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Updated: Aug 15, 2026
09:01
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
CCL5 Levels, Disease Progression, and Mortality in Respiratory Viral Infections: A Systematic Review and
Carlos Pita-Martínez1, Daniel Sepúlveda-Crespo1,2, Jesús F Bermejo-Martín3,4,5
1Unidad de Infección Viral e Inmunidad. Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
JAMA Network Open
|August 13, 2026
Summary
Elevated levels of chemokine C-C motif ligand 5 (CCL5) are linked to better outcomes in respiratory viral infections, suggesting it indicates a strong immune response, not harmful inflammation. CCL5 may help predict patient risk.
Area of Science:
- Immunology and Virology
- Biomarker Discovery
- Systematic Review and Meta-Analysis
Background:
- The role of chemokine C-C motif ligand 5 (CCL5) in respiratory viral infections is debated, with potential involvement in both viral clearance and detrimental hyperinflammation.
- Understanding CCL5's precise role is crucial for managing respiratory viral infections and developing effective treatment strategies.
Purpose of the Study:
- To quantitatively assess the association between CCL5 levels and adverse outcomes, including disease progression and mortality, in patients with respiratory viral infections.
- To clarify whether elevated CCL5 signifies a protective immune response or contributes to pathogenic inflammation.
Main Methods:
- A comprehensive systematic review and meta-analysis of 18 observational studies involving 2376 patients with confirmed respiratory viral infections.
- Searches were conducted across major databases (Medline, PubMed, Embase, Scopus, Web of Science, Cochrane Library, CABI, Global Health) up to October 2025.
- Data extraction, risk of bias assessment (Newcastle-Ottawa Scale), and certainty of evidence evaluation (GRADE) were performed independently by two reviewers, with data pooled using a random-effects model following PRISMA guidelines.
Main Results:
- Elevated CCL5 levels were significantly associated with reduced odds of unfavorable disease progression (OR, 0.78; 95% CI, 0.71-0.85) and all-cause mortality (OR, 0.65; 95% CI, 0.55-0.76).
- The protective association for mortality was stronger than for disease progression.
- Consistent protective associations were observed across subgroup analyses by virus type (coronavirus vs. non-coronavirus) and age group (pediatric vs. adult).
Conclusions:
- Elevated CCL5 levels in respiratory viral infections are associated with favorable outcomes and improved survival, indicating a competent antiviral immune response rather than pathogenic hyperinflammation.
- These findings highlight CCL5's potential as a prognostic biomarker for risk stratification in patients with respiratory viral infections.
- Further research may explore therapeutic modulation of CCL5 pathways.
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