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Epidemiology and potential methods for prevention of neonatal intestinal viral infections
R H Yolken1, Y Maldonado, J Kinney
1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Insights
Neonatal gastrointestinal viral infections, including rotavirus, cause significant illness. Promising prevention strategies involve oral immunoglobulins, glycoprotein inhibitors, and protease inhibitors, showing success in animal models.
Area of Science:
- Gastroenterology
- Virology
- Neonatal Medicine
Background:
- Neonatal viral gastrointestinal infections are a significant health concern.
- Enteric viruses like rotavirus contribute to severe conditions such as necrotizing enterocolitis.
- High-risk neonates are particularly vulnerable to these infections.
Purpose of the Study:
- To explore potential strategies for preventing and treating viral infections in the neonatal gastrointestinal tract.
- To evaluate novel therapeutic approaches for reducing morbidity and mortality in neonates.
Main Methods:
- Investigating the use of antiviral immunoglobulins, particularly via oral administration for enhanced mucosal efficacy.
- Examining inhibitors targeting specific viral glycoproteins to block cell entry.
- Assessing the potential of protease inhibitors to disrupt viral replication cycles.
Main Results:
- Antiviral immunoglobulins, glycoprotein inhibitors, and protease inhibitors have demonstrated efficacy in inhibiting rotavirus in experimental animal models.
- Oral immunoglobulin administration may offer superior antiviral effects compared to serum concentrations.
Conclusions:
- Several promising methods exist for preventing and treating neonatal enteric viral infections.
- Successful human application of these strategies could significantly decrease illness and death in high-risk infants.
- Further research is warranted to translate these findings into clinical practice.
Abstract:
Viral infections of the gastrointestinal tract remain a major problem during the neonatal period. In addition to causing acute diarrhea, rotaviruses and other enteric viruses may be involved in the pathogenesis of necrotizing enterocolitis and other neonatal enteric diseases. There are several potential methods for the prevention and treatment of gastrointestinal viral infections. Antiviral immunoglobulins might be used to inhibit intestinal viral replication. Since only small concentrations of serum immunoglobulins are present at mucosal surfaces, oral administration of immunoglobulins might be utilized to maximize antiviral efficacy. Alternatively, inhibitors of specific glycoproteins of virus-cell binding might be used to prevent the productive infection of intestinal epithelial cells. In addition, since many enteric viruses require proteolytic enzymes for protein cleavage, protease inhibitors may prove effective for inhibition of intestinal viral replication. At this time, these methods have proven useful for the inhibition of rotavirus infection in experimental animals. The successful application of these and other methods for the prevention of enteric infections in humans might substantially reduce the morbidity and mortality associated with enteric diseases in high-risk neonates.