Evaluation of nasal levels of interferon and clinical severity of influenza in children.

BACKGROUND: Experimental data show that type I interferon has a key role in innate immune response against influenza infection. OBJECTIVE: We compared nasal levels of interferon-α2 and ß among inpatients and outpatients with influenza. STUDY DESIGN: Children younger than 5 years of age with influenza-like illness seeking care at the emergency department within the first 72 h of disease onset were prospectively included. Clinical and demographic data and secretions through nasal wash were obtained. Influenza infection was assessed through reverse-transcription polymerase chain reaction and nasal levels of interferon-α2 and ß were measured by enzyme-linked immunosorbent assay. All patients followed until the end of the disease. RESULTS: One hundred patients were included, of which 24 had confirmed influenza infection, and 5 of them were hospitalized. Subtypes A (H3N2) and B were confirmed in 10 and 14 patients, respectively. Seventy-six patients without influenza, including 48% of outpatients, were recruited as controls. All hospitalized patients were significantly younger regardless of influenza status (age <6 months in 59% vs. 23.2%, p < 0.001). All other data were similar among the groups. Comparing median levels of interferon-α2 among children with influenza, levels were significantly higher in outpatients than in hospitalized patients and were 263.2 pg/mL (25-75 interquartile range: 58.3-634) and detectable in only one patient (90 pg/mL), respectively. The levels of interferon-α2 in controls and those of interferon-ß in all groups were not detected. CONCLUSIONS: Higher levels of interferon-α2 in patients with less severe influenza reinforce experimental evidence about the protective role of interferon-α2 against influenza infection.

A network flow approach to predict protein targets and flavonoid backbones to treat respiratory syncytial virus infection.

BACKGROUND: Respiratory syncytial virus (RSV) infection is the major cause of respiratory disease in lower respiratory tract in infants and young children. Attempts to develop effective vaccines or pharmacological treatments to inhibit RSV infection without undesired effects on human health have been unsuccessful. However, RSV infection has been reported to be affected by flavonoids. The mechanisms underlying viral inhibition induced by these compounds are largely unknown, making the development of new drugs difficult. METHODS: To understand the mechanisms induced by flavonoids to inhibit RSV infection, a systems pharmacology-based study was performed using microarray data from primary culture of human bronchial cells infected by RSV, together with compound-proteomic interaction data available for Homo sapiens. RESULTS: After an initial evaluation of 26 flavonoids, 5 compounds (resveratrol, quercetin, myricetin, apigenin, and tricetin) were identified through topological analysis of a major chemical-protein (CP) and protein-protein interacting (PPI) network. In a nonclustered form, these flavonoids regulate directly the activity of two protein bottlenecks involved in inflammation and apoptosis. CONCLUSIONS: Our findings may potentially help uncovering mechanisms of action of early RSV infection and provide chemical backbones and their protein targets in the difficult quest to develop new effective drugs.

Dermatitis herpetiformis as the only manifestation of celiac disease: case report and literature review / Dermatite herpetiforme como única manifestação de doença celíaca: relato de caso e revisão da literatura

Aims: To present a case of dermatitis herpetiformis, a papulovesicular rash due to deposits of immunoglobulin A in the papillary dermis. This is a common extraintestinal manifestation of celiac disease, although rare in childhood.Case description: A 10-year-old girl was diagnosed with celiac disease, suspected only due to the occurrence of typical lesions of dermatitis herpetiformis. Intestinal biopsy demonstrated total atrophy of duodenal villi in spite of the lack of clinical digestive manifestations. Under a gluten-free diet the patient presented favorable evolution, with regression of cutaneous lesions.Conclusions: Dermatitis herpetiformis is a common manifestation of celiac disease, but is not frequent in infants. Therefore, is very important to investigate any child that presents a chronic papulovesicular cutaneous eruption non-responsive to usual treatments in order to perform a precocious diagnosis of celiac disease, avoiding its serious repercussions...

