The human immune response to respiratory syncytial virus infection

Research output: Contribution to journalArticlepeer-review

Abstract

Respiratory syncytial virus (RSV) is an important aetiological agent of respiratory infections, particularly in children. Much data regarding the immune response to RSV comes from animal models and in vitro studies. Here, we provide a comprehensive description of the human immune response to RSV infection, based on a systematic literature review of research in infected humans.

There is an initial strong neutrophil response to RSV infection in humans, positively correlated with disease severity and mediated by IL-8. Dendritic cells migrate to the lungs as the primary antigen presenting cell. An initial systemic T-cell lymphopenia is followed by a pulmonary CD8+ T-cell response, mediating viral clearance. Humoral immunity to reinfection is incomplete but RSV-IgG and -IgA are protective. B-cell stimulating factors derived from airway epithelium play a major role in protective antibody generation. IFN-γ has a strongly protective role and a Th2-biased response may be deleterious. Other cytokines
(particularly IL-17A), chemokines (particularly CCL-5 and CCL-3) and local innate immune factors (including cathelicidins and IFN-λ) contribute to pathogenesis.

In summary, neutrophilic inflammation is incriminated as a harmful response whereas CD8+T-cells and IFN-γ have protective roles. These may represent important therapeutic targets to modulate the immunopathogenesis of RSV infection.
Original languageEnglish
Pages (from-to)481-502
Number of pages22
JournalClinical Microbiology Reviews
Volume30
Issue number2
Early online date8 Feb 2017
DOIs
Publication statusPublished - Apr 2017

Keywords

  • Cytokines
  • Humans
  • Respiratory Syncytial Virus Infections
  • Respiratory Syncytial Viruses
  • T-Lymphocytes
  • Journal Article
  • Review

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