Prevalence of respiratory syncytial virus IgG antibodies in infants living in a rural area of Mozambique

A case control study was carried out in Manhiça (Mozambique). Serum samples were collected from infants < 1 year of age in hospital to assess the effect of serum antibodies on the incidence of respiratory syncytial virus (RSV) infection. Sera were collected from a total of 31 cases of RSV infection and paired uninfected controls matched for age and sex. Anti‐RSV antibodies were assessed by a membrane fluorescent antibody test (MFAT) for immunoglobulin G (IgG) antibodies and by a neutralizing antibody test. IgG RSV antibodies were of higher prevalence and at higher levels in the control group when compared to the infected case group (P < 0.001), indicating an important role for IgG antibodies in protection. To assess infection before recruitment, IgA RSV antibodies were also measured by MFAT. IgA RSV antibody prevalence was very low in patients and controls (0/31 and 4/31 respectively), suggesting that most of the detected IgG RSV antibody in both groups was of maternal origin. Re‐analysis of data from the subset of 27 matched, IgA RSV antibody negative infant pairs mirrored the full analysis indicating that maternal antibody has an important role in RSV protection. Similar results were obtained when neutralizing antibodies were measured and when the measurement was done against subgroup A virus strain A2, subgroup B virus strain 8/60 and a contemporary subgroup A isolate, Moz00. No significant differences in the reactivity of maternal antibodies with the three virus strains were observed. The data described below represent the first analysis of the role of maternal antibodies in reducing the risk of pediatric infection in developing countries. The results reinforce the concept of maternal vaccination for the control of RSV in very young children in whom the risk and severity of infection are the highest. J. Med. Virol. 67:616–623, 2002. © 2002 Wiley‐Liss, Inc.     

Secretion of respiratory syncytial virus inhibitors and antibody in human milk throughout lactation

Neutralising inhibitors to respiratory syncytial (RS) virus have been demonstrated in the whey of most samples of human milk tested. Although high titres were secreted in colostra of some mothers (1/10–1/2,560; median 1/40) inhibitor levels in milk collected after the first week of lactation were uniformly low (median 1/10). High neutralising titres correlated with high colostral levels of specific antiviral IgA but, unlike neutralising activity, IgA antiviral antibody persisted in the milk of only four of 18 mothers. Similarly, antiviral IgG and IgM antibodies were not generally detected after the first postpartum week. Differences in antibody secretion among mothers did not correlate with differences in total protein or total immunoglobulin secretion, and appeared to reflect maternal immune status. In one mother a marked rise in specific antiviral IgA and IgG secretions during the second and third months of lactation suggested a response to virus infection. The relevance of maternal immunity and colostral and milk antiviral antibody to protection of breast-fed babies from RS-virus bronchiolitis is discussed.     

Decreased interferon-gamma response in respiratory syncytial virus compared to other respiratory viral infections in infants

An inappropriate interferon-gamma response has been implicated in the pathogenesis of severe respiratory syncytial virus (RSV) lower respiratory tract illness (LRTI). To assess whether this is unique for RSV primary LRTI compared to a first non-RSV LRTI, intracellular interferon-gamma was determined by flow cytometry in peripheral blood mononuclear cells from 32 infants with a primary RSV infection, 28 with a first non-RSV LRTI due to adenoviral, parainfluenzaviral and rhinoviral infection and 13 healthy infants. Interferon-gamma responses were increased significantly during adenoviral, parainfluenzaviral and the majority of the rhinoviral infections, but remained low during RSV and severe rhinoviral infection. Low interferon-gamma responses were associated with a more severe clinical course of LRTI. This indicates that depending on the nature of the viral pathogen, respiratory virus infections in infants differ significantly with regard to the quantity of the interferon-gamma production and that this may contribute to the clinical course of the disease.     

Cell-mediated immunity in respiratory syncytial virus disease

Systemic cell-mediated responses to respiratory syncytial (RS) virus were detected, using a whole blood transformation assay, in 10 of 28 infants and children with RS virus infections during the period 1–14 days postadmission. Cell-mediated responses were unrelated to the age of the patient or the severity of illness. No correlation was found between cellular responses and fourfold or greater rises in antibody titre to RS virus, as determined by a membrane immunofluorescence technique. Patients under 6 months of age had significantly lower levels of IgA and IgG antibody to RS virus compared to older patients, although cell-mediated responses were similar in both groups. The presence of cell-mediated reactivity to RS virus was also demonstrated in 5 of 95 samples of cord blood examined, and cellular responses failed to correlate with the levels of IgG antibody to RS virus.     

Local antibody production and respiratory syncytial virus infection in children with leukaemia

Children undergoing therapy for acute lymphoblastic leukaemia (ALL) are at increased risk of severe viral respiratory infection, and some find it difficult to terminate virus secretion. This increased severity may result from a defect in the mucosal immune response. To test this hypothesis, nasal immunoglobulin secretion and specific antiviral antibody responses to infection with respiratory syncytial (RS) virus in children with ALL have been compared with those in a normal age-matched comparison group. Children with leukaemia secreted normal levels of IgA and slightly raised IgM levels. IgG levels were depressed. Following RS virus infection, the majority of children with leukaemia secreted normal amounts of IgA and IgG nasal antibody and successfully cleared the virus. However, three of the 13 children studied made poor or undetectable nasal antibody responses, which correlated with their inability to clear the virus.     

Experimental respiratory syncytial virus pneumonia in cebus monkeys.

