Made available in DSpace on 2015-12-06T23:46:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2013 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: O resfriado comum a uma das sindromes infecciosas mais frequentes na infancia, sendo causado por um grupo numeroso de virus, podendo vir acompanhado de complicacoes e uma significativa morbidade. Constitui uma das principais causas de consultas em servicos de atendimento primario a Saúde e um dos principais motivos para o uso indevido de antibioticos.! OBJETIVOS. Descrever a ocorrencia, etiologia, evolucao clinica, uso de antibioticos e absenteismo no trabalho dos responsaveis dos casos de resfriados comuns dentre as criancas atendidas em um servico de atencao primaria a Saúde na cidade de São Paulo. METODOS. No periodo de mar/2008 a fev/2009, foi selecionada uma amostra de casos de criancas menores de 12 anos com diagnostico de resfriado comun com inicio ate cinco dias, as quais foram acompanhadas ate a resolucao completa do quadro. Foram excluidos casos com suspeita de infeccoes bacterianas secundarias, cardiopatias congenitas, doencas pulmonares cronicas, imunodefiCiências e historico de prematuridade. Os dados clinicos foram anotados em formularios padronizados e as amostras de lavado de nasofaringe (uma por caso) foram submetidas a uma ou mais tecnicas laboratoriais (imunofluorescencia direta, reacao da polimerase em cadeia e reacao da polimerase em cadeia em tempo real) para a deteccao de rinovirus (HRV), virus sincicial respiratorio (RSV), parainfluenza 1, 2 e 3 (PIV1-3), adenovirus (AdV), metapneumovirus (hMPV), bocavirus (HBoV), influenza A e B (IFVA e IFVB), coronavirus (HCoV) e enterovirus (HEV). RESULTADOS. Os resfriados representaram 29,0% de todas as consultas medicas (955/3282). Foi obtida uma amostra de 134 casos, com media de idade de 3,6 anos (med 2,6 a). Em 73,8% (99/134) dos casos foi detectado pelo menos um virus, tendo sido o HRV (41,0%) e o IFVA (17,2%) os mais frequentes. O tempo medio de duracao dos sintomas foi de 8,8 dias, nao tendo havido diferencas nas medias de duracao dos sintomas associados aos diferentes virus. A coriza (91,8%) e a tosse (90,3%) foram as manifestacoes mais frequentes, sendo que o quadro associado aos diferentes virus foi semelhante, exceto pelos casos com HRV que apresentaram menos febre (p=0,025) e com IFVB que apresentaram menos tosse (p=0,001). As coinfeccoes ocorreram em 30,3% dos casos (30/99) e nao apresentaram diferencas com relacao as manifestacoes clinicas, ocorrencia de complicacoes e media de duracao dos sintomas quando comparadas aos casos com monoinfeccoes, O indice de complicacoes foi de 11,9%, porem, os antibioticos foram prescritos em 39,6% dos casos, tendo sido a maior parte das prescricoes consideradas indevidas. Foi verificada uma media de 1,5 consultas e 1,0 dia de absenteismo por caso de resfriado. CONCLUSAO. Apesar de considerados patologias benignas, os resfriados foram responsaveis por um alto indice de uso indevido de antibioticos, consultas medicas e dias de absenteismo no trabalho. A ampliacao das faixas etarias para as vacinas disponiveis no sistema publico de Saúde, a disponibilizacao de testes diagnosticos rapidos para os virus respiratorios e o estimulo a educacao medica continuada poderiam contribuir para melhorar o cenario atual possibilitando uma profilaxia mais ampla, o diagnostico rapido e o uso racional de antibioticos / INTRODUCTION. The common cold are caused by a large group of viruses and is one of the most frequent infectious syndromes in childhood which can be followed by complications and a significant morbidity. They are a major cause of consultations in primary care services and a major reason for the misuse of antibiotics. OBJECTIVES. To describe the occurence, etiology, clinical course, complications, use of antibiotics, number of consultations and days of work absenteeism of parents in cases of common colds in children attending an outpatient primary health care service in São Paulo city. METHODS. From mar/2008 to Feb/2009, we selected a sample of cases of children under 12 years diagnosed with common colds starting up to five days, which were followed until resolution of symptoms. We excluded cases with suspected secondary bacterial infections, congenital heart disease, chronic lung diseases, immunodeficiencies and history of prematurity. Clinical data were recorded on a standardized form and samples of nasopharyngeal wash (one for each case) were subjected to one or more laboratory techniques (direct immunofluorescence, polymerase chain reaction and real time polymerase chain reaction) for detection of rhinovirus (HRV), respiratory syncytial virus (RSV), parainfluenza virus 1, 2 and 3 (PIV1-3), adenovirus (AdV), metapneumovirus (hMPV) Bocavirus (HBoV), influenza A and B (IFVA and IFVB ), coronavirus (HCoV) and enterovirus (HEV). RESULTS. Colds accounted for 29.0% of all medical consultations (955/3282). We obtained a sample of 134 cases of common cold cases, with a mean age of 3.6 years (med 2.6). At least one virus was detected in 73.8% (99/134) of cases and HRV (41.0%) and IFVA (17.2%) were the most frequent viral agents. The mean time of symptoms was 8.8 days, with no differences among different types of viruses. Coriza (91.8%) and cough (90.3%) were the most frequent symptoms, and the clinical characteristics among different types of viruses were similar, except for the fact that cases with HRV had less fever (p = 0.025) and with IFVB had less cough (p = 0.001). The coinfections occurred in 30.3% of cases (30/99) and were not different with respect to clinical manifestations, rate of complications and duration of symptoms when compared to cases with monoinfections. The complication rate was 11.9%, however, antibiotics were prescribed in 39,6% of cases, with most prescriptions considered improper. The average of doctos visits and lost work days was 1.5 visits and 1.0 days of absenteeism per case of common cold. CONCLUSION. Although considered benign diseases, common colds were responsible for a high rate of antibiotics misuse, doctor visits and days of work absenteeism. A wider coverage for all ages with vaccines available in the Brazilian public health system, the availability of rapid diagnostic tests for respiratory viruses and the continuous medical education could improve the current scenario and promote a broader prevention, rapid diagnosis and rational use of antibiotics. / BV UNIFESP: Teses e dissertações

Certains virus respiratoires comme rhinovirus semblent favoriser la colonisation par staphylococcus aureus. Cependant, les détails des mécanismes impliqués dans cette synergie n’ont pas été suffisamment élucidés. Le but de cette thèse a été de développer et valider un modèle in vitro mimant la colonisation du vestibule nasal par s. aureus en utilisant les kératinocytes humains hacat. Ce modèle a permis d’étudier (i) les pouvoirs d’adhésion et d’internalisation d’une collection de souche clinique de s. aureus, (ii) l’efficacité intracellulaire des molécules antimicrobiennes utilisées dans le cadre de la décolonisation nasale de s. aureus, (iii) l’effet de la clarithromycine sur l’infection par rhinovirus et (iv) l’impact de l’infection par rhinovirus ou de l’inflammation non spécifique sur la colonisation par s. aureus. ce travail a principalement permis d’identifier un nouveau mécanisme alternatif de l’internalisation de s. aureus à travers la liaison entre la protéine bactérienne eap (extracellular adherence protein) et le récepteur cellulaire icam-1 (intracellular adhesion molecule 1). Cette voie alternative est favorisée en cas d’infection par rhinovirus ou d’inflammation, ce qui pourrait expliquer les observations cliniques de l’augmentation de la charge de s. aureus ou du risque d’infection par cette bactérie lors des infections virales respiratoires ou d’inflammation post-traumatique. Les résultats de cette thèse illustrent la complexité des interactions entre les cellules épithéliales de la muqueuse, s. aureus et les pathogènes viraux et ouvrent les perspectives sur d’autres études nécessaires afin de proposer des stratégies préventives ou thérapeutiques adaptées. / Some respiratory viruses such as rhinoviruses seem to promote staphylococcus aureus colonization. However, the details of the bacterial and cellular mechanisms involved in this synergy have not been sufficiently elucidated. The aim of this thesis was to develop and validate an in vitro model mimicking s. aureus colonization of the nasal vestibule by using hacat human keratinocytes. This model allowed to study (i) the adhesion and internalization capacities of various clinical s. aureus strains, (ii) the intracellular efficiency of the antimicrobial molecules used for s. aureus nasal decolonization, (iii) the effect of clarithromycin on rhinovirus infection, and (iv) the impact of rhinovirus infection and non-specific inflammation on s. aureus colonization. This work has mainly identified a new alternative mechanism for the internalization of s. aureus through the binding between the bacterial protein eap (extracellular adherence protein) and the cell receptor icam-1 (intracellular adhesion molecule 1). This alternative pathway is favored in case of rhinovirus infection or inflammation; which could explain the clinical observations of the increase of the load of s. aureus or the risk of infection by this bacterium during respiratory viral infections or post-traumatic inflammations. The results of this thesis illustrate the complexity of the interactions between the mucosal epithelial cells, s. aureus and viral pathogens and suggest that other studies are needed to propose appropriate preventive or therapeutic strategies.

