Relationship Between Rotavirus and TLRs and Research Progress of Traditional Chinese Medicine / 中国实验方剂学杂志

Rotavirus (RV) infection of human body is mainly colonized in human intestinal epithelial cells, which results in small intestinal epithelial cell damage, and then induces diarrhea, fever and other symptoms. It is one of the most common causes of infantile diarrhea. Toll-like receptors (TLRs), as a kind of pattern recognition receptors, play an important role in the host immune system after virus infection. After different viruses infect human body, various pathogens trigger the host immune response through TLRs, induce the release of various cytokines, and stimulate a series of inflammatory reactions, such as fever, cough and diarrhea, which may further lead to more serious adverse consequences. According to the findings, the anti-inflammatory and anti-viral mechanisms of various effective drugs developed for different pathogens may be closely related to the intervention of TLRs signaling pathway and the regulation of immune response. A large number of studies have shown that rotavirus infection can induce inflammation by affecting the expressions of related proteins and genes in Toll-like receptor 3 (TLR3) and Toll-like receptor 4 (TLR4) signal transduction pathways, stimulating the release of inflammatory cytokines and inducing inflammatory response. Some studies on the mechanism of drug treatment for rotavirus diarrhea also started with TLRs, but only a few clinical and experimental studies on traditional Chinese medicine(TCM) and rotavirus diarrhea involve TLRs signaling pathway. Therefore, this article will focus on the relationship between TLRs signaling pathway and different viral infections, especially with rotavirus infection, in three aspects:viral infection and TLRs signaling pathway, RV infection and TLRs signaling pathway, and the research of traditional Chinese medicine in the treatment of rotavirus diarrhea, in order to guide the clinical and experimental studies on the treatment of rotavirus diarrhea with TCM based on TLR3 and TLR4 signaling pathways.

Expanded Indian National Rotavirus Surveillance Network in the Context of Rotavirus Vaccine Introduction.

Objective: To extend a nation-wide rotavirus surveillance network in India, and to generate geographically representative data on rotaviral disease burden and prevalent strains. Design: Hospital-based surveillance. Setting: A comprehensive multicenter, multi-state hospital based surveillance network was established in a phased manner involving 28 hospital sites across 17 states and two union territories in India. Patients: Cases of acute diarrhea among children below 5 years of age admitted in the participating hospitals. Results: During the 28-month study period between September 2012 and December 2014, 11898 children were enrolled and stool samples from 10207 children admitted with acute diarrhea were tested; 39.6% were positive for rotavirus. Highest positivity was seen in Tanda (60.4%) and Bhubaneswar (60.4%) followed by Midnapore (59.5%). Rotavirus infection was seen more among children aged below 2 years with highest (46.7%) positivity in the age group of 12-23 months. Cooler months of September – February accounted for most of the rotavirus-associated gastroenteritis, with highest prevalence seen during December – February (56.4%). 64% of rotavirus-infected children had severe to very severe disease. G1 P[8] was the predominant rotavirus strain (62.7%) during the surveillance period. Conclusions: The surveillance data highlights the high rotaviral disease burden in India. The network will continue to be a platform for monitoring the impact of the vaccine.

Rotavirus diarrhea in Vietnam 1998-2003

Over 5 years we have conducted sentinel surveillance for rotavirus at six hospitals in Vietnam. More than 10,000 children less than 5 years old were admitted with diarrhea with fecal specimens screened for rotavirus. Overall, 55% were positive and there is variability in rates of rotavirus detection between sites (44%-62%). The older age children become infected, the higher percentage of rotavirus detected. the rotavirus strains appear to be the common type.

Rotavirus acute gastroenteritis among Filipino children

This is a prospective study aimed to determine the clinical profile of pediatric patients less than 5 years old with rotavirus diarrhea seen at the Philippine General Hospital from August 1-September 15, 2001. Ninety-one patients with acute diarrhea were included in the study. Of these 39 patients (42.9 percent) had rotavirus antigen in the stool as detected by the ELISA method. The mean age of the patients was 11.5 months with 61.5 percent of the patients belonging to the 7-12 months of age, mostly well-nourished. The stools were described as watery (74.4 percent), yellow in color (84.7 percent), with no pus, red blood cells or parasite. Average duration of diarrhea prior to consultation was 2.5 +/- 1.8 days with 7 episodes per day. Vomiting, fever and concomitant upper respiratory tract infection were noted in 76.9 percent, 64 percent and 23.7 percent of the patients respectively. A comparison of the rotavirus versus bacterial etiology of diarrhea showed fever and vomiting to be more predominant in rotavirus while dehydration was noted in bacterial isolates. Antibiotic was noted to be given to 38.5 percent rotavirus cases. Increased awareness of rotavirus diarrhea, regarding its high incidence and clinical profile, will help guide physicians in their rational use of antibiotics for patients with acute diarrhea