Department of Pediatrics, Division of Allergy, Immunology, and Pulmonary Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
J Clin Virol. 2013 Aug;57(4):291-9. doi: 10.1016/j.jcv.2013.04.015. Epub 2013 May 25.
While the discovery of HRV-Cs is recent, there are no indications that they are new viruses, or that they are emerging in real-time. Genetically, HRV-Cs are most closely related to the members of HRV-A and HRV-B but even a small genetic difference can impart encompass significant changes to their clinical impact, complicated by a diverse human background of prior virus exposure and underlying host immune and disease variability. It is well known that HRVs are a major trigger of asthma exacerbations and HRV-Cs are now under investigation for their potential involvement in asthma inception. The newly described HRV-Cs account for a large proportion of HRV-related illness, including common colds and wheezing exacerbations. HRV-Cs are genetically diverse and appear to circulate with seasonal variation, exchanging dominance with HRV-A. Whether HRV-Cs are consistently more pathogenic or "asthmagenic" is unproven. Antigenic diversity complicates passive and active prophylactic interventions (i.e. antibodies or vaccines), so further identification and characterisation of individual types (and their neutralising antigens) is likely to inform future preventive strategies. In the meantime, new antivirals should benefit groups at risk of the most severe disease.
虽然 HRV-C 的发现时间较晚,但并没有迹象表明它们是新型病毒,也没有实时出现的迹象。从遗传学角度来看,HRV-C 与 HRV-A 和 HRV-B 的成员最为密切相关,但即使是很小的遗传差异也可能对其临床影响产生重大变化,这使得情况变得更加复杂,因为人类之前的病毒暴露和潜在的宿主免疫和疾病变异性存在多样性。众所周知,HRV 是哮喘恶化的主要诱因,目前正在研究 HRV-C 是否可能与哮喘的发生有关。新描述的 HRV-C 占与 HRV 相关疾病的很大一部分,包括普通感冒和喘息加重。HRV-C 的遗传多样性很大,似乎随着季节变化而传播,与 HRV-A 交替占主导地位。HRV-C 是否始终更具致病性或“哮喘性”尚未得到证实。抗原多样性使被动和主动预防干预(即抗体或疫苗)变得复杂,因此进一步鉴定和描述各个类型(及其中和抗原)可能会为未来的预防策略提供信息。与此同时,新的抗病毒药物应该使最易患重病的人群受益。