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Clinical Microbiology Reviews, July 2005, p. 541-555, Vol. 18, No. 3
0893-8512/05/$08.00+0     doi:10.1128/CMR.18.3.541-555.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Immune Responses and Disease Enhancement during Respiratory Syncytial Virus Infection

Peter J. M. Openshaw* and John S. Tregoning

Department of Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London W2 1PG, United Kingdom

Respiratory syncytial virus (RSV) is one of the commonest and most troublesome viruses of infancy. It causes most cases of bronchiolitis, which is associated with wheezing in later childhood. In primary infection, the peak of disease typically coincides with the development of specific T- and B-cell responses, which seem, in large part, to be responsible for disease. Animal models clearly show that a range of immune responses can enhance disease severity, particularly after vaccination with formalin-inactivated RSV. Prior immune sensitization leads to exuberant chemokine production, an excessive cellular influx, and an overabundance of cytokines during RSV challenge. Under different circumstances, specific mediators and T-cell subsets and antibody-antigen immune complex deposition are incriminated as major factors in disease. Animal models of immune enhancement permit a deep understanding of the role of specific immune responses in RSV disease, assist in vaccine design, and indicate which immunomodulatory therapy might be beneficial to children with bronchiolitis.

* Corresponding author. Mailing address: Department of Respiratory Medicine, National Heart and Lung and Wright Fleming Institutes, Faculty of Medicine, Imperial College London, Paddington, London W2 1PG, United Kingdom. Phone: (44) 20 7594 3854. Fax: (44) 20 7262 8913. E-mail: p.openshaw{at}imperial.ac.uk.

Clinical Microbiology Reviews, July 2005, p. 541-555, Vol. 18, No. 3
0893-8512/05/$08.00+0     doi:10.1128/CMR.18.3.541-555.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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