Objetivos: Apresentar um caso de dermatite herpetiforme, uma erupção cutânea papulovesicular pruriginosa devida ao depósito de imunoglobulina A na derme papilar. Esta é uma manifestação extraintestinal comum da doença celíaca, embora rara na infância.Relato de caso: Uma paciente com 10 anos de idade foi diagnosticada com doença celíaca, cuja suspeita surgiu unicamente em decorrência de lesões típicas de dermatite herpetiforme. A biópsia intestinal demonstrou atrofia total das vilosidades duodenais, apesar da ausência de manifestações clínicas digestivas. Com dieta livre de glúten a paciente apresentou evolução favorável, com regressão das lesões cutâneas.Conclusões: A dermatite herpetiforme é uma manifestação comum da doença celíaca que, no entanto, é infrequente na infância. Por isso, é fundamental alto grau de suspeição em qualquer criança que apresentar uma erupção cutânea papulovesicular crônica não responsiva a medidas simples, a fim de realizar o diagnóstico precoce da doença celíaca, evitando suas graves repercussões...

Los contaminantes atmosféricos urbanos son factores de riesgo significativos para el asma y la neumonía en niños: influencia del lugar de medición de los contaminantes / Urban Air Pollutants are Significant Risk Factors for Asthma and Pneumonia in Children: The Influence of Location on the Measurement of Pollutants

Antecedentes: La contaminación atmosférica se asocia a una carga sustancial para la salud humana; sin embargo, los contaminantes de mayor importancia pueden variar según el lugar. Es necesaria una monitorización adecuada para determinar el efecto de dichos contaminantes sobre la salud respiratoria. Objetivos: Este estudio se diseñó para evaluar el papel de la exposición en el exterior, en el interior y personal a los contaminantes derivados de la combustión NO2 y O3 sobre la salud respiratoria de los niños en una zona urbana económicamente poco favorecida de São Paulo (Brasil). Métodos: Se determinaron de forma continua los niveles de NO2 y O3 en el aire del exterior, el interior, y también en la exposición personal, durante 30 días con el empleo de aparatos de medición pasiva. Se evaluó la salud respiratoria con una versión en brasileño del cuestionario ISAAC. Resultados: Se dispuso de datos completos de 64 niños de 6 a 10 años de edad. La morbilidad respiratoria fue alta, con 43 (67,2%) niños en los que había habido sibilancias en alguna ocasión, 27 (42,2%) con sibilancias en el mes anterior, 17 (26,6%) con asma en alguna ocasión y 21 (32,8%) con neumonía en alguna ocasión. Las correlaciones entre los niveles de NO2 y O3 determinados en las 3 localizaciones evaluadas fueron bajas. Los niveles de NO2 en el área de interior y la exposición personal a O3 mostraron una asociación independiente con el asma (p=0,02 en ambos casos), la neumonía (O3, p=0,02) y la presencia de sibilancias en alguna ocasión (p<0,01 en ambos casos). No se observaron asociaciones entre el NO2 y el O3 del exterior y la salud respiratoria(AU)

Conclusiones: La exposición a niveles más elevados de NO2 y O3 se asoció a un aumento del riesgo de asma y neumonía en los niños; sin embargo, el lugar en el que se determinan los contaminantes influye en los resultados. Las determinaciones realizadas en el interior y las determinaciones personales fueron las más exactas(AU)

Background: Air pollution is associated with a substantial burden on human health; however, the most important pollutants may vary with location. Proper monitoring is necessary to determine the effect of these pollutants on respiratory health. Objectives: This study was designed to evaluate the role of outdoor, indoor and personal exposure to combustion-related pollutants NO2 and O3 on respiratory health of children in a non-affluent urban area of São Paulo, Brazil. Methods: Levels of NO2 and O3 were continuously measured in outdoor and indoor air, as well as personal exposure, for 30 days using passive measurement monitors. Respiratory health was assessed with a Brazilian version of the ISAAC questionnaire. Results: Complete data were available from 64 children, aged 6-10 years. Respiratory morbidity was high, with 43 (67.2%) reporting having had wheezing at any time, 27 (42.2%) wheezing in the last month, 17 (26.6%) asthma at any time and 21 (32.8%) pneumonia at any time. Correlations between levels of NO2 and O3 measured in the three locations evaluated were poor. Levels of NO2 in indoor air and personal exposure to O3 were independently associated with asthma (both cases P=0.02), pneumonia (O3, P=0.02) and wheezing at any time (both cases P<0.01). No associations were seen between outdoor NO2 and O3 and respiratory health. Conclusions: Exposure to higher levels of NO2 and O3 was associated with increased risk for asthma and pneumonia in children. Nonetheless, the place where the pollutants are measured influences the results. The measurements taken in indoor and personal exposure were the most accurate(AU)