Respiratory viral infections: Pathogenetic rationale for interferon therapy

Acute respiratory infections (ARIs) is a significant pathology in the current landscape of infectious diseases. Interferons, one of which is interferon alpha-2b nasal drop formulation, play a special role in the treatment and prevention of ARIs in children and adults. This article presents case reports of the use of interferon alpha-2b in pediatrics. The same infection within a singlehousehold outbreak developed differently in different people: from mild rhinitis in a 6-month-old child to complicated croup in a 4-year-old child with a history of allergies. Prescription of interferon alpha-2b nasal drops to all contacts (including the infant recently exposed to the virus and healthy adults) is justified. It boosts local immunity, breaks the chain of infection, and prevents a recurrence of the disease if a person continues to be in contact with the infection source. None of the household members who received interferon alpha-2b nasal drops as a prophylactic agent became ill, despite close contact with the convalescent person. These case reports illustrate the variability of the ARI course in children of different ages within a singlehousehold outbreak and the effectiveness of post-exposure prophylaxis with interferon alpha-2b to prevent transmission of infectious agents among exposed persons.

1. Nikolaeva SV, Dyusenbaev AS, Novikov MYU, Pogorelova OO, Rubleva OV, Batalin IS. Epidemic challenges and treatment strategies of viral infections in children. Infectious Diseases. 2026;24(1):75–84. (In Russ.) https://doi.org/10.20953/1729-9225-2026-1-75-84.

2. Николаева СВ, Хлыповка ЮН, Медкова АЮ, Горелов АВ. Место микстинфекций в этиологической структуре острых респираторных инфекций у госпитализированных детей. В: Актуальные вопросы инфекционных болезней в клинике и эксперименте: XXIV ежегодная Всероссийская научно-практическая конференция с международным участием, Махачкала, 25–26 октября 2019 г. Махачкала: Дагестанский государственный медицинский университет; 2019. С. 191–195. Режим доступа: https://www.elibrary.ru/mbjxqv.

3. Gorelov AV, Nikolaeva SV. Topical issues of infectious respiratory pathology in children. Pediatriya – Zhurnal im G.N. Speranskogo. 2020;99(6):8–14. (In Russ.) https://doi.org/10.24110/0031-403X-2020-99-6-8-14.

4. Карнеева ОВ, Юнусов АС, Гуров АВ, Поляков ДП, Рязанцев СВ, Геппе НА и др. Клинические рекомендации «Отит средний острый». 2024. Режим доступа: https://cr.minzdrav.gov.ru/view-cr/314_3.

5. Карнеева ОВ, Юнусов АС, Гуров АВ, Абдулкеримов ХТ, Рязанцев СВ, Карпова ЕП и др. Клинические рекомендации «Острый синусит». 2024. Режим доступа: https://cr.minzdrav.gov.ru/view-cr/313_3.

6. Калюжин ОВ. Острые респираторные вирусные инфекции: современные вызовы, противовирусный ответ, иммунопрофилактика, иммунотерапия. М.: МИА; 2014. 144 с. Режим доступа: https://www.elibrary.ru/rzqyyx.

7. Belardelli F, Gresser I. The neglected role of type I interferon in the T cell response: implications for its clinical use. Immunol Today. 1996;17(8):369–372. https://doi.org/10.1016/0167-5699(96)10027-x.

8. Prodeus A, Niborski V, Scherzenmeir J, Gorelov A, Shcherbina A, Rumyantsev A. Fermented milk Consumption and common infections in children attending day-care centers: a randomized trail. J Pediatr Gastroenterol Nutr. 2016;63(5):534–543. https://doi.org/10.1097/mpg.0000000000001248.

9. Al-Mulla HM, Turrell L, Smith NM, Payne L, Baliji S, Züst R et al. Competitive fitness in coronaviruses is not correlated with size or number of double-membrane vesicles under reduced-temperature growth conditions. MBio. 2014;5(2):e01107–13. https://doi.org/10.1128/mbio.01107-13.

