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Severe infantile lower respiratory tract illness may be characterised by a reduced, rather than increased, immune response
Senior House Officer, University Hospital of North Tees, Teesside; jeicarter@hotmail.com
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Welliver T, Garofalo R, Hosakote Y, et al. Severe human lower respiratory tract illness caused by respiratory syncytial virus and influenza virus is characterized by the absence of pulmonary cytotoxic lymphocyte responses. J Infect Dis 2007;195:1126–36.[CrossRef][Medline]
The pathogenesis of severe infantile respiratory illness due to respiratory syncytial virus (RSV) and influenza virus is not fully understood. Some evidence suggests there is an increased T lymphocyte and cytokine response to infection. However, this cross-sectional study found otherwise.
Nasopharyngeal secretions from 72 infants <12 months’ of age, who had survived infection with RSV (n = 36) or influenza virus (n = 36), were examined for cytokine content. Post mortem lung specimens from 20 infants who had died of bronchiolitis caused by RSV (n = 9) or influenza virus (n = 11) underwent immunohistochemical staining to look for evidence of an immune response. In those who
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