Upper Respiratory Tract Bacterial-Immune Interactions during Respiratory Syncytial Virus Infection in Infancy
AUTHORS
- PMID: 34534566 [PubMed].
ABSTRACT
BACKGROUND: The risk factors determining short- and long-term morbidity following acute respiratory infection (ARI) due to respiratory syncytial virus (RSV) in infancy remain poorly understood.
OBJECTIVES: To examine the associations of the upper respiratory tract (URT) microbiome during RSV ARI in infancy with the acute local immune response and short- and long-term clinical outcomes.
METHODS: We characterized the URT microbiome by 16S ribosomal RNA sequencing and assessed the acute local immune response by measuring 53 immune mediators with high-throughput immunoassays in 357 RSV-infected infants. Our short- and long-term clinical outcomes included several markers of disease severity and the number of wheezing episodes in the 4 year of life, respectively.
RESULTS: We found several specific URT bacterial-immune mediator associations. In addition, the Shannon ⍺-diversity index of the URT microbiome was associated with a higher respiratory severity score (RSS) (β [95% CI]=0.50 [0.13-0.86]), greater odds of a lower ARI (OR [95% CI]=1.63 [1.10-2.43]), and higher number of wheezing episodes in the 4 year of life (β [95% CI]=0.89 [0.37-1.40]). The Jaccard β-diversity index of the URT microbiome differed by level of care required (p=0.04). Furthermore, we found an interaction between the Shannon ⍺-diversity index of the URT microbiome and the first principal component of the acute local immune response on the RSS (p=0.048).
CONCLUSIONS: The URT microbiome during RSV ARI in infancy is associated with the acute local immune response, the disease severity, and the number of wheezing episodes in the 4 year of life. Our results also suggest complex URT bacterial-immune interactions that can impact the severity of the RSV ARI.
Tags: alumni publications 2021