Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Pediatrics, The University of Melbourne-Parkville Campus, Melbourne, Victoria, Australia.
Thorax. 2021 Sep;76(9):942-950. doi: 10.1136/thoraxjnl-2020-216291. Epub 2021 Feb 11.
Respiratory syncytial virus (RSV) is the most common viral pathogen associated with acute lower respiratory tract infection (LRTI) in children under 5 years of age. Severe RSV disease is associated with the development of chronic respiratory complications such as recurrent wheezing and asthma. A common risk factor for developing severe RSV disease is premature gestation and this is largely due to an immature innate immune system. This increases susceptibility to RSV since the innate immune system is less able to protect against pathogens at a time when adaptive immunity has not fully developed. This review focuses on comparing different aspects of innate immunity between preterm and term infants to better understand why preterm infants are more susceptible to severe RSV disease. Identifying early life innate immune biomarkers associated with the development of severe RSV disease, and understanding how these compare between preterm and term infants, remains a critically important question that would aid the development of interventions to reduce the burden of disease in this vulnerable population.
呼吸道合胞病毒（RSV）是 5 岁以下儿童急性下呼吸道感染（LRTI）最常见的病毒病原体。严重 RSV 疾病与慢性呼吸道并发症的发展有关，如反复喘息和哮喘。发生严重 RSV 疾病的常见危险因素是早产，这主要是由于先天免疫系统不成熟。由于先天免疫系统在适应性免疫尚未完全发育时，对病原体的保护能力较弱，因此更容易受到 RSV 的影响。本综述重点比较了早产儿和足月儿先天免疫系统的不同方面，以更好地理解为什么早产儿更容易患严重 RSV 疾病。确定与严重 RSV 疾病发展相关的早期生命先天免疫生物标志物，并了解这些标志物在早产儿和足月儿之间的差异，仍然是一个至关重要的问题，这将有助于制定干预措施，减轻这一脆弱人群的疾病负担。
