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Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children

BACKGROUND: Upper respiratory tract infections (URTIs), including rhinitis, nasopharyngitis, tonsillitis and otitis media (OM), comprise of 88% of total respiratory infections, especially in children. Therefore effective prevention and treatment of RTIs remain a high priority worldwide. Preclinical...

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Autores principales: Feleszko, Wojciech, Marengo, Ricardo, Vieira, Antonio Sousa, Ratajczak, Karol, Mayorga Butrón, José Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6850198/
https://www.ncbi.nlm.nih.gov/pubmed/30920131
http://dx.doi.org/10.1111/coa.13335
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author Feleszko, Wojciech
Marengo, Ricardo
Vieira, Antonio Sousa
Ratajczak, Karol
Mayorga Butrón, José Luis
author_facet Feleszko, Wojciech
Marengo, Ricardo
Vieira, Antonio Sousa
Ratajczak, Karol
Mayorga Butrón, José Luis
author_sort Feleszko, Wojciech
collection PubMed
description BACKGROUND: Upper respiratory tract infections (URTIs), including rhinitis, nasopharyngitis, tonsillitis and otitis media (OM), comprise of 88% of total respiratory infections, especially in children. Therefore effective prevention and treatment of RTIs remain a high priority worldwide. Preclinical and clinical data highlight the rationale for the use and effectiveness of immunity‐targeted approaches, including targeted immunisations and non‐specific immunomodulation in the prevention and management of recurrent upper RTIs. OBJECTIVE OF REVIEW: The idea of this review was to summarise the current evidence and address key questions concerning the use of conservative and immunity‐targeted approaches to recurrent and chronic URTIs, with a focus on the paediatric population. SEARCH STRATEGY/EVALUATION METHOD: Literature searches were conducted in March 2017 and updated in September 2017 using: Academic Search Complete; CENTRAL; Health Source: Nursing/Academic Edition; MEDLINE; clinicaltrials.gov; and Cochrane databases. In total, 84 articles were retrieved and reviewed. Two independent researchers focused on primary and secondary endpoints in systematic reviews, meta‐analyses and randomised, controlled trials, using immunity‐directed strategies as the control group or within a subpopulation of larger studies. Existing guidelines and interventional/observational studies on novel applications were also included. RESULTS: Children are particularly susceptible to RTIs due to the relative immaturity of their immune systems, as well as other potential predisposing factors such as day care attendance and/or toxic environmental factors (eg increased pathogenic microbial exposure and air pollutants). Recurrent URTIs can affect otherwise healthy children, leading to clinical sequelae and complications, including the development of chronic conditions or the need for surgery. Available pre‐clinical and clinical data highlight the rationale for the use and effectiveness of immunity‐targeted approaches, including targeted immunisations (flu and pneumococcal vaccines) and non‐specific immunomodulation (bacterial lysates), in the prevention and management of recurrent croup, tonsillitis, otitis media, recurrent acute rhinosinusitis and chronic rhinosinusitis. CONCLUSIONS: In this review, we summarise the current evidence and provide data demonstrating that some immunity‐targeted strategies, including vaccination and immunomodulation, have proved effective in the treatment and prevention of recurrent and chronic URTIs in children.
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spelling pubmed-68501982019-11-18 Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children Feleszko, Wojciech Marengo, Ricardo Vieira, Antonio Sousa Ratajczak, Karol Mayorga Butrón, José Luis Clin Otolaryngol Original Articles BACKGROUND: Upper respiratory tract infections (URTIs), including rhinitis, nasopharyngitis, tonsillitis and otitis media (OM), comprise of 88% of total respiratory infections, especially in children. Therefore effective prevention and treatment of RTIs remain a high priority worldwide. Preclinical and clinical data highlight the rationale for the use and effectiveness of immunity‐targeted approaches, including targeted immunisations and non‐specific immunomodulation in the prevention and management of recurrent upper RTIs. OBJECTIVE OF REVIEW: The idea of this review was to summarise the current evidence and address key questions concerning the use of conservative and immunity‐targeted approaches to recurrent and chronic URTIs, with a focus on the paediatric population. SEARCH STRATEGY/EVALUATION METHOD: Literature searches were conducted in March 2017 and updated in September 2017 using: Academic Search Complete; CENTRAL; Health Source: Nursing/Academic Edition; MEDLINE; clinicaltrials.gov; and Cochrane databases. In total, 84 articles were retrieved and reviewed. Two independent researchers focused on primary and secondary endpoints in systematic reviews, meta‐analyses and randomised, controlled trials, using immunity‐directed strategies as the control group or within a subpopulation of larger studies. Existing guidelines and interventional/observational studies on novel applications were also included. RESULTS: Children are particularly susceptible to RTIs due to the relative immaturity of their immune systems, as well as other potential predisposing factors such as day care attendance and/or toxic environmental factors (eg increased pathogenic microbial exposure and air pollutants). Recurrent URTIs can affect otherwise healthy children, leading to clinical sequelae and complications, including the development of chronic conditions or the need for surgery. Available pre‐clinical and clinical data highlight the rationale for the use and effectiveness of immunity‐targeted approaches, including targeted immunisations (flu and pneumococcal vaccines) and non‐specific immunomodulation (bacterial lysates), in the prevention and management of recurrent croup, tonsillitis, otitis media, recurrent acute rhinosinusitis and chronic rhinosinusitis. CONCLUSIONS: In this review, we summarise the current evidence and provide data demonstrating that some immunity‐targeted strategies, including vaccination and immunomodulation, have proved effective in the treatment and prevention of recurrent and chronic URTIs in children. John Wiley and Sons Inc. 2019-04-14 2019-07 /pmc/articles/PMC6850198/ /pubmed/30920131 http://dx.doi.org/10.1111/coa.13335 Text en © 2019 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Feleszko, Wojciech
Marengo, Ricardo
Vieira, Antonio Sousa
Ratajczak, Karol
Mayorga Butrón, José Luis
Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
title Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
title_full Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
title_fullStr Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
title_full_unstemmed Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
title_short Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
title_sort immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6850198/
https://www.ncbi.nlm.nih.gov/pubmed/30920131
http://dx.doi.org/10.1111/coa.13335
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