10. Sologub TV, Golobokov GS, Tsvetkov VV, Tokin II. Interferon-gamma in the treatment of influenza and other respiratory viral infections. Meditsinskiy Sovet. 2015;(7):54–58. (In Russ.) Available at: https://www.medsovet.pro/jour/article/view/212.

11. Feklisova LV, Tselipanova EE, Gorelov AV, Kanner EV. Efficiency of interferon agents in the comprehensive treatment of children with acute respiratory diseases. Farmateka. 2013;(11):70–74. (In Russ.) Available at: https://urologyjournal.ru/articles/Effektivnostprimeneniya-interferonovyh-preparatov-v-kompleksnom-lechenii-detei-s-ostrymi-respiratornymi-zabolevaniyami.html.

12. Zakharova IN, Torshkhoeva LB, Zaplatnikov AL, Korovina NA, Malinovskaya VV, Chebotareva TA et al. Features of the interferon system in acute respiratory infections and clinical immunological efficacy of modified interferon therapy in young children. Effective Pharmacotherapy. 2011;(26):70–73. (In Russ.) Available at: https://www.elibrary.ru/shghmt.

13. Zakharova IN, Malinovskaya VV, Torshkhoeva LB, Koroid NV, Mozzhukhina MV, Lagadze IB. Administration of recombinant alpha2binterferon (VIFERON®) under acute respiratory infections in early childhood. Effective Pharmacotherapy. 2014;(3):6–16. (In Russ.) Available at: https://www.elibrary.ru/sakypr.

14. Malinovskaya VV, Karaulov AV, Shuvalov AN, Shamsheva DS. Methods of correction of virus-induced inhibition of endogenous interferon type I synthesis Infectious Diseases. 2025;23(1):85–94. (In Russ.) https://doi.org/10.20953/1729-9225-2025-1-85-94.

15. Ruzhentsova TA, Meshkova NA, Khavkina DА. Effects of combination therapy with interferon alpha-2b and vitamins E and C on the course of acute respiratory infections and influenza in children: results of meta-analysis. Infectious Diseases. 2020;18(2):68–78. (In Russ.) https://doi.org/10.20953/1729-9225-2020-2-68-78.

16. Горелов АВ. Роль препаратов интерферона альфа-2b в общетерапевтической практике. СПб.; 2014. 44 с.

17. Hayden FG, Albrecht JK, Kaiser DL, Gwaltney JM Jr. Prevention of natural colds by contact prophylaxis with intranasal alpha 2-interferon. N Engl J Med. 1986;314(2):71–75. https://doi.org/10.1056/NEJM198601093140202.

18. Gao L, Yu S, Chen Q, Duan Z, Zhou J, Mao C et al. A randomized controlled trial of low- dose recombinant human interferons alpha- 2b nasal spray to prevent acute viral respiratory infections in military recruits. Vaccine. 2010;28(28):4445–4451. https://doi.org/10.1016/j.vaccine.2010.03.062.

19. Yu DX, Chen Q, Zhang LL, Liu Y, Yu ZA, Li ZF et al. A field trial of recombi nant human interferon alpha-2b for nasal spray to prevent SARS and other respiratory viral infections. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2005;19(3):216–219. Available at: https://pubmed.ncbi.nlm.nih.gov/16261200/.

20. Zakharova IN, Pupykina VV, Kuznetsova IS. The interferon system: Modern view on structural and functional organization and clinical application. Meditsinskiy Sovet. 2026;20(1):62–69. (In Russ.) https://doi.org/10.21518/ms2026-041.

21. Горелов АВ, Малявин АГ, Чуланов ВП, Жданов КВ, Лиознов ДА, Эсауленко ЕВ и соавт. Клинические рекомендации "Острые респираторные вирусные инфекции (ОРВИ) у взрослых". 2025. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/724_2.

22. Баранов АА, Намазова-Баранова ЛС, Лобзин ЮВ, Таточенко ВК, Усков АН, Куличенко ТВ и соавт. Клинические рекомендации "Острая респираторная вирусная инфекция (ОРВИ)". 2022. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/25_2.