Theophylline metabolism in acute asthma with MxA‐indicated viral infection

Febrile children are often given antibiotics empirically and unnecessarily. MxA is a protein induced in peripheral lymphoid cells by type 1 interferons during active viral infection. The ability of a whole blood ELISA assay for MxA to identify children with viral illness was studied in 122 children who presented with acute onset fever and 52 age-matched healthy controls. The febrile children were divided into three groups according to their final diagnoses: etiologically diagnosed viral infection, clinically diagnosed viral infection, and bacterial infection. MxA levels in the bacterial infection group and controls were similar and low (90.9 Ϯ 69.7 and 76.9 Ϯ 63.2 ng/mL, respectively). In contrast, mean MxA levels in the two viral infection groups were higher than in both the bacterial and control groups (719.2 Ϯ 386.4 and 827.0 Ϯ 651.1, respectively). A receiver operating characteristic analysis showed that the area under the curve of the MxA level was greater than under the curves of both the white blood cell count and the C-reactive protein concentration. Whole blood assay of MxA is a clinically useful tool for diagnosing viral illness in febrile children and should help reduce use of unnecessary antibiotics. (Pediatr Res 60: 770-774, 2006)

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MxA-Based Recognition of Viral Illness in Febrile Children by a Whole Blood Assay

Nakabayashi

Adachi

Itazawa

et al. 2006

Pediatr Res

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Interferon-Inducible Myxovirus Resistance Proteins: Potential Biomarkers for Differentiating Viral from Bacterial Infections

et al. 2019

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BACKGROUND In 2015, the 68th World Health Assembly declared that effective, rapid, low-cost diagnostic tools were needed for guiding optimal use of antibiotics in medicine. This review is devoted to interferon-inducible myxovirus resistance proteins as potential biomarkers for differentiating viral from bacterial infections. CONTENT After viral infection, a branch of the interferon (IFN)-induced molecular reactions is triggered by the binding of IFNs with their receptors, a process leading to the activation of mx1 and mx2, which produce antiviral Mx proteins (MxA and MxB). We summarize current knowledge of the structures and functions of type I and III IFNs. Antiviral mechanisms of Mx proteins are discussed in reference to their structural and functional data to provide an in-depth picture of protection against viral attacks. Knowing such a mechanism may allow the development of countermeasures and the specific detection of any viral infection. Clinical research data indicate that Mx proteins are biomarkers for many virus infections, with some exceptions, whereas C-reactive protein (CRP) and procalcitonin have established positions as general biomarkers for bacterial infections. SUMMARY Mx genes are not directly induced by viruses and are not expressed constitutively; their expression strictly depends on IFN signaling. MxA protein production in peripheral blood cells has been shown to be a clinically sensitive and specific marker for viral infection. Viral infections specifically increase MxA concentrations, whereas viruses have only a modest increase in CRP or procalcitonin concentrations. Therefore, comparison of MxA and CRP and/or procalcitonin values can be used for the differentiation of infectious etiology.

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Aminophylline for treating asthma and chronic obstructive pulmonary disease

Nuhoğlu

2008

Expert Review of Respiratory Medicine

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Aminophylline is a complex of theophylline and ethylenediamine. Its main pharmacological action is relaxation of bronchial smooth muscle. Two meta-analyses examining the efficacy of aminophylline in acute asthma attacks in children and in adults have been reported by the Cochrane Collaboration. In the meta-analysis reporting results from studies in children, it was concluded that aminophylline does not add any benefit to standard care. Yet one study, which has the largest patient population, reports that aminophylline improves lung functions within 6-8 h and reduces the risk of intubation. The meta-analysis examining adult studies revealed that there is no outstanding difference between aminophylline and standard therapy in the management of adult acute asthma. In conclusion, aminophylline may be an alternative to intravenous infusion of beta-agonists, heliox or magnesium sulfate administration in children in whom respiratory fatigue begins to develop and intensive-care unit admission and mechanical ventilation seems to be the next treatment in line. However, in adults, it is not recommended for use in the treatment of acute asthma owing to its possible adverse effects.

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Theophylline metabolism in acute asthma with MxA‐indicated viral infection

Abstract: Viral infection appeared to affect theophylline metabolism. Flow cytometric assay of lymphoid MxA protein expression in whole blood is an easy and useful method of evaluating viral infection in acute asthma exacerbation.

Cited by 4 publications

References 24 publications

MxA-Based Recognition of Viral Illness in Febrile Children by a Whole Blood Assay

MxA-Based Recognition of Viral Illness in Febrile Children by a Whole Blood Assay

Interferon-Inducible Myxovirus Resistance Proteins: Potential Biomarkers for Differentiating Viral from Bacterial Infections

Aminophylline for treating asthma and chronic obstructive pulmonary disease

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