The project was undertaken to monitor a group of 30 foals on a farm both clinically and microbiologically from birth until one year of age, to determine the aetiology of upper respiratory tract infections and to establish immune profiles of some of the known respiratory viral pathogens. One to two months prior to the birth of their foals, blood for serology was collected from the mares. The same specimens were collected from the foals just after birth, prior to suckling and a day after suckling. Thereafter the foals were examined monthly for the presence of respiratory disease and specimens taken. The following specimens were collected from each foal: three nasopharyngeal swabs, (one for virus isolation, one for bacteria and fungus isolation, and one for mycoplasma isolation) and blood that was allowed to clot. Blood was collected in heparin from sick foals with elevated rectal temperatures. Virus isolation was done on roller tube cultures of equine embryonic lung (EEL), Vero cells and rabbit kidney 13 (RK13) cells. The bacteria (including mycoplasmas) and fungi were cultured from the swabs and identified using a variety of traditional methods. The serum neutralization test (SNT) was used to detect antibodies to equid herpesvirus 1 (EHV-1), equid herpesvirus 4 (EHV-4), equine rhinovirus 1 (ERV-1), equine rhinovirus 2 (ERV-2) and equine adenovirus 1 (EAdV-1). The complement fixation test (CFT) was used to detect antibodies to EHV-1 and EHV-4 and the haemagglutination inhibition test (HIT) antibodies to equine influenzavirus (EIV). Only EHV-4 was cultured from the nasopharyngeal swabs of nine foals when they were 5 to 6 months of age and from one foal two months later. A wide variety of bacteria and fungi were cultured and it was established that coagulase-negative staphylococci, viridans streptococci, Moraxella spp. and Flavobacterium spp. predominated in most of the samples. Several potential bacterial pathogens were isolated but the most common were Streptococcus equi subsp. zooepidemicus, Actinobacillus equuland Staphylococcus aureus. Colostrum-derived antibodies were detected for all the viruses in all but two of the foals. It was found that the foals had similar or slightly higher titres than their mothers. The levels declined in direct proportion to what they initially were and were depleted by the time the foals were 2 to 7 months of age. Antibodies to natural infection was detected to EHV-4, ERV-2 and EAdV-1. A rise in antibody titres occurred when the foals were 5 to 6 months of age, two months later and when they were one year of age. Antibodies resulting from immunization was detected to EHV-1, EHV-4 and EIV. It was established that the most important virus causing upper respiratory tract disease of the foals from 5 to 12 months of age was EHV-1 with EAdV-1 playing a minor role. These viruses caused repeated bouts of infection with a two to five months interval. Streptococcus equi subsp. zooepidemicus was considered to be the most important secondary pathogen. Prior to this period most of the foals were healthy with only a few suffering from upper respiratory disease. The aetiology was not determined in these cases, but based on the bacteriology results, it was suspected that some of them were suffering from bacterial infections. / Dissertation (MSc (Veterinary Science))--University of Pretoria, 2005. / Veterinary Tropical Diseases / unrestricted

<div>Viruses are a group of contagious microbes that have compact structures, containing a nucleic acid core and a protein shell. The replication of viruses requires assistance from hosts which can be almost any cellular organism. Viral infections are often associated with diseases and have been a major threat to the human race. To cope with viral diseases, we need to understand viruses, including their structures, life cycle, pathogenesis and interactions with their hosts. The first structure of a human virus was determined by the Rossmann lab in 1985 using X-ray crystallography.