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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
Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy
Insights
Children hospitalized with respiratory syncytial virus (RSV) lower respiratory tract infection showed increased bronchial hyperresponsiveness and reduced expiratory airflow at age 10. This suggests a lasting impact of early-life viral infections on lung function.
Area of Science:
- Pediatrics
- Pulmonology
- Infectious Diseases
Background:
- Infants hospitalized with lower respiratory tract infections (LRTI) due to respiratory syncytial virus (RSV) may experience long-term respiratory sequelae.
- Understanding the long-term effects of severe early-life RSV infection is crucial for pediatric respiratory health.
Purpose of the Study:
- To investigate the long-term respiratory health outcomes in children previously hospitalized with RSV LRTI.
- To assess bronchial lability, lung function, and wheezing history at age 10 in index children compared to controls.
Main Methods:
- Longitudinal follow-up of children hospitalized with RSV LRTI in infancy.
- Assessment included skin prick tests, spirometry, histamine challenge tests, exercise tests, and single-breath nitrogen washout.
- Comparison with a control group of children without a history of RSV LRTI.
Main Results:
- Index children had significantly more episodes of wheeze (42% vs 19%) and a threefold increase in bronchial lability compared to controls.
- Reduced maximum expiratory airflow was observed in index children, even when excluding those with recurrent wheeze.
- No significant difference in atopy was found between the groups, and ventilation was not uneven.
Conclusions:
- Early-life RSV LRTI is associated with persistent bronchial hyperresponsiveness and altered lung function in childhood.
- These findings suggest that severe RSV infection may lead to permanent airway damage or unmask underlying airway susceptibility.
- Further research is needed to elucidate the exact mechanisms and long-term clinical implications.
Abstract:
Of the 180 children admitted to hospitals in Tyneside in the first year of life with proved respiratory syncytial virus lower respiratory tract infection, 130 were seen for review 10 years later and 34 of the remaining 50 children accounted for. Skin tests, lung function tests, and histamine-challenge and exercise tests for bronchial lability were undertaken in over 100 of the index children and a similar number of control children. A total of 55 (42%) of the 130 index children had had further episodes of wheeze, while only 21 (19%) out of 111 controls had ever wheezed; but few (6.2% v 4.5%) had troublesome symptoms at the age of 10. There was a threefold increase in the incidence of bronchial lability in the index children but no excess of atopy. Maximum expiratory air flow was reduced throughout the vital capacity manoeuvre in the index children, even when those with a history of recurrent wheeze were excluded. Results of single-breath nitrogen washout tests were normal, however, suggesting that ventilation was not appreciably uneven, even though expiratory flow was restricted. These differences might have been caused by infection damaging the growing lung but might also be explained by pre-existing differences in the airway, rendering certain children more susceptible to symptomatic infection when first challenged by the virus in infancy.
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