Lung function of preterm infants before and after viral infections

Abstract

These results suggest viral LRTIs, regardless of whether hospitalisation is required, adversely affect prematurely born infants' airway resistance at follow up.

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

“…This is predominantly in the form of asthma, but viral LRTI has even been proposed as an etiology of chronic bronchitis (34), obstructive pulmonary disease (35)(36)(37), and idiopathic pulmonary fibrosis (38,39). In a retrospective study of preterm infants with viral LRTIs, significantly elevated airway resistance remained after 1 year of follow-up (40). RSV infection was the most prevalent lower respiratory tract infection that was detected among a panel of common respiratory viruses (40).…”

“…In a retrospective study of preterm infants with viral LRTIs, significantly elevated airway resistance remained after 1 year of follow-up (40). RSV infection was the most prevalent lower respiratory tract infection that was detected among a panel of common respiratory viruses (40). The increased resistance is most likely a product of the airway inflammation and an inherited hyperreactive profile of the infants due to viral infection.…”

The impact of respiratory viruses on lung health after preterm birth

“…The risk of asthma, recurrent wheeze and long-lasting impairments in lung function following severe RSV-related respiratory illness during infancy is more pronounced among preterm infants with BPD [66,71] and those born at a lower gestational age [68]. Although most studies demonstrating persistent respiratory morbidity following RSV-related respiratory illness have focused on hospitalised infants, a single study has demonstrated persistent airway resistance at 1 year of age in preterm infants following mild RSV infection that did not require hospitalisation [72]. …”

“…Although it is possible that the immature lungs in preterm infants might be particularly susceptible to long-term damage following severe RSV-related respiratory illness during early life [66,73], RSV infection during such a critical period of lung growth and development can also result in chronic alterations and remodelling of the developing airways independent of pre-existing neonatal factors [50,72]. The underlying mechanisms through which RSV could promote the development of suboptimal lung health and function later in life are yet to be fully elucidated.…”

“…Several mechanistic pathways have been hypothesised to describe the potential role of severe RSV-related respiratory illnesses in the pathogenesis of asthma and wheezing disorders later in life, including persistent activation of atypical immune responses and alterations to the structure and function of the developing airway [50,72,74]. Mouse models have also demonstrated the ability of RSV to induce and maintain prolonged inflammatory responses leading to significant damage to the airway epithelium, as well as chronic airway remodelling and persistent airway hyperresponsiveness following the initial infection [75–77].…”