</div><div>Thanks to the recent advances in both hardware and software, cryo-electron microscopy (cryo-EM) has emerged as a powerful tool to study virus structures. Cryo-EM allows structural determination for a wide range of specimens to high resolution comparable to what can be achieved by X-ray crystallography. Currently two techniques of cryo-EM are commonly used in structural virology: single particles analysis (SPA) and electron tomography (ET). </div><div>Single particle analysis has been used to determine the structures of viruses complexed with host factors in three studies that are to be discussed with more details in chapters 2-4. </div><div>The structure of B19 parvovirus complexed with Fabs of a neutralizing human antibody was determined to 3.2 Å resolution. This structure showed that amino acids from three neighboring VP2 proteins form a quaternary structure epitope. In addition, the structure of human rhinovirus-C (RV-C) complexed with its cellular receptor, CDHR3, was determined to 3.9 Å resolution. Despite the low occupancy of the receptors, a “powerful” localized 3D classification procedure helped to select viral particles that had more bound receptors. Furthermore, structures were determined to 10 Å resolution of bacteriophage ΦX174 bound to lipopolysaccharide (LPS) bilayers, before and after genome ejection. These structures showed a series of conformational changes that occurred when a phage penetrated the bacterial membranes. These studies are good examples of applying cryo-EM to investigate virus-host interactions.</div><div>However, single particle analysis requires samples to be isolated, homogenous and monodispersed. On the contrary, tomography allows in situ studies and is applicable to samples with more flexibility and more heterogeneity. In the case of ΦX174, the structural changes that are involved in the assembly of the H-tube during infection remains a huge mystery. To provide an environment that is more similar to the surface of a bacterial cell, LPS-containing liposomes were mixed with ΦX174 viruses. It was then observed that the ΦX174 particles bound to these liposomes in a very compact manner which was impossible interpret with single particle analysis. Using cryo-ET, 3D volumes of liposome-ΦX174 complexes were reconstructed and structural details were visualized by sub-tomogram classification and averaging.</div><div>The emergence of cryo-EM has not only made high-resolution structural studies possible but also broadened the scope of samples with which virologists could work. Moreover, studies on flexible and heterogeneous complexes between viruses and host factors are now possible using either single particle analysis or electron tomography. These techniques will help us to understand virus-host relationships and finally, to develop effective anti-viral therapies.</div>

Rinovírus (RV) é freqüentemente detectado nos tecidos tonsilares e nas secreções de nasofaringe de pacientes com doença adenotonsilar crônica, sem sintomas de infecção respiratória aguda (IRA). O objetivo deste estudo foi investigar a infecção por rinovírus em tonsilas humanas, com base em dois aspectos: infecção in vivo de células linfóides de tonsilas humanas naturalmente infectadas; e infecção ex vivo de células dissociadas desses tecidos inoculadas com rinovírus, visando a contribuir para elucidar possíveis mecanismos de infecção em amígdalas palatinas e adenóides humanas. De um total de 104 pacientes com doenças adenotonsilar crônicas, 21.1% (22/104) e 42.3% (44/104) apresentaram respectivamente amígdalas palatinas e adenóides positivas para RV por PCR. A replicação viral foi confirmada por hibridização in situ com sonda para intermediário replicativo nas regiões internas e externas aos folículos linfóides de amígdalas e adenóides, bem como em porções do epitélio ciliado de adenoides, e apenas raramente nas células epiteliais escamosas de tonsilas palatinas. A presença e distribuição de proteína estrutural do capsídeo viral foi detectada por imunohistoquímica (IHQ), utilizando anticorpos contra proteínas estruturais virais VP1 e VP2 nas tonsilas positivas para RV por qPCR. Os resultados indicaram marcação positiva tanto na superfície (epitélio), quanto em regiões extrafoliculares e centros germinativos. Em seguida, foi