Motokazu Nakabayashi

MxA-based recognition of viral illness in Febrile children by a whole blood assay

Febrile children are often given antibiotics empirically and unnecessarily. MxA is a protein induced in peripheral lymphoid cells by type 1 interferons during active viral infection. The ability of a whole blood ELISA assay for MxA to identify children with viral illness was studied in 122 children who presented with acute onset fever and 52 age-matched healthy controls. The febrile children were divided into three groups according to their final diagnoses: etiologically diagnosed viral infection, clinically diagnosed viral infection, and bacterial infection. MxA levels in the bacterial infection group and controls were similar and low (90.9 ± 69.7 and 76.9 ± 63.2 ng/mL, respectively). In contrast, mean MxA levels in the two viral infection groups were higher than in both the bacterial and control groups (719.2 ± 386.4 and 827.0 ± 651.1, respectively). A receiver operating characteristic analysis showed that the area under the curve of the MxA level was greater than under the curves of both the white blood cell count and the C-reactive protein concentration. Whole blood assay of MxA is a clinically useful tool for diagnosing viral illness in febrile children and should help reduce use of unnecessary antibiotics.

Theophylline metabolism in acute asthma with MxA-indicated viral infection

Background: Although viral infection might alter theophylline metabolism in acute asthma, there are some difficulties in detecting infection due to various kinds of viruses in a clinical setting.

Safety and usefulness of a novel eMotion electric mesh nebulizer in children with asthma.

BACKGROUND A new electronic mesh nebulizer, eMotion® is known to have higher performance compared to conventional nebulizers. However, there are some concerns about whether too much delivered dose might cause side effects with higher frequency. METHODS To evaluate the safety and usefulness of the nebulizer, we measured changes in heart rates and lung functions of 73 asthmatic children when they inhaled 1μg/kg of procaterol with eMotion® or a conventional nebulizer, Junior BOY®. RESULTS In 34 children with mild asthma exacerbation, physical findings, lung function and transcutaneous oxygen saturation levels were improved after inhalation using both nebulizers. No adverse effects including significant increase of heart rate were found. Improvements in the rates of the parameters were comparable. When response to beta2-agonist inhalation was checked in 39 children in stable condition, similar degrees of improvement in lung function were observed, and heart rates did not change after inhalation with either nebulizers. CONCLUSIONS Safety and efficacy was comparable between eMotion® and a conventional nebulizer when it was used to administer beta2-agonists in asthmatic children. However, from the fact that eMotion® needs only 3-4 minutes to inhale 2mL solution, eMotion® could be more useful for most children who usually do not prefer longer inhalation time with conventional compressor nebulizers.