Respiratory virus-induced bacterial dysregulation in pediatric airway tissue and the dual actions of Echinacea in reducing complications

Introduction 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 ex vivo pediatric airway model and the therapeutic potential of Echinacea purpurea extract. Methods 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 Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae ( S. pneumoniae ) 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 ® (EF extract) was tested for its effect on bacterial dysregulation. Results RSV and HPIV3 increased bacterial adhesion by upregulating PAFr, ICAM-1, and CEACAM-1. Hib adhered primarily via ICAM-1, while S. pneumoniae 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. Conclusion Our findings provide a mechanistic explanation for the observed effects of E. purpurea in reducing RTI complications and the need for antibiotic prescriptions in clinical settings.