Featured Research

from universities, journals, and other organizations

Infants with severe RSV disease may be immunosuppressed

Date:
December 10, 2012
Source:
Nationwide Children's Hospital
Summary:
Infants with severe lower respiratory tract infection caused by respiratory syncytial virus (RSV) may have a dysfunctional innate immune response that relates to the severity of their disease.

Infants with severe lower respiratory tract infection caused by respiratory syncytial virus (RSV) may have a dysfunctional innate immune response that relates to the severity of their disease. These are the findings from a Nationwide Children's Hospital study appearing in a recent issue of the Journal of Infectious Diseases.

Related Articles


RSV is the leading cause of lower respiratory tract infection in young children worldwide. The majority of children hospitalized with this condition are previously healthy with no known risk factors for serious disease. Of these infants, up to 20 percent will develop a disease severe enough to require admission to the pediatric intensive care unit (PICU).

It's suggested that viral factors and the host immune response both contribute to the severity of RSV disease. A child's functional innate immune response is increasingly being recognized as contributing to disease severity, but few studies have examined this phenomenon.

"For a long time we thought that children with severe RSV disease had higher concentrations of innate immunity cytokines, but it seems to be the opposite," said the study's senior author Asuncion Mejias, MD, PhD, physician scientist in Infectious Diseases at Nationwide Children's Hospital. "When we stimulate the blood of these infants the production of innate immunity cytokines is severely impaired, and more importantly, this weakened response correlates with the more severe forms of the disease."

To investigate the relationship between innate immunity and RSV disease severity, Dr. Mejias and Octavio Ramilo, MD, chief of Infectious Diseases at Nationwide Children's in collaboration with Cesar Mella, MD, and Mark Hall, MD, from Critical Care at Nationwide Children's, sought to determine whether patients with bronchiolitis admitted to the PICU had decreased whole blood functional innate immune responses. They also examined the relationships between innate immune dysfunction and disease outcomes.

The team evaluated 66 previously-healthy children less than two years old who were hospitalized with a first episode of RSV bronchiolitis during the 2010 -- 2011 respiratory season. A nasal wash sample and a blood sample were obtained from each patient within 24 hours of admission to confirm RSV infection, and to measure cytokine concentrations before and after LPS stimulation. The team also enrolled healthy infants for control comparison.

They found that critically ill children with RSV admitted to the PICU had a significantly lower production capacity of innate cytokines compared with healthy controls and infants with less severe RSV bronchiolitis hospitalized in the Infectious Diseases unit.

"Whether children who develop severe RSV disease are born with an already impaired immune response, and RSV just uncovers their abnormal immune system will require further studies," says Dr. Mejias, who is also a faculty member at The Ohio State University (OSU) College of Medicine. "Our study clearly suggests the presence of an inadequate, rather than excessive, functional innate immune response in children with RSV. This inadequate functional innate immune response is directly associated with the severity of the disease."

Dr. Hall, also with OSU College of Medicine, said that immune monitoring of RSV patients at the time of hospitalization could have important clinical implications.

"Our data suggest that children with the most severe forms of RSV disease may already be immunosuppressed when we meet them in the ICU, raising the possibility of worsening this immunosuppression with the addition of commonly prescribed corticosteroids used to blunt the pro-inflammatory response to RSV," said Dr. Hall.

Prospective immune monitoring may be helpful to identify children with bronchiolitis at high-risk for severe disease.

The findings also suggest the potential for the use of immune stimulant drugs that have been used with some success in reversing innate immune suppression in critically ill adults and children.

"Further studies are needed to explain the mechanisms responsible for innate immune suppression observed in critically-ill RSV-infected children," said Dr. Ramilo, also with OSU College of Medicine.


Story Source:

The above story is based on materials provided by Nationwide Children's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. C. Mella, M. C. Suarez-Arrabal, S. Lopez, J. Stephens, S. Fernandez, M. Hall, O. Ramilo, A. Mejias. Innate Immune Dysfunction is Associated with Enhanced Disease Severity in Infants with Respiratory Syncytial Virus Bronchiolitis. Journal of Infectious Diseases, 2012; DOI: 10.1093/infdis/jis721

Cite This Page:

Nationwide Children's Hospital. "Infants with severe RSV disease may be immunosuppressed." ScienceDaily. ScienceDaily, 10 December 2012. <www.sciencedaily.com/releases/2012/12/121210133454.htm>.
Nationwide Children's Hospital. (2012, December 10). Infants with severe RSV disease may be immunosuppressed. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2012/12/121210133454.htm
Nationwide Children's Hospital. "Infants with severe RSV disease may be immunosuppressed." ScienceDaily. www.sciencedaily.com/releases/2012/12/121210133454.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) — A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) — Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) — Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins