Liang Yaowen, Wei Jie, Shen Jianjun, Liang Zihao, Ma Xiuchang, Du Yuchen, Qian Wenxian, Dong Hui, Huang Ping, Chen Apeng, Yi Changhua
The Second Hospital of Nanjing, Affiliated Hospital to Nanjing University of Chinese Medicine, Nanjing, China.
Department of Chinese Medicine, The Second Hospital of Nanjing, Affiliated Hospital to Nanjing University of Chinese Medicine, Nanjing, China.
Ital J Pediatr. 2025 Jan 9;51(1):4. doi: 10.1186/s13052-024-01836-1.
Human adenovirus is an infectious agent that causes respiratory infections in adults and children. It has been found that immunocompromised children are highly susceptible to this pathogen, as it can swiftly evolve into severe pneumonia with multiple sequelae. Due to the lack of immunity in children, the body's response mechanisms to innate and acquired immunity are specialized. We first examined the infection classification and clinical characteristics associated with adenovirus in children. Subsequently, we explored the in-depth understanding of the pathogenic mechanism of adenovirus pneumonia in children, focusing on immunological and cellular biological aspects. Adenovirus infection in children can disrupt the balance of the innate immune response, inducing immune cells to secrete an abundance of pro-inflammatory cytokines. This cascade results in a cytokine storm, which triggers an inflammatory response and causes lung tissue damage. As a result, the infection may progress to a severe state, potentially leading to multi-organ failure. Immunocompromised children exhibit impaired immune cell numbers and functions, which affects both the secretion of antibodies to humoral immunity and the immune response of cellular immunity to adenovirus. Lastly, we reviewed the progress in treating adenovirus pneumonia in children. There are many treatments for adenovirus pneumonia in children, which must be personalized based on a thorough assessment to optimize treatment outcomes. Recent advancements in pharmaceutical development have provided new treatment options for children. Immunomodulatory therapy can reduce inflammation in children, while adjuvant therapy can improve respiratory function; however, it can also lead to complications. Further, co-infections increased the complexity of diagnosis and treatment, necessitating dynamic adjustments to treatment regimens. This review could serve as the basis for identifying potential therapeutic approaches to alleviate the symptoms associated with adenovirus infections in children.
人腺病毒是一种可导致成人和儿童呼吸道感染的病原体。研究发现，免疫功能低下的儿童极易感染这种病原体，因为它可迅速演变成伴有多种后遗症的重症肺炎。由于儿童缺乏免疫力，其机体对固有免疫和获得性免疫的反应机制具有特殊性。我们首先研究了与儿童腺病毒感染相关的感染分类和临床特征。随后，我们深入探讨了儿童腺病毒肺炎的致病机制，重点关注免疫学和细胞生物学方面。儿童腺病毒感染会破坏固有免疫反应的平衡，诱导免疫细胞分泌大量促炎细胞因子。这一连串反应会引发细胞因子风暴，进而触发炎症反应并导致肺组织损伤。结果，感染可能会发展到严重状态，有可能导致多器官功能衰竭。免疫功能低下的儿童免疫细胞数量和功能受损，这会影响体液免疫中抗体的分泌以及细胞免疫对腺病毒的免疫反应。最后，我们回顾了儿童腺病毒肺炎的治疗进展。儿童腺病毒肺炎有多种治疗方法，必须在全面评估的基础上进行个性化治疗，以优化治疗效果。药物研发的最新进展为儿童提供了新的治疗选择。免疫调节疗法可减轻儿童炎症，辅助疗法可改善呼吸功能；然而，它也可能导致并发症。此外，合并感染增加了诊断和治疗的复杂性，需要动态调整治疗方案。这篇综述可为确定减轻儿童腺病毒感染相关症状的潜在治疗方法提供依据。
