The molecular epidemiology of respiratory viruses associated with asthma attacks: A single-center observational study in Japan.
The molecular epidemiology of respiratory viruses associated with asthma attacks: A single-center observational study in Japan.
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DOI：
10.1097/md.0000000000008204
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发表时间：
2017-10
期刊：
影响因子：
1.6
通讯作者：
Takizawa H
中科院分区：
文献类型：
--
作者：
Saraya T;Kimura H;Kurai D;Ishii H;Takizawa H
很少有报告描述病毒性呼吸道感染（VRI）在成人患者哮喘恶化中的重要性。本研究的目的是阐明沿着分子流行病学的成人哮喘患者的VRI谱。2012年8月至2015年5月在杏林大学医院进行了一项横断面观察性研究。为了确定呼吸道病原体在住院患者和门诊患者患有哮喘发作，RT-PCR/测序/系统发育分析方法应用与传统的微生物方法。对10种病毒进行了系统发育和成对距离分析。共有106例哮喘发作患者在住院（n = 49）和门诊（n = 57）设置入组本研究。 共106份呼吸道样本来自鼻咽拭子（n = 68）或痰液（n = 38）。 在这些患者中，确定了单独病毒（n = 39）、病毒和细菌（n = 5）以及单独细菌（n = 5）的患者。 住院患者和门诊患者中病毒感染者分别占总感染者的31.1%（n = 33）和10.4%（n = 11）。 住院患者中病毒阳性患者的频率（75.3%，n = 33）显著高于门诊患者（19.3%，n = 11）。 主要VRI包括人鼻病毒（HRV）（n = 24）、人偏肺病毒（hMPV）（n = 9）、流感病毒（Inf-V）（n = 8）和呼吸道合胞病毒（RSV）（n = 3）感染，具有季节性变化。 HRV-A和HRV-C是最常见的病毒，在系统发育分析中存在广泛的遗传差异。成人哮喘急性发作与VRI（如HRV-A或HRV-C、hMPV、RSV和Inf-V感染）高度相关，具有季节性变化和遗传差异，但哮喘发作患者在整个季节中发生VRI的频率相似。
Few reports have described the significance of viral respiratory infections (VRIs) in exacerbation of asthma in adult patients. The aim of this study was to elucidate the profiles of VRIs in adult patients with asthma along with their molecular epidemiology. A cross-sectional observational study was conducted at Kyorin University Hospital from August 2012 to May 2015. To identify respiratory pathogens in inpatients and outpatients suffering from asthma attacks, RT-PCR/sequencing/phylogenetic analysis methods were applied alongside conventional microbiological methods. Phylogenetic and pairwise distance analyses of 10 viruses were performed. A total of 106 asthma attack patients enrolled in this study in both inpatient (n = 49) and outpatient (n = 57) settings. The total 106 respiratory samples were obtained from nasopharyngeal swab (n = 68) or sputum (n = 38). Among these, patients with virus alone (n = 39), virus and bacterial (n = 5), and bacterial alone (n = 5) were identified. The ratio of virus-positive patients in inpatient or outpatient to the total cases were 31.1% (n = 33) and 10.4% (n = 11), respectively. The frequency of virus-positive patients was significantly higher in inpatients (75.3%, n = 33) than in outpatients (19.3%, n = 11). Major VRIs included human rhinovirus (HRV) (n = 24), human metapneumovirus (hMPV) (n = 9), influenza virus (Inf-V) (n = 8), and respiratory syncytial virus (RSV) (n = 3) infections with seasonal variations. HRV-A and HRV-C were the most commonly detected viruses, with wide genetic divergence on phylogenetic analysis. Asthmatic exacerbations in adults are highly associated with VRIs such as HRV-A or HRV-C, hMPV, RSV, and Inf-V infections with seasonal variations and genetic divergence, but similar frequencies of VRIs occurred in asthma attack patients throughout the seasons.