TLR3 and TLR7 prognostic role in early pediatric rotavirus infection

Introduction. Rotavirus infection is an urgent problem for pediatric infectology. The disease does not always proceed smoothly, it is assumed that TLR3 and TLR7 play an important role in its prognosis. The initial number of cells expressing such receptors in early children can probably be considered a predictor of unfavorable course and outcomes of rotavirus infection.

Materials and methods. Infants with rotavirus infection were divided into groups depending on the initial count of TLR3- and TLR7-expressing immunocompetent cells. All patients were examined using general clinical methods. Rotavirus infection was diagnosed by molecular genetic (RNA detected by PCR) and immunochromatographic (determination of antigen) method. Parameters of cellular immunity were assessed by flow cytometry. Statistical data processing was carried out using the Statistica 8.0 program for independent samples using the nonparametric Mann–Whitney criterion and the Pearson criterion c².

Results. It was found that in patients with an initially small vs. high count of TLR3-expressing cells, the symptoms of exicosis were observed significantly longer, which determined a significantly longer infusion rehydration therapy. In patients with an initially small count of TLR7-expressing cells, no significant differences were observed during disease course. However, only this group similar to infants with a small count of TLR3-expressing cells were treated with antibiotics due to concomitant bacterial infections. Only convalescents with small count of simultaneously TLR3- and TLR7-expressing cells had repeated episodes of ARI and allergic diseases in catamnesis, whereas infants with extremely low count of TLR3-expressing cells developed additionally an unfavorable outcome such as reactive pancreatopathy.

Conclusion. The initially low count of TLR3- and TLR7-expressing immunocompetent cells leads to a more severe course of rotavirus infection in infants requiring adjusted therapy by introducing antibacterial drugs and in some cases also contributes to arising adverse outcomes and consequences in 6–12 month catamnesis.