The Human Immune Response to Respiratory Syncytial Virus Infection
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TLDR
In summary, neutrophilic inflammation is incriminated as a harmful response, whereas CD8+ T cells and IFN-γ have protective roles, which may represent important therapeutic targets to modulate the immunopathogenesis of RSV infection.Abstract:
Respiratory syncytial virus (RSV) is an important etiological agent of respiratory infections, particularly in children. Much information regarding the immune response to RSV comes from animal models and in vitro studies. Here, we provide a comprehensive description of the human immune response to RSV infection, based on a systematic literature review of research on infected humans. There is an initial strong neutrophil response to RSV infection in humans, which is positively correlated with disease severity and mediated by interleukin-8 (IL-8). Dendritic cells migrate to the lungs as the primary antigen-presenting cell. An initial systemic T-cell lymphopenia is followed by a pulmonary CD8+ T-cell response, mediating viral clearance. Humoral immunity to reinfection is incomplete, but RSV IgG and IgA are protective. B-cell-stimulating factors derived from airway epithelium play a major role in protective antibody generation. Gamma interferon (IFN-γ) has a strongly protective role, and a Th2-biased response may be deleterious. Other cytokines (particularly IL-17A), chemokines (particularly CCL-5 and CCL-3), and local innate immune factors (including cathelicidins and IFN-λ) contribute to pathogenesis. In summary, neutrophilic inflammation is incriminated as a harmful response, whereas CD8+ T cells and IFN-γ have protective roles. These may represent important therapeutic targets to modulate the immunopathogenesis of RSV infection.read more
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References
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Journal ArticleDOI
Immunity to and Frequency of Reinfection with Respiratory Syncytial Virus
TL;DR: It is suggested that humoral neutralizing, F, and G antibodies correlate with resistance to reinfection, but protection is far from complete and is of short duration.
Journal ArticleDOI
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TL;DR: Findings implicate RSV infection as an important mechanism of recurrent wheeze during the first year of life in otherwise healthy preterm infants, even after the end of treatment.
Journal ArticleDOI
The Development of Respiratory Syncytial Virus-Specific IgE and the Release of Histamine in Nasopharyngeal Secretions after Infection
Robert C. Welliver,David T. Wong,Martha Sun,Elliott Middleton,Russell S. Vaughan,Pearay L. Ogra +5 more
TL;DR: Formation of RSV-specific IgE and release of histamine may adversely affect the outcome ofRSV infection and is correlated significantly with the degree of hypoxia.
Journal ArticleDOI
The histopathology of fatal untreated human respiratory syncytial virus infection
TL;DR: Airway obstruction was a prominent feature in all cases attributed to epithelial and inflammatory cell debris mixed with fibrin, mucus, and edema, and compounded by compression from hyperplastic lymphoid follicles, which inform the understanding of RSV pathogenesis and may facilitate the development of new approaches for prevention and treatment.
Journal ArticleDOI
Severe Human Lower Respiratory Tract Illness Caused by Respiratory Syncytial Virus and Influenza Virus Is Characterized by the Absence of Pulmonary Cytotoxic Lymphocyte Responses
Timothy P. Welliver,Roberto P. Garofalo,Yashoda M. Hosakote,Karen H. Hintz,Luis F. Avendaño,Katherine Sánchez,Luis Velozo,Hasan S. Jafri,Susana Chavez-Bueno,Pearay L. Ogra,Lu Ann McKinney,Jennifer L. Reed,Robert C. Welliver +12 more
TL;DR: Severe infantile RSV and influenza virus LRTI is characterized by inadequate (rather than excessive) adaptive immune responses, robust viral replication, and apoptotic crisis.
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