesia on the right arm. Three days before admission, she had photophobia, tremulousness of the trunk and head, and astasia-abasia. A neurological examination revealed difficulty in standing, and jerky movement of the body and right arm, her limbs were well coordinated. An ocular examination resulted in normal findings except for intermittent oscillation of the eyeballs. As the pupils and fundi were normal, so were the routine laboratory tests. The cerebrospinal fluid was clear and colorless under normal pressure, and showed no more than 6 mononuclear cells in any of the three examinations. CSF protein was registered 20 mg/dl, glucose 75 mg/dl, and no virus titers were elevated. Electroencephalogram was slightly abnormal due to a slowing of the Alpha wave in the background activity. Both computerized tomography and vertebral-angiography were normal. A slow and steady abatement of all symptoms started while she was taking steroid treatment in hospital. Electrooculogram showed irregular disconjugation of the eyes rotating or moving in horizontal and vertical direction. There movements conjugated or disconjugated in both eyes with 5-7 Hz of frequency and 10-20 degrees of amplitude. They decreased when the eyelids were closed or staying in a dark room. These ocular movements were regarded as opsoclonus. Then opsoclonus changed to flutter-like oscillation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Sequence comparisons of A/AA/6/60 influenza viruses: mutations which may contribute to attenuation.

Influenza virus infection is a worldwide public health threat. Cold-adaptation was used to develop a vaccine line (ca A/AA/6/60 H2N2) which promised to reduce the morbidity and mortality associated with influenza and to serve as a model for other live virus vaccines. This study establishes that two distinct lines of wt A/AA/6/60 viruses exist with different phenotypic and genotypic characteristics. The two virus lines have the same parent but different passage histories. The first line is both temperature sensitive (ts) and attenuated in ferrets and the second line (after multiple passages in chick kidney cells, eggs and mice) is non-ts and virulent in ferrets. Both lines of viruses have been further differentiated by sequence analysis. We have identified point mutations common to all virulent viruses but absent from the attenuated viruses. This was accomplished by comparing the nucleotide sequences of the six internal genes in three different attenuated passages of A/AA/6/60 with those of five different virulent passages of the same virus. The corresponding nucleotides of the attenuated viruses, therefore, represent candidate attenuating lesions: 6 in the basic polymerase genes (5 in PB1, 1 in PB2), 2 in the acidic polymerase gene (PA), 1 in the matrix (M) gene, 2 in the non-structural (NS) gene, and none in the nucleoprotein (NP) gene. Two of the 5 attenuating lesions in PB1 are silent; 1/2 in PA is silent; and 1/2 in NS is silent. Further changes which might be identified by comparing nucleotide and amino acid sequences of the A/AA/6/60 viruses with those of other influenza viruses may also contribute to the attenuation of the ca virus. Our study identifies nucleotides which more precisely define virulence for this virus and suggests that growth of the virus at low temperature may have preserved a non-virulent virus population rather than attenuating a virulent one.

Animals↗

A case of granular lymphocyte proliferation with T-cell phenotype.

Immunological studies were conducted on a case of granular lymphocytosis with benign clinical feature. A 60-year-old Japanese woman was found incidentally to have lymphocytosis when she had a common cold. A complete blood count showed 47,200 leukocyte per mm3 with 82% granular lymphocytes, 8% small lymphocytes and others. Hemoglobin was 11.5 g/dl and platelet count was 365 X 10(3)/mm3. Surface marker study revealed erythrocyte-rosettes 94%, Leu-1 59%, Leu-2a 70%, Leu-3a 14%, Leu-4 98%, Leu-7 57%, Leu-11 5%, HLA-DR 92%, BA-2 6%, common ALL antigen 4%, and surface immunoglobulin 2%. These results suggest granular lymphocyte proliferation with T-cell phenotype. Natural killer activity was 4.5%, but it was elevated to 11.4% after interleukin-2 stimulation by 2 days' culture. Human T-cell lymphotropic virus-I antibody was absent. No lymphadenopathy and no hepatosplenomegaly were seen, except for bone marrow infiltration of granular lymphocytes. The patient has been in good health without any acute distress. The leukocyte count has gradually decreased to 12,300/mm3 with 79% lymphocytes in 6 months of follow-up without any therapy. This case is suggestive of benign lymphocytosis, although similar cases have been reported previously as chronic lymphocytic leukemia with T-cell marker and/or natural killer function.

