Geppe Natalia A, Zaplatnikov Andrey L, Kondyurina Elena G, Chepurnaya Maria M, Kolosova Natalia G
Filatov Clinical Institute of Children's Health, Sechenov First Moscow State Medical University, Moscow 119435, Russia.
Russian Medical Academy of Continuous Professional Education, Moscow 123242, Russia.
Microorganisms. 2023 Mar 28;11(4):858. doi: 10.3390/microorganisms11040858.
The common cold, which is mostly caused by respiratory viruses and clinically represented by the symptoms of acute respiratory viral infections (ARVI) with mainly upper respiratory tract involvement, is an important problem in pediatric practice. Due to the high prevalence, socio-economic burden, and lack of effective prevention measures (except for influenza and, partially, RSV infection), ARVI require strong medical attention. The purpose of this descriptive literature review was to analyze the current practical approaches to the treatment of ARVI to facilitate the choice of therapy in routine practice. This descriptive overview includes information on the causative agents of ARVI. Special attention is paid to the role of interferon gamma as a cytokine with antiviral and immunomodulatory effects on the pathogenesis of ARVI. Modern approaches to the treatment of ARVI, including antiviral, pathogenesis-directed and symptomatic therapy are presented. The emphasis is on the use of antibody-based drugs in the immunoprophylaxis and immunotherapy of ARVI. The data presented in this review allow us to conclude that a modern, balanced and evidence-based approach to the choice of ARVI treatment in children should be used in clinical practice. The published results of clinical trials and systematic reviews with meta-analyses of ARVI in children allow us to conclude that it is possible and expedient to use broad-spectrum antiviral drugs in complex therapy. This approach can provide an adequate response of the child's immune system to the virus without limiting the clinical possibilities of using only symptomatic therapy.
普通感冒主要由呼吸道病毒引起,临床上以急性呼吸道病毒感染(ARVI)症状为表现,主要累及上呼吸道,是儿科实践中的一个重要问题。由于其高发病率、社会经济负担以及缺乏有效的预防措施(除流感和部分呼吸道合胞病毒感染外),ARVI需要得到强有力的医学关注。本描述性文献综述的目的是分析当前治疗ARVI的实际方法,以方便在常规实践中选择治疗方案。这一描述性概述包括有关ARVI病原体的信息。特别关注γ干扰素作为一种对ARVI发病机制具有抗病毒和免疫调节作用的细胞因子的作用。介绍了治疗ARVI的现代方法,包括抗病毒治疗、针对发病机制的治疗和对症治疗。重点是基于抗体的药物在ARVI免疫预防和免疫治疗中的应用。本综述中提供的数据使我们得出结论,在临床实践中应采用现代、平衡且基于证据的方法来选择儿童ARVI的治疗方案。已发表的关于儿童ARVI的临床试验结果以及带有荟萃分析结果的系统评价使我们得出结论,在综合治疗中使用广谱抗病毒药物是可行且适宜的。这种方法可以使儿童免疫系统对病毒做出充分反应,同时又不限制仅使用对症治疗的临床可能性。