Immunopathogenesis of Respiratory Syncytial Virus Bronchiolitis

Bennett, Berkeley L.; Garofalo, Roberto P.; Cron, Stanley G.; Hosakote, Yashoda Madaiah; Atmar, Robert L.; Macias, Charles G.; Piedra, Pedro A.

doi:10.1086/515575

Cited by 120 publications

(110 citation statements)

References 45 publications

(65 reference statements)

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“…(McNamara et al, 2003) Nasal lavage was used as a means to compare the immune profile of 63 children with RSV bronchiolitis and 22 controls in a study in Texas of children less than 2 years of age. (Bennett et al, 2007) The RSV bronchiolitis group had a significantly greater number of inflammatory cells, as well as median nasal lavage concentrations of IL-8 (269.4 vs 13.8) compared to controls. IL-8 is an important neutrophil survival and chemotactic factor and the increase demonstrated in this study suggests a mechanism for the increased neutrophils seen in the previously mentioned bronchoscopy studies.…”

Section: Immunologic Determinants Of Severe Rsv Bronchiolitis In Humamentioning

confidence: 86%

Challenges and Opportunities for Respiratory Syncytial Virus Vaccines

2013

Current Topics in Microbiology and Immunology

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Reactive airway disease (RAD) is a general term for respiratory illnesses manifested by wheezing. Respiratory syncytial virus (RSV) results in wheezing, either by causing bronchiolitis or by inducing acute exacerbations of asthma. There has been a long standing interest in whether severe RSV bronchiolitis in infancy is a risk factor for the development of asthma later in childhood. While epidemiologic studies have suggested that such a link exists, a very recent study suggests that infants with greater airways responsiveness to methacholine instead have an increased prevalence of severe RSV bronchiolitis. Increased airways responsiveness to methacholine has been implicated as a key factor for loss of lung function in asthmatic subjects, suggesting that instead of being causal, severe RSV infection may instead be a marker of a predisposing factor for asthma. In this chapter, we will explore the evidence that RSV infection leads to RAD in infants and adults, and how these different forms of RAD may be linked.

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Section: Immunologic Determinants Of Severe Rsv Bronchiolitis In Humamentioning

confidence: 86%

Challenges and Opportunities for Respiratory Syncytial Virus Vaccines

2013

Current Topics in Microbiology and Immunology

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“…Smyth y col encontraron una asociación entre la cantidad de IL-8 producida localmente en las vías aéreas y cuantificadas por RNAm y la gravedad de la infección por VRS 25 . En cambio, Bennett y col encontraron un aumento significativo en el aspirado nasofaríngeo de ILs proinflamatorias pero que no tenía relación con la gravedad de la enfermedad ni con la presencia del VRS 26 . La presencia de neutrófilos sí está relacionada con la inflamación de la vía aérea en la bronquiolitis por VRS [27][28] .…”

Section: Discussionunclassified

Aumento de interleuquinas proinflamatorias y de cortisol plasmático en bronquiolitis por virus respiratorio sincicial: relación con la gravedad de la infección

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“…In addition, in a description of the 2009 novel H1N1 pandemic in Argentina, Libster and colleagues 63 described that 3 children (23%) died within 3 days of the onset of symptoms. Although there are few data on this topic, high levels of cytokines have been associated with reduced severity of illness in bronchiolitis, 64,65 which is the opposite for influenza. 66 Further study on the acute immune responses of this subgroup of children who have rapid respiratory decline may provide further insight into how RSV and HRV pathogenesis may differ from influenza in infants.…”

Section: Discussionmentioning

confidence: 99%

Prospective Multicenter Study of Children With Bronchiolitis Requiring Mechanical Ventilation

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Bronchiolitis is one of the most common infectious respiratory conditions of early childhood, and most children have a mild clinical course. Unfortunately, the small subgroup of children requiring continuous positive airway pressure and/or intubation remains ill-defined. WHAT THIS STUDY ADDS:In children with bronchiolitis, we found several demographic, historical, and clinical factors that predicted the need for mechanical respiratory support including in utero smoke exposure. We also found a novel subgroup of children with bronchiolitis who have a rapid respiratory decline. abstract OBJECTIVE: To identify factors associated with continuous positive airway pressure (CPAP) and/or intubation for children with bronchiolitis. METHODS:We performed a 16-center, prospective cohort study of hospitalized children aged ,2 years with bronchiolitis. For 3 consecutive years from November 1 until March 31, beginning in 2007, researchers collected clinical data and a nasopharyngeal aspirate from study participants. We oversampled children from the ICU. Samples of nasopharyngeal aspirate were tested by polymerase chain reaction for 18 pathogens.RESULTS: There were 161 children who required CPAP and/or intubation. The median age of the overall cohort was 4 months; 59% were male; 61% white, 24% black, and 36% Hispanic. In the multivariable model predicting CPAP/intubation, the significant factors were: age ,2 months (odds ratio [OR] 4.3; 95% confidence interval [CI] 1.7-11.5), maternal smoking during pregnancy (OR 1.4; 95% CI 1.1-1.9), birth weight ,5 pounds (OR 1.7; 95% CI 1.0-2.6), breathing difficulty began ,1 day before admission (OR 1.6; 95% CI 1.2-2.1), presence of apnea (OR 4.8; 95% CI 2.5-8.5), inadequate oral intake (OR 2.5; 95% CI 1.3-4.3), severe retractions (OR 11.1; 95% CI 2.4-33.0), and room air oxygen saturation ,85% (OR 3.3; 95% CI 2.0-4.8). The optimism-corrected c-statistic for the final model was 0.80. CONCLUSIONS:In this multicenter study of children hospitalized with bronchiolitis, we identified several demographic, historical, and clinical factors that predicted the use of CPAP and/or intubation, including children born to mothers who smoked during pregnancy. We also identified a novel subgroup of children who required mechanical respiratory support ,1 day after respiratory symptoms began.

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Immunopathogenesis of Respiratory Syncytial Virus Bronchiolitis

Cited by 120 publications

References 45 publications

Challenges and Opportunities for Respiratory Syncytial Virus Vaccines

Challenges and Opportunities for Respiratory Syncytial Virus Vaccines

Aumento de interleuquinas proinflamatorias y de cortisol plasmático en bronquiolitis por virus respiratorio sincicial: relación con la gravedad de la infección

Prospective Multicenter Study of Children With Bronchiolitis Requiring Mechanical Ventilation

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