Respiratory syncytial virus infection: its role in aeroallergen sensitization during the first two years of life

Abstract

Our aim was to study the influence of infection with the respiratory syncytial virus (RSV) in non-hospitalized infants on sensitization to aeroallergens and the early manifestation of atopy. Six hundred and nine infants from the prospective German Multicenter Cohort Study on Atopy were included, 38% of whom had an elevated atopic risk. RSV IgG and IgM antibodies were tested by ELISA with gradient purified RSV antigen. Specific IgE against mites, cat dandruff, birch and grass pollens and relevant nutritional antigens were tested with CAP-RAST-FEIA (Pharmacia, Sweden). Of the cord sera 99% were positive for RSV-IgG, 44.7% at one year and 64.2% (n = 265) at two years of age. The positivity rate after 12 months varied with the season of birth, the number of siblings and the degree of exposure to tobacco smoke; and correlated closely with attacks of wheezing during infancy. Twenty (2.8%) children were found to be sensitized against at least one aeroallergen at one year, and 28 (10.5%) at two years. By the first birthday, mite sensitization (n = 3) could only be seen in the RSV-infected children; grass pollen sensitization (n = 9) was associated with RSV seropositivity (logistic regression model including the confounders mentioned above: with RSV IgG < p = 0.048 > and IgM < p = 0.0006 >), as was birch sensitization (n = 5) with RSV IgM (p = 0.009). No such differences could be detected at two years. No correlation of RSV seropositivity to any allergic manifestation could be found. We conclude, that it is only in the first year of life, that RSV infection plays a significant role in promoting sensitization against aeroallergens, which do not at this time produce allergic symptoms.

Transient Suppression of Atopy in Early Childhood Is Associated With High Vaccination Coverage

“…From infancy on, the incidence of atopic dermatitis in our cohort was more frequent among children with first-degree relatives with the same phenotype. 21 In contrast, recurrent wheezing during the first 2 years of life was associated with serologic evidence of respiratory syncytial virus infection, 22 and thereafter, a positive family history of asthma became a risk factor. 21 In this study, the risk of both allergic sensitization and (more clear-cut after infancy) asthma symptoms was reduced in children with a higher vaccination coverage (Figs 2 and 3), suggesting that vaccinations may have a stronger impact on allergic than on nonallergic asthma.…”

Human Metapneumovirus Elicits Weak IFN-γ Memory Responses Compared with Respiratory Syncytial Virus

“…Extensive literature describes human humoral immune responses to RSV (15)(16)(17)(18)(19) and MPV (5,19). Seropositivity usually develops during early childhood.…”

Progress in Defining the Role of RSV in Allergy and Asthma: From Clinical Observations to Animal Models

“…A cohort study done by Foster et al also found that IgE, to common allergens, was more common after severe RSV infections in young children (Foster et al, 1996). Furthermore, RSV infection after 2 years of age did not play a role in sensitization against aeroallergens (Foster et al, 1996). This implies that RSV plays a pivotal role in influencing immune responses to allergens in young children.…”

“…Children who developed RSV, early in life, were more likely to produce IgE to common food and inhalant allergens such as egg white, cat, birch and mite (Sigurs et al, 1995). A cohort study done by Foster et al also found that IgE, to common allergens, was more common after severe RSV infections in young children (Foster et al, 1996). Furthermore, RSV infection after 2 years of age did not play a role in sensitization against aeroallergens (Foster et al, 1996).…”