possível verificar a co-localização da marcação positiva da proteína estrutural VP2 de RV com marcadores linfocitários de membrana. Células CD4 + e CD20 + apresentaram marcação positiva para VP2 verificada usando estratégia de \'sequential immuno-peroxidase labelling and erasing\' (SIMPLE). Culturas primárias de células linfomononucleares (CLMN) de tonsilas sabidamente negativas para RV por PCR, foram infectadas in vitro, com RV (MOI=1). A replicação de RV foi titulada por TCID50, mostrando aumento inicial (24 h) e subsequente queda após 48 horas. Por IF observamos que os fenótipos de CLMN infectadas com RV in vitro foram células T CD4 + e B, mas também com células CD8 +, CD56 + e CD33 +. RV não infectou células CD123 +. RV foi isolado em WI- 38 e HeLa a partir de tecidos e secreções de nasofaringe de pacientes com hipertrofia tonsilar sem sintomas de infecção respiratória aguda. Nossos resultados confirmam que tonsilas de pacientes sem sintomas respiratórios agudos podem ser reservatórios de RV, que infecta não somente epitélio, mas também CLMN (frequentemente linfócitos T CD4 + e linfócitos B). A detecção de RNA intermediário replicativo e proteínas estruturais VP1 e VP2 nas tonsilas hipertróficas, além do isolamento de vírus infeccioso a partir de tecidos e secreções nasofaríngeas, classificam tonsilas hipertróficas como sítios de infecção e replicação de RV, e sugerem que esses indivíduos hipertróficos são portadores assintomáticos de RV persistente, e podem ser importantes fontes de transmissão de RV na comunidade. / The chronic adenotonsillar diseases are frequent otorhinolaryngologic conditions caused by chronic inflammation of adenoids and palatine tonsils. Rhinovirus (RV) is highly frequently detected in secretions, and tonsillar tissues from patients experience chronic tonsillar hypertrophy without symptoms of ARI, and our goal is to full understanding of viral infections in hypertrophic tonsillar tissues by RV. Of 104 enrolled patients with adenotonsillar chronic diseases, 21.1% (22/104) and 42.3% (44/104) had palatine tonsils and adenoids positive for RV by qPCR, respectively. RV Viral replication was confirmed by in situ hybridizations. Minus-strand RNA were detected in all tested samples (7 tonsils and 9 adenoids), and positive reactions were seen inside and outside of lymphoid follicles from tonsils and adenoids, in the ciliated epithelium of the adenoids and rarely in positive squamous epithelium cells from tonsils. The presence of viral structural protein VP1 and VP2 was detected within and outside of the lymphoid follicles from tonsils and adenoids, and also in epithelial cells from adenoids by immunohistochemistry (IHC). Later, by sequential immuno-peroxidase labelling and erasing protocol (SIMPLE), we saw co-localization of RV VP2 capsid protein staining with CD4 positive cells and CD20 positive cells. We confirmed that RV could infect primary culture of tonsilar mononuclear cells (TMNCs). Additionally, intracellular replication of RV in TMNCs, measured by TCID50 in HeLa cells, had an initial increase in the first 24 hours, and dropped at 48 hours post infection. Immunolocalization staining with anti-RV and TMNCs surface markers indicated that phenotypes of susceptible cells were T-cells both CD4+ and CD20+, but also, we saw co-localization of VP-2 protein with CD8+ cells, CD56+ cells and CD33+ cells. RV-16 couldn\'t infect CD123+ cell in our experiments. Finally, we were able to recover 4 rhinoviruses by inoculating WI-38 fibroblast cells and HeLa cells, confirming by the cytopathic effect and immunofluorescence positive staining with anti-VP1 antibody. Taken together, our results indicate that tonsils and adenoids of patients without ARI may be reservoirs of replicating human rhinovirus, infecting manly Tcells CD4+ and CD20+ B-cells. The high-frequency detection of RNA (-) and VP1 expression in tissues from patients with chronic adenotonsillar diseases, plus the isolation of infectious viral particles, suggests that these detected agents replicate in the adenotonsillar tissues and this specific sites may be important sources of transmission of RV in the community.

