{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:04:59Z","timestamp":1775840699033,"version":"3.50.1"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Respiratory tract infections (RTIs) contribute to pediatric morbidity and are often complicated by viral-bacterial superinfections, which exacerbate disease severity and increase antibiotic use. This study examined viral-induced bacterial adhesion in an <jats:italic>ex vivo<\/jats:italic> pediatric airway model and the therapeutic potential of <jats:italic>Echinacea purpurea<\/jats:italic> extract.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>EpiAirway tissue from a 6-year-old boy was infected with respiratory syncytial virus (RSV), human parainfluenza virus type 3 (HPIV3), or rhinovirus 14 (RV14). Adhesion of <jats:italic>Haemophilus influenzae<\/jats:italic> type b (Hib) and <jats:italic>Streptococcus pneumoniae<\/jats:italic> (<jats:italic>S. pneumoniae<\/jats:italic>) was assessed alongside the expression of platelet-activating factor receptor (PAFr), intercellular adhesion molecule-1 (ICAM-1), and carcinoembryonic antigen-related cell adhesion molecule-1 (CEACAM-1). Echinaforce<jats:sup>\u00ae<\/jats:sup> (EF extract) was tested for its effect on bacterial dysregulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RSV and HPIV3 increased bacterial adhesion by upregulating PAFr, ICAM-1, and CEACAM-1. Hib adhered primarily via ICAM-1, while <jats:italic>S. pneumoniae<\/jats:italic> favored PAFr. RV14 strongly induced CEACAM-1 but did not cause significant bacterial dysregulation. EF significantly reduced virus-induced receptor overexpression, resulting in inhibition of bacterial adhesion and biofilm-like formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings provide a mechanistic explanation for the observed effects of <jats:italic>E. purpurea<\/jats:italic> in reducing RTI complications and the need for antibiotic prescriptions in clinical settings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1579551","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T04:35:31Z","timestamp":1748579731000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Respiratory virus-induced bacterial dysregulation in pediatric airway tissue and the dual actions of Echinacea in reducing complications"],"prefix":"10.3389","volume":"16","author":[{"given":"Selvarani","family":"Vimalanathan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahfuza","family":"Sreya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranganayaki","family":"Nandanavanam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Schoop","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Gancitano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Saberi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Malikovskaia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Hudson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1001\/archpedi.152.3.244","article-title":"Prevalence of clinical sinusitis in young children followed up by primary care pediatricians","volume":"152","author":"Aitken","year":"1998","journal-title":"Arch. 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