Respiratory outcomes in high-risk children 7 to 10 years after prophylaxis with respiratory syncytial virus immune globulin

Wenzel, Sally E.; Gibbs, Robyn L.; Lehr, Marsha V.; Simões, Eric A F

doi:10.1016/s0002-9343(02)01095-1

Cited by 100 publications

(67 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings suggest that protection against early RSV lower respiratory tract infection by passive prophylaxis may also protect against the chronic sequelae of this infection and particularly reduce the incidence of postbronchiolitis childhood asthma (19,20). This hypothesis is supported by a recent report based on the retrospective analysis of children protected with polyclonal RSV immune globulin (21) and is also being tested in an ongoing clinical trial involving the more potent MAb palivizumab (22).…”

Section: Discussionmentioning

confidence: 77%

Persistent Airway Inflammation after Resolution of Respiratory Syncytial Virus Infection in Rats

2004

View full text Add to dashboard Cite

Neurogenic inflammation is markedly potentiated in airways that are infected with respiratory syncytial virus (RSV). Aims of this study were to determine whether this potentiation persists after the virus is cleared, investigate the mechanism of postviral potentiation, and define whether prophylaxis with a MAb against the RSV fusion protein (palivizumab) prevents this effect. Thirty days after inoculation, no evidence of active RSV infection was found in the airway epithelium by plaque assay or immunostaining and no viral nucleic sequences were detected by PCR, yet capsaicin-induced plasma extravasation in the airways that were infected 30 d earlier with RSV was still significantly larger compared with pathogen-free controls. Substance P content in lung tissues and capsaicin-induced release of this peptide from sensory nerves were significantly increased at 30 d. The administration of palivizumab 24 h before virus inoculation prevented the development of abnormal neurogenic inflammatory responses. Our data suggest that the airways remain abnormally susceptible to the proinflammatory effects of sensory nerves after RSV infection is cleared, as a result of changes in sensory innervation, and that this abnormality can be prevented by passive prophylaxis against RSV. Respiratory syncytial virus (RSV) infection presents a large public health burden worldwide (1). Half of all infants become infected with RSV in the first year of life, and by 2 y of age, most children have been infected with RSV at least once. RSV is estimated to cause up to 90% of all childhood bronchiolitis and up to 40% of all pediatric pneumonias, resulting in Ͼ120,000 hospitalizations annually in the United States (2). In addition, there is growing evidence that early RSV infection is an important risk factor for the development of recurrent wheezing during the first decade of life (3). Despite intense research efforts, the mechanism by which this virus predisposes to long-term sequelae is still unclear.In previous studies, we have shown that during an acute RSV infection the airways become abnormally susceptible to the proinflammatory effects of the neurotransmitter substance P (SP) released from sensory nerves, as a result of up-regulation of the high-affinity SP [neurokinin 1 (NK1)] receptor (4). This effect can be prevented by the administration of a MAb against the RSV fusion protein (palivizumab; MedImmune, Inc., Gaithersburg, MD, U.S.A.), given either before inoculation or during the early phase of the infection (5). However, for linking the acute viral infection with the development of long-term changes, it is essential to establish that the inflammatory changes persist after the virus is cleared from the airways.In the present study, we first analyzed lung tissues obtained from rats 5 d or 30 d after inoculation of RSV to establish whether evidence of persistent viral infection can be found after resolution of the acute phase. Then we investigated whether the increased neurogenic plasma extravasation ob- ABSTRACT 657

show abstract

Section: Discussionmentioning

confidence: 77%

Persistent Airway Inflammation after Resolution of Respiratory Syncytial Virus Infection in Rats

2004

View full text Add to dashboard Cite

show abstract

“…This study revealed that by preventing hospitalization due to severe RSV infection, the risk of recurrent wheezing in later childhood was reduced by 50%. Similarly, treatment with polyclonal immune globulins against RSV has also been demonstrated to reduce the incidence of childhood asthma 7-10 y later (9). These studies and others suggest that severe RSV infection is not simply a marker of asthma predisposition but instead provide support for a causal relationship between early-life viral exposure and childhood asthma.…”

mentioning

confidence: 78%

NK Cell Deficiency Predisposes to Viral-Induced Th2-Type Allergic Inflammation via Epithelial-Derived IL-25

Kaiko

Phipps²,

Angkasekwinai

et al. 2010

The Journal of Immunology

133

115

View full text Add to dashboard Cite

show abstract

“…Significantly less atopy and a lower likelihood of RAD attacks were observed. Based on this preliminary evidence, WENZEL et al [29] suggested that RSV prophylaxis might have long-term benefit in reducing the risk of RAD. Being 50-100-times more potent than RSV immune globulin, palivizumab may be an important alternative in the prophylaxis of RSV and the avoidance of reversible airway obstruction.…”

mentioning

confidence: 99%

“…RSV causes prolonged pulmonary inflammation that may exaggerate this response [27] and which anti-inflammatory therapy does not appear to mitigate [28]. However, prevention of both the severe RSV LRI and depression of the inflammatory responses, by monthly infusions of 750 mg?kg -1 of RSV immune globulin to infants with bronchopulmonary dysplasia has been shown to improve not only their pulmonary function but also to decrease their sensitisation to aeroallergens [29].…”

mentioning

confidence: 99%

“…The contribution of controlled, prospective interventional studies conducted in larger study populations, testing the effect of RSVspecific prophylaxis on the chronic sequelae of RSV infection will be particularly important. An example of the latter is a recently published study of children with chronic lung disease of prematurity that had received RSV immune globulin 7-10 yrs earlier [29]. Pulmonary function was significantly better in the treatment group than in matched control patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Respiratory syncytial virus and subsequent asthma: one step closer to unravelling the Gordian knot?

Piedimonte

Simões

2002

European Respiratory Journal

View full text Add to dashboard Cite

Respiratory outcomes in high-risk children 7 to 10 years after prophylaxis with respiratory syncytial virus immune globulin

Cited by 100 publications

References 23 publications

Persistent Airway Inflammation after Resolution of Respiratory Syncytial Virus Infection in Rats

Persistent Airway Inflammation after Resolution of Respiratory Syncytial Virus Infection in Rats

NK Cell Deficiency Predisposes to Viral-Induced Th2-Type Allergic Inflammation via Epithelial-Derived IL-25

Respiratory syncytial virus and subsequent asthma: one step closer to unravelling the Gordian knot?

Contact Info

Product

Resources

About