Respiratory syncytial virus treatment and the respiratory microbiome

Respiratory syncytial virus (RSV) is one of the great threats to child health because it is associated with considerable acute and long-term respiratory morbidity. 1 Mejias A Wu B Tandon N et al. Risk of childhood wheeze and asthma after respiratory syncytial virus infection in full-term infants. Pediatr Allergy Immunol. 2020; 31: 47-56 Crossref PubMed Scopus (23) Google Scholar Worldwide, in children younger than 1 year, RSV is the leading cause of lower respiratory tract infection (LRTI) and hospitalisation, and in resource-limited countries the second most common cause of mortality. 2 Lozano R Naghavi M Foreman K et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380: 2095-2128 Summary Full Text Full Text PDF PubMed Scopus (9866) Google Scholar , 3 Shi T McAllister DA O'Brien KL et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017; 390: 946-958 Summary Full Text Full Text PDF PubMed Scopus (1171) Google Scholar The high burden associated with RSV has made the development of interventions to prevent and treat RSV a global health priority. Clinical trials are in progress and follow-up studies of those intervention trials provide an ideal opportunity to gain an improved understanding of the mechanisms that contribute to acute and long-term RSV respiratory morbidity, as highlighted in a report by Wing Ho Man and colleagues 4 Man WH Scheltema NM Clerc M et al. Infant respiratory syncytial virus prophylaxis and nasopharyngeal microbiota until 6 years of life: a subanalysis of the MAKI randomised controlled trial. Lancet Respir Med. 2020; (published online March 20.)https://doi.org/10.1016/S2213-2600(19)30470-9 Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar in The Lancet Respiratory Medicine. Infant respiratory syncytial virus prophylaxis and nasopharyngeal microbiota until 6 years of life: a subanalysis of the MAKI randomised controlled trialPalivizumab in infancy in otherwise healthy preterm infants is associated with persistent effects on the abundance of specific, potentially pathogenic, microbial taxa in the respiratory tract. Several of the palivizumab-associated biomarker species were associated with reversible airway obstruction at age 6 years. These results warrant further studies to establish the long-term ecological effects and health consequences of palivizumab in infancy. Full-Text PDF