Dissertation committee:
Τσιόδρας Σωτήριος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κρούπης Χρήστος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νανάς Σεραφείμ, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μπούμπας Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βασιλειάδης Ιωάννης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πιτταράς Θεόδωρος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ρούτση Χριστίνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
In a first epidemiological study of 604 patients who visited a Tertiary Hospital ER, we identified the causes of viral respiratory infections by molecular methods and examined clinical-epidemiological correlations. The study focused on mixed viral respiratory infections, for which little evidence is published in the literature. A significant number of respiratory infections with mixed viral infection were observed in the current study that evaluated both adults and children. Most of the mixed infections observed were co-infections with RSV and influenza viruses.
Mixed viral infections were associated with younger age and increased rates of fever but were not associated with increased rates of hospitalization. We could not statistically associate the presence of mixed viral infections with underlying co-morbidities. However, mixed viral infections appeared to be more common than individual viral infections in patients with severe underlying diseases such as COPD patients and patients with cardiovascular disease.
In a second pilot study of 76 patients, we described the correlations of levels of cytokines belonging to the IL-17 family of cytokine levels with specific viral respiratory infections documented by a molecular method. Elevated levels of major cytokines participating in the Th17 response were detected in laboratory confirmed type A H3N2 influenza compared to other types of influenza, RSV virus and other respiratory viruses in this study.
This marked Th17 response at the cytokine level may be involved in the pathogenesis and immune control of acute influenza A H3N2 infection. Similar findings for infection with PIV viruses are indicative of involvement of the Th17 immune response pathway in the control of parainfluenza virus infection. Future exploitation of this cytokine pathway for diagnostic, therapeutic and prognostic purposes is essential and can greatly assist in the management of common but potentially serious viral respiratory infections.
Keywords:
Influenza, H3N2, Respiratory viruses, Interleukins, RSV, Immunity
