Upper respiratory tract bacterial-immune interactions during respiratory syncytial virus infection in infancy - 03/03/22
, Tina V. Hartert, MD, MPH d, ⁎ Abstract |
Background |
The risk factors determining short- and long-term morbidity following acute respiratory infection (ARI) due to respiratory syncytial virus (RSV) in infancy remain poorly understood.
Objectives |
Our aim was to examine the associations of the upper respiratory tract (URT) microbiome during RSV ARI in infancy with the acute local immune response and short- and long-term clinical outcomes.
Methods |
We characterized the URT microbiome by 16S ribosomal RNA sequencing and assessed the acute local immune response by measuring 53 immune mediators with high-throughput immunoassays in 357 RSV-infected infants. Our short- and long-term clinical outcomes included several markers of disease severity and the number of wheezing episodes in the fourth year of life, respectively.
Results |
We found several specific URT bacterial-immune mediator associations. In addition, the Shannon ⍺-diversity index of the URT microbiome was associated with a higher respiratory severity score (β =.50 [95% CI = 0.13-0.86]), greater odds of a lower ARI (odds ratio = 1.63 [95% CI = 1.10-2.43]), and higher number of wheezing episodes in the fourth year of life (β = 0.89 [95% CI = 0.37-1.40]). The Jaccard β-diversity index of the URT microbiome differed by level of care required (P = .04). Furthermore, we found an interaction between the Shannon ⍺-diversity index of the URT microbiome and the first principal component of the acute local immune response on the respiratory severity score (P = .048).
Conclusions |
The URT microbiome during RSV ARI in infancy is associated with the acute local immune response, disease severity, and number of wheezing episodes in the fourth year of life. Our results also suggest complex URT bacterial-immune interactions that can affect the severity of the RSV ARI.
Le texte complet de cet article est disponible en PDF.Key words : Airway, bronchiolitis, chemokines, cytokines, growth factors, immune response, infancy, mediation, microbiome, nasopharynx, respiratory syncytial virus, severity, wheezing
Abbreviations used : ARI, INSPIRE, IQR, MFI, PC, rRNA, RSS, RSV, URT
Plan
| Supported by funds from the National Institute of Allergy and Infectious Diseases (awards U19AI095227, K24AI77930, HHSN272200900007C, R21AI142321, U19AI110819, R21AI154016, R21AI149262, and UG3OD023282); the National Heart, Lung, and Blood Institute (awards K23HL148638 and R01HL146401); the National Institute of General Medical Sciences (award R01GM140464); the Parker B. Francis Fellowship Program; the Vanderbilt Institute for Clinical and Translational Research (grant support from the National Center for Advancing Translational Sciences under grant UL1TR000445); the Department of Pediatrics at Vanderbilt University Medical Center (grant support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development under grant K12HD087023); the Vanderbilt Building Interdisciplinary Research Careers in Women's Health K-12 program (grant support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development under grant K12HD04348318); and the Vanderbilt Technologies for Advanced Genomics Core (grant support from the National Institutes of Health awards UL1RR024975, P30CA68485, P30EY08126, and G20RR030956). |
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| Disclosure of potential conflict of interest: L. J. Anderson has done paid consultancies on respiratory syncytial virus (RSV) vaccines for Bavarian Nordic, Novavax, Daiichi-Sankyo, ClearPath Development Company, and Pfizer; he receives funding from Pfizer through Emory University for laboratory surveillance studies of RSV infection in adults, he is a coinventor on several US Centers for Disease Control and Prevention patents on the RSV G protein and its CX3C chemokine motif relative to immune therapy and vaccine development, and he is also coinventor on a patent filing for the use of RSV platform virus-like particles with the F and G proteins for vaccines. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 149 - N° 3
P. 966-976 - mars 2022 Retour au numéro
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