Female↗

Tat-human immunodeficiency virus-1 induces human monocyte chemotaxis by activation of vascular endothelial growth factor receptor-1.

Human immunodeficiency virus-1 (HIV-1) Tat protein can be released by infected cells and activates mesenchymal cells. Among these, monocytes respond to Tat by migrating into tissues and releasing inflammatory mediators. In the present study, we have examined the molecular mechanism of monocyte activation by Tat, showing that this viral protein signals inside the cells through the tyrosine kinase receptor for vascular endothelial growth factor encoded by fms-like tyrosine kinase gene (VEGFR-1/Flt-1). Subnanomolar concentrations of Tat induced monocyte chemotaxis, which was inhibited by cell preincubation with vascular-endothelial growth factor-A (VEGF-A). This desensitisation was specific for VEGF-A, because it not was observed with FMLP. In addition, the soluble form of VEGFR-1 specifically inhibited polarization and migration induced by Tat and VEGF-A, thus confirming the common use of this receptor. Binding studies performed at equilibrium by using radiolabeled Tat showed that monocytes expressed a unique class of binding site, with a kd of approximately 0.2 nmol/L. The binding of radiolabeled Tat to monocyte surface and the cross-linking to a protein of 150 kD was inhibited specifically by an excess of cold Tat or VEGF-A. Western blot analysis with an antibody anti-VEGFR-1/Flt-1 performed on monocyte phosphoproteins immunoprecipitated by an monoclonal antibody anti-phosphotyrosine showed that Tat induced a rapid phosphorylation in tyrosine residue of the 150-kD VEGFR-1/Flt-1. Taken together, these results suggest that biologic activities of HIV-1 Tat in human monocytes may, at least in part, be elicited by activation of VEGFR-1/Flt-1.

Antibodies, Monoclonal↗

Use of IgM-hepatitis A antibody testing. Investigating a common-source, food borne outbreak.

An outbreak of hepatitis, type A, affecting 30 employees of a large metropolitan department store was investigated using traditional case findings, a food preference questionnaire, and case-control methods. In addition, the new serological tests for IgM and IgG antibody to hepatitis A virus (anti-HAV) were employed to establish a serological diagnosis of hepatitis A infection, to define the control group, and to identify the index case, an asymptomatic food handler. Twenty-five of 25 cases tested had IgM anti-HAV, whereas none of 73 controls and one of 46 food handlers were IgM anti-HAV positive. This test eliminated three suspect cases that were diagnosed as hepatitis but that had atypical epidemiologic features. Epidemiologic and serological analysis confirmed the association of illness with eating in the employees' cafeteria and eating cold sandwiches.

Acute Disease↗

Recombination patterns in aphthoviruses mirror those found in other picornaviruses.

Foot-and-mouth disease virus (FMDV) is thought to evolve largely through genetic drift driven by the inherently error-prone nature of its RNA polymerase. There is, however, increasing evidence that recombination is an important mechanism in the evolution of these and other related picornoviruses. Here, we use an extensive set of recombination detection methods to identify 86 unique potential recombination events among 125 publicly available FMDV complete genome sequences. The large number of events detected between members of different serotypes suggests that horizontal flow of sequences among the serotypes is relatively common and does not incur severe fitness costs. Interestingly, the distribution of recombination breakpoints was found to be largely nonrandom. Whereas there are clear breakpoint cold spots within the structural genes, two statistically significant hot spots precisely separate these from the nonstructural genes. Very similar breakpoint distributions were found for other picornovirus species in the genera Enterovirus and Teschovirus. Our results suggest that genome regions encoding the structural proteins of both FMDV and other picornaviruses are functionally interchangeable modules, supporting recent proposals that the structural and nonstructural coding regions of the picornaviruses are evolving largely independently of one another.

Aphthovirus↗

Virological and serological analysis of rhinovirus infections during the first two years of life in a cohort of children.

The occurrence of rhinovirus infections in a cohort of 329 children during the first 2 years of life was determined by virus detection and serological methods. Rhinovirus detection on nasopharyngeal aspirates and middle ear fluids comprised a combination of virus isolation in HeLa Ohio cells and a reverse transcription-polymerase chain reaction (RT-PCR)-hybridization assay on the inoculated cell cultures. Nasopharyngeal aspirates were collected when the child was referred to the study clinic because of respiratory symptoms. Nasopharyngeal aspirates and middle ear fluids were collected after clinical diagnosis of an acute otitis media. Complement-fixing antibodies to rhinovirus were determined from scheduled serum specimens collected at 6, 12, 18, and 24 months of age and from paired sera taken in the cases of acute otitis media. Rhinovirus infections were shown to be common in infants, 24% of the children had complement-fixing antibodies at the age of 6 months and 22% had had at least one rhinovirus episode indicated by virus detection. At the age of 2 years, 91.3% of the children had rhinovirus-specific antibodies, while 79% of the children had experienced rhinovirus infection as judged by the virus detection tests. However, the complement-fixation assay was poor as a diagnostic test. Of 458 acute otitis media episodes studied, 41% were shown to be associated with a rhinovirus by RT-PCR-hybridization, while significant fourfold rise in rhinoviral antibodies was detected only in 7% of the cases.

Acute Disease↗

Tolerance and efficacy of intranasal administration of recombinant beta serine interferon in healthy adults.

We performed two studies to determine the dose-related tolerance and the efficacy of recombinant beta serine interferon (rIFN-beta ser) in experimental rhinovirus infection. In the tolerance study, 120 healthy adults received intranasal sprays of rIFN-beta ser or placebo daily for 25 d. No differences in nasal symptoms were found. Rhinoscopy detected more mucosal bleeding sites in high-dose (38%) versus low-dose (12.5%) or placebo (12.5%) recipients. There were more subepithelial lymphocytes in nasal biopsy specimens in the high-dose (54%) than the low-dose (17%) or placebo (17%) groups. In the efficacy study, 34 volunteers received daily nasal drops of IFN, beginning 36 h before challenge and for three days afterwards. The numbers of infections and days of shedding of virus were not reduced, but colds occurred less often in the high-dose (25%) than in the low-dose (55%) or placebo (64%) recipients. Nasal mucus weights were lower in the high-dose (mean +/- SD g per five days; 5 +/- 4) than placebo (31 +/- 37) recipients. Thus, rIFN-beta ser may have a more favorable therapeutic ratio than do previously tested alpha interferons.

Administration, Intranasal↗

Effect of live attenuated, cold recombinant (CR) influenza virus vaccines on pulmonary function in healthy and asthmatic adults.

The effects of intranasal inoculation with live attenuated, CR influenza virus vaccines on pulmonary function in healthy and asthmatic adults were evaluated in placebo-controlled, double-blind studies. In 46 healthy adult volunteers, there were no statistically significant alterations in pulmonary function as measured by spirometry and histamine bronchoprovocation tests in the first week following monovalent CR influenza virus vaccine [type A (H3N2, H1N1) and type B]. Among healthy adults with pre-inoculation PC20s less than 10 mg ml-1, 8/12 were infected following vaccination but no significant alterations occurred in histamine bronchoprovocation. In 11 asthmatic adults, no statistically significant alterations in pulmonary function, as measured by spirometry, were noted during the first 7 days postinoculation with bivalent CR influenza virus vaccine type A (H3N2 and H1N1). Postinoculation respiratory illnesses were more common in CR influenza virus vaccine recipients than placebo recipients, but they were mild, consisting of afebrile pharyngitis and transient rhinorrhea. Attenuated CR influenza virus vaccines do not appear to impair pulmonary function during the first week following immunization of healthy and asthmatic adults.

Adolescent↗