Enteroviruses belong to the Picornaviridae family and are small icosahedral viruses with RNA genomes of positive polarity, containing a single open reading frame. They mostly cause mild or asymptomatic infections, but also a wide array of diseases including: poliomyelitis, encephalitis, gastroenteritis, aseptic meningitis, myocarditis, hand-foot-and-mouth disease, hepatitis and respiratory diseases, ranging from severe infections to the common cold. The projects described in this thesis have been carried out through reverse genetic studies of Enterovirus B and Rhinovirus C.                   In Papers I and II, a cassette vector was used to study recombination and translation of the RNA genome. It was found that the non-structural coding region could replicate when combined with the structural protein-coding region of other viruses of the same species. Furthermore, the genome could be translated and replicated without the presence of the structural protein-coding region. Moreover, it was found that when two additional nucleotides were introduced, shifting the reading frame, the virus could revert to the original reading frame, restoring efficient replication. In Paper III, a vector containing the genome of echovirus 5 was altered to produce an authentic 5’end of the in vitro transcribed RNA, which increased efficiency of replication initiation 20 times. This result is important, as it may lead to more efficient oncolytic virotherapy. An authentic 5’end was further used in Paper IV, where replication of Rhinovirus C in cell lines was attempted. Although passaging of the virus was unsuccessful, the genome was replicated and cytopathic effect induced after transfection. The restriction of efficient replication was therefore hypothesized to lie in the attachment and entry stages of the replication cycle. In Paper V, a cytolytic virus was found to have almost 10 times larger impact on gene expression of the host cell than a non-cytolytic variant. Furthermore, the lytic virus was found to build up inside the host cell, while the non-cytolytic virus was efficiently released.                   As a whole, this thesis has contributed to a deeper understanding of replication of enteroviruses, which may prove important in development of novel vaccines, antiviral agents and oncolytic virotherapies.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 7 uppsatser.

abstract: The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma exacerbation which can result in severe morbidity. Most human rhinovirus types utilize Intercellular Adhesion Molecule-1 (ICAM-1) as a receptor to enter cells and initiate infection. Expression of this cell-surface protein is elevated in the respiratory tract of asthma patients. The theoretical basis for this research is the observation that plasma measures of the soluble form of Intercellular Adhesion Molecule-1 (sICAM-1) decrease in response to vitamin C supplementation. As rhinovirus infection occurs in the upper respiratory tract, the primary aim of this study was to evaluate change in sICAM-1 concentration in nasal lavage of asthmatic individuals in response to vitamin C supplementation. Otherwise healthy asthmatic adults between the ages of 18-65 years who were not currently using steroidal nasal sprays, smoking, or actively training for competitive sports were recruited from a university community and surrounding area to participate in an 18-day double-blind randomized placebo-controlled supplement study with a parallel arm design. 13 subjects were stratified based on age, gender, BMI and baseline plasma vitamin C level to receive either 500 mg vitamin C twice daily (VTC, n=7) or placebo (PLC, n=6). Biochemical measures included nasal lavage sICAM-1, plasma sICAM-1, plasma histamine, and plasma vitamin C. Survey measures included Wisconsin Upper Respiratory Symptom Survey-21 to assess colds, Daytime Symptom Diary Scale to assess asthma symptoms, and measures of diet quality including a vitamin C food frequency questionnaire and Rapid Eating Assessment for Participants. No between group comparison of means reached significance (Mann-Whitney U test, p>0.05). Nasal lavage sICAM-1 levels were decreased in VTC group by 37% at study day 4, although this finding did not reach significance. Findings in this study can be used to develop future investigations into the response of nasal lavage sICAM-1 to vitamin C supplementation. / Dissertation/Thesis / Masters Thesis Nutrition 2014

