Halfhide Clare, Smyth Rosalind L
Institute of Child Health, University of Liverpool, Royal Liverpool Children's Hospital, Eaton Road, Liverpool, UK.
Paediatr Respir Rev. 2008 Dec;9(4):251-62. doi: 10.1016/j.prrv.2008.05.005. Epub 2008 Oct 23.
Bronchiolitis and preschool recurrent wheeze (PSRW) are common paediatric problems causing significant morbidity and mortality in the first years of life. Respiratory syncytial virus (RSV) and rhinoviruses are the commonest pathogens associated with these illnesses. Why some infants are severely affected, requiring admission to hospital, whilst others experience a simple cold is not fully understood: research has suggested that the innate immune response to these viruses is important. The innate immune system has many components and activation or deficiency in one or many areas may explain the different clinical presentations and disease severities that can occur in these infants. This review will summarize the recent evidence highlighting how RSV and rhinoviruses may modulate the innate immune response in both bronchiolitis and PSRW, and discuss how these illnesses affect the long-term development of the infant lung and the possible susceptibility to persistent airway disease.
细支气管炎和学龄前反复喘息(PSRW)是常见的儿科问题,在生命的最初几年会导致显著的发病率和死亡率。呼吸道合胞病毒(RSV)和鼻病毒是与这些疾病相关的最常见病原体。为什么有些婴儿会受到严重影响,需要住院治疗,而另一些婴儿只是患了普通感冒,目前尚不完全清楚:研究表明,对这些病毒的先天免疫反应很重要。先天免疫系统有许多组成部分,一个或多个区域的激活或缺陷可能解释了这些婴儿可能出现的不同临床表现和疾病严重程度。本综述将总结近期证据,突出RSV和鼻病毒如何在细支气管炎和PSRW中调节先天免疫反应,并讨论这些疾病如何影响婴儿肺部的长期发育以及对持续性气道疾病的可能易感性。