54 Glucocorticoids have potent anti-inflammatory Selleck INCB024360 effects and have been successfully used in maintenance treatment in
patients with persistent asthma, controlling inflammation and preventing exacerbations. Some studies have assessed its effect on virus-induced asthma. The suppression of the release of pro-inflammatory mediators induced by HRV infection in vitro in bronchial epithelial cells, such as CCL5, CCL10, CXCL8, and IL6, as well as the reduction of factors associated with remodeling, was achieved after the use of budesonide. 58 Other in vitro studies documented the action of other corticosteroids alone or in combination with bronchodilators or leukotriene www.selleckchem.com/products/nu7441.html antagonists in reducing the release of several inflammatory molecules, with potential modulation of the deleterious effects of viruses on the asthmatic population. 51 and 59 Despite the proven benefits of inhaled corticosteroids in the control of asthma triggered by multiple factors, their action on virus-induced exacerbations is unclear. The use of low-to-moderate doses of inhaled corticosteroids as maintenance therapy cannot prevent intermittent viral-induced wheezing. 60 and 61 However, better results have been obtained with the intermittent use of inhaled corticosteroids
at high doses.62 The use of viral detection techniques with high sensitivity and specificity has increased the identification of some respiratory viruses in children with asthma exacerbation. The direct or indirect immunofluorescence reactions still have great practical importance, as they can detect a panel
of seven viruses (FLUV- A and B, PIV- 1-3, hAdV and hRSV), being an affordable and fast method, with good sensitivity, especially in children.18 It is currently used by the Brazilian Ministry of Health for the screening of respiratory viruses in the diagnosis of severe acute flu-like illness and Flu-like illness in sentinel units. The techniques for nucleic acid amplification (RT-PCR) are more expensive, but more sensitive; thus, they are used in research and by the Brazilian Ministry of Health for the identification and genotyping of Flu.38 Furthermore, it allows tuclazepam for the identification of some viruses with significant clinical and epidemiological importance, such as hRV and Bocavirus, not identified by immunofluorescence. 17 and 54 As for the method used to obtain the sample, it is worth mentioning the controversial issue of nasopharyngeal swab in viral research. Although its use has been consolidated for bacterial infections (S. pneumoniae and S. aureus), its role in viral infections still deserves some consideration. The authors agree that, from the practical point of view, it is more feasible, eliminating the use of suction systems, probes, and more specialized training, when compared to aspirate or lavage samples.