Rinovírus (RV) é freqüentemente detectado nos tecidos tonsilares e nas secreções de nasofaringe de pacientes com doença adenotonsilar crônica, sem sintomas de infecção respiratória aguda (IRA). O objetivo deste estudo foi investigar a infecção por rinovírus em tonsilas humanas, com base em dois aspectos: infecção in vivo de células linfóides de tonsilas humanas naturalmente infectadas; e infecção ex vivo de células dissociadas desses tecidos inoculadas com rinovírus, visando a contribuir para elucidar possíveis mecanismos de infecção em amígdalas palatinas e adenóides humanas. De um total de 104 pacientes com doenças adenotonsilar crônicas, 21.1% (22/104) e 42.3% (44/104) apresentaram respectivamente amígdalas palatinas e adenóides positivas para RV por PCR. A replicação viral foi confirmada por hibridização in situ com sonda para intermediário replicativo nas regiões internas e externas aos folículos linfóides de amígdalas e adenóides, bem como em porções do epitélio ciliado de adenoides, e apenas raramente nas células epiteliais escamosas de tonsilas palatinas. A presença e distribuição de proteína estrutural do capsídeo viral foi detectada por imunohistoquímica (IHQ), utilizando anticorpos contra proteínas estruturais virais VP1 e VP2 nas tonsilas positivas para RV por qPCR. Os resultados indicaram marcação positiva tanto na superfície (epitélio), quanto em regiões extrafoliculares e centros germinativos. Em seguida, foi possível verificar a co-localização da marcação positiva da proteína estrutural VP2 de RV com marcadores linfocitários de membrana. Células CD4 + e CD20 + apresentaram marcação positiva para VP2 verificada usando estratégia de \'sequential immuno-peroxidase labelling and erasing\' (SIMPLE). Culturas primárias de células linfomononucleares (CLMN) de tonsilas sabidamente negativas para RV por PCR, foram infectadas in vitro, com RV (MOI=1). A replicação de RV foi titulada por TCID50, mostrando aumento inicial (24 h) e subsequente queda após 48 horas. Por IF observamos que os fenótipos de CLMN infectadas com RV in vitro foram células T CD4 + e B, mas também com células CD8 +, CD56 + e CD33 +. RV não infectou células CD123 +. RV foi isolado em WI- 38 e HeLa a partir de tecidos e secreções de nasofaringe de pacientes com hipertrofia tonsilar sem sintomas de infecção respiratória aguda. Nossos resultados confirmam que tonsilas de pacientes sem sintomas respiratórios agudos podem ser reservatórios de RV, que infecta não somente epitélio, mas também CLMN (frequentemente linfócitos T CD4 + e linfócitos B). A detecção de RNA intermediário replicativo e proteínas estruturais VP1 e VP2 nas tonsilas hipertróficas, além do isolamento de vírus infeccioso a partir de tecidos e secreções nasofaríngeas, classificam tonsilas hipertróficas como sítios de infecção e replicação de RV, e sugerem que esses indivíduos hipertróficos são portadores assintomáticos de RV persistente, e podem ser importantes fontes de transmissão de RV na comunidade. / The chronic adenotonsillar diseases are frequent otorhinolaryngologic conditions caused by chronic inflammation of adenoids and palatine tonsils. Rhinovirus (RV) is highly frequently detected in secretions, and tonsillar tissues from patients experience chronic tonsillar hypertrophy without symptoms of ARI, and our goal is to full understanding of viral infections in hypertrophic tonsillar tissues by RV. Of 104 enrolled patients with adenotonsillar chronic diseases, 21.1% (22/104) and 42.3% (44/104) had palatine tonsils and adenoids positive for RV by qPCR, respectively. RV Viral replication was confirmed by in situ hybridizations. Minus-strand RNA were detected in all tested samples (7 tonsils and 9 adenoids), and positive reactions were seen inside and outside of lymphoid follicles from tonsils and adenoids, in the ciliated epithelium of the adenoids and rarely in positive squamous epithelium cells from tonsils. The presence of viral structural protein VP1 and VP2 was detected within and outside of the lymphoid follicles from tonsils and adenoids, and also in epithelial cells from adenoids by immunohistochemistry (IHC). Later, by sequential immuno-peroxidase labelling and erasing protocol (SIMPLE), we saw co-localization of RV VP2 capsid protein staining with CD4 positive cells and CD20 positive cells. We confirmed that RV could infect primary culture of tonsilar mononuclear cells (TMNCs). Additionally, intracellular replication of RV in TMNCs, measured by TCID50 in HeLa cells, had an initial increase in the first 24 hours, and dropped at 48 hours post infection. Immunolocalization staining with anti-RV and TMNCs surface markers indicated that phenotypes of susceptible cells were T-cells both CD4+ and CD20+, but also, we saw co-localization of VP-2 protein with CD8+ cells, CD56+ cells and CD33+ cells. RV-16 couldn\'t infect CD123+ cell in our experiments. Finally, we were able to recover 4 rhinoviruses by inoculating WI-38 fibroblast cells and HeLa cells, confirming by the cytopathic effect and immunofluorescence positive staining with anti-VP1 antibody. Taken together, our results indicate that tonsils and adenoids of patients without ARI may be reservoirs of replicating human rhinovirus, infecting manly Tcells CD4+ and CD20+ B-cells. The high-frequency detection of RNA (-) and VP1 expression in tissues from patients with chronic adenotonsillar diseases, plus the isolation of infectious viral particles, suggests that these detected agents replicate in the adenotonsillar tissues and this specific sites may be important sources of transmission of RV in the community.

Picornaviruses are responsible for some of the most common and debilitating diseases affecting humans and animals worldwide. The objectives of this dissertation research were (1) estimate phylogenetic relationships among 11 picornavirus genera and within three species: foot-and-mouth disease virus (FMDV: Aphthovirus) which afflicts cloven-hoofed animals and human rhinovirus A and B (HRV: Enterovirus) which cause the common cold; (2) better understand the impact recombination has on genomic organization and evolution; (3) characterize where positive and purifying selection has occurred in proteins and how selection has influenced phenotype. The dissertation includes four studies. The first chapter provides an overview of the evolutionary significance of recombination, its detection and estimation, and its effect on phylogenetic analysis in four biological systems: bacteria, viruses, mitochondria, and the human genome. Chapter two investigates the inter- and intra-serotypic relationships within FMDV by examining 12 genes. Gene sequences were analyzed to assess recombination breakpoint locations, genetic diversity, and natural selection in FMDV. Recombination breakpoints were located throughout the genome. Paraphyletic relationships among serotypes were not as prevalent as previously reported, suggesting that convergent evolution was prevalent. Purifying selection was the dominant evolutionary force influencing both genotype and phenotype. Chapter three examines inter- and intra-specific relationships of HRV using 11 genes. Similar hypotheses were tested as in chapter two. No recombination was detected and phylogenetic relationships among enteroviruses, HRV-A, and HRV-B remain unresolved. The evolution of HRV-A major serotypes appeared to be under extensive purifying selection, HRV-A minor serotypes under predominantly positive selection, and a nearly equal influence from both kinds of selection was evident for HRV-B serotypes. Chapter four examines phylogenetic relationships among genera using three conserved genes. The hypothesis of cospeciation between picornaviruses and their hosts was also tested. The deepest split in the family separated Hepatovirus, ‘Tremovirus’, Parechovirus, and seal picornavirus type 1 from the remainder of the family. Enterovirus and ‘Sapelovirus’ were sister taxa. Cardiovirus, ‘Senecavirus’, Aphthovirus, Erbovirus, Teschovirus, and Kobuvirus were derived from a common ancestor with Kobuvirus occupying a basal position relative to the other genera in this clade. My analyses suggest that picornaviruses have not cospeciated with their known hosts.