Into 14 juvenile cebus monkeys that lacked serum antibodies for RS virus 10(8) plaque-forming units (pfu) of wild-type respiratory syncytial (RS) virus were inoculated transtracheally. Roentgenographic evidence of pneumonia developed in 13 of 14 infected animals. Gross pathologic changes occurred in each of the 13 monkeys that were sacrificed. Patchy areas of red consolidation were seen in the lower lobes 24 hours after inoculation, and there was progression to gray consolidation seven days later. Each of the infected animals had histologic evidence of interstitial pneumonia. Changes were detected in the lung as early as 24 hours after inoculation; they consisted primarily of infiltration of the alveolar wall. By the fourth to sixth day after inoculation there was marked interstitial thickening, pulmonary consolidation, formation of multinucleated giant cells and development of eosinophilic cytoplasmic inclusion bodies within alveolar cells. RS viral antigens, detected by indirect immunofluorescence, were distributed throughout cells of the alveolar wall and the bronchiolar epithelium. The virus grew to highest titer in the lungs on the fourth to sixth day after inoculation; up to 10(8) pfu/gram of tissue were detected. The cebus monkey represents the first experimental host to develop extensive pulmonary lesions during infection with respiratory syncytial virus.     

婴幼儿呼吸道合胞病毒感染分子流行病学研究

目的　探讨婴幼儿呼吸道合胞病毒(RSV)感染的分子流行病学情况。方法　采用随机扩增多态DNA(RAPD)技术,对长春市儿童医院1992～1994年分离并鉴定的96株RSV和一株标准RSV进行RAPD分析。结果　所有RSV毒株都有扩增带,共有四种带型。不同疾病来源的RSV基因型不同。来源毛细支气管炎的RSV有8714%为R1型。结论　RAPD技术能从分子水平了解婴幼儿RSV感染情况;R1型RSV可能为引起婴幼儿毛细支气管炎的主要病原。     

Immunoglobulin class-specific antibody response in respiratory syncytial virus infection measured by enzyme immunoassay

Immunoglobulin class-specific enzyme immunoassay (EIA) was used for determination of antibody responses in sera collected from 26 children with acute primary respiratory syncytial virus (RSV) infections. All 26 patients had IgG antibody responses with a significant titer increase in 24 (92%); an IgM antibody response was detected in 19 of the 26 (73%). From patients aged 6 months or less only 5 of 8 produced detectable IgM antibodies, whereas all patients aged 1–2 years did so. IgM antibodies appeared within 1 week after onset of illness and persisted from 20 days to 2–3 months. An IgA antibody response was observed in 20 of 26 (77%) patients with a significant titer increase detected in 17 of 26 (65%) patients. In some patients the persistence of IgA antibodies followed that of the IgM antibodies, but in others the IgA antibody titers remained stable up to the end of the follow-up. The most sensitive assay system for serological diagnosis of acute RSV infection in children was the determination of titer increases by IgG antibody.     

Experimental respiratory syncytial virus infection of four species of primates.

Four species of nonhuman primates were inoculated intranasally with 10(3.1) to 10(3.7) plaque forming units (pfu) of respiratory syncytial (RS) virus. Adults squirrel monkeys and newborn rhesus monkeys became infected and shed small quantities (peak titer 10(2.0) pfu/ml of nasopharyngeal swab specimen) of virus, but illness did not develop. Infant cebus monkeys aged 2 months became infected, shed 10(2.3) to 10(3.8) pfu/ml of nasopharyngeal swab specimen, but did not become ill. Chimpanzees aged 15 to 18 months shed a large quantity of virus, up to 10(6.0) pfu/ml of nasopharyngeal swab specimen and developed an upper respiratory illness. Chimpanzees are proposed as a possible animal model for future study of the immunopathology of RS virus disease and for in vivo evaluation of attenuated live virus vaccine candidates.     

A reverse passive haemagglutination test for the detection of respiratory syncytial virus in nasal secretions from infants

A reverse passive haemagglutination (RPH) test has been developed for the detection of respiratory syncytial (RS) virus in nasal secretions, taken from infants with acute respiratory illness. In the final form of the procedure, RS virus was detected in 24 of 25 samples positive for RS virus by tissue culture and/or fluorescence antibody staining and in two samples negative for RS virus by these techniques. The simplicity of the technique and the rapidity with which it may be performed together with its apparently high degree of sensitivity should make RPH useful in the rapid diagnosis of RS virus.     

Primary respiratory syncytial virus infection in mice

A mouse model of respiratory syncytial virus (RSV) infection is described. A high-titered, large-volume inoculum results in replication of RSV to a high titer in lungs of BALB/c mice. Mice older than 15 weeks of age are more susceptible to RSV infection. Titers up to 10(6.9) plaque-forming units (pfu)/gram lung can be attained in 32-week-old mice. Older mice experience a clinical illness manifested by ruffled fur, reduced activity, and weight loss. Lung histology of older mice infected with RSV shows bronchiolitis and increased number of lymphocytes and macrophages in alveolar spaces compared with that of mice less than 8 weeks old. This model will serve as the basis for investigating immunodeterminants of recovery and protection from RSV infection.     

Immunoprophylaxis and immunotherapy of respiratory syncytial virus infection in the cotton rat

Human convalescent antiserum to respiratory syncytial virus (RSV) administered intraperitoneally to cotton rats prior to RSV challenge provided near-complete protection from pulmonary infection. Antiserum given subsequent to viral challenge reduced pulmonary viral titers 100-fold or greater within 24 h. Sandoglobulin, a preparation of purified human IgG with high titer of anti-RSV neutralizing activity, produced the same effects as convalescent antiserum. Sandoglobulin was absorbed rapidly and produced a significant therapeutic reduction in virus titer within 3 h. The level of virus reduction in pulmonary and nasal tissues was directly proportional to the neutralizing antibody titer in the cotton rat serum, and was always greater in the lungs than the nose. Animals treated therapeutically with Sandoglobulin had a depressed primary antibody response to infection, but were completely resistant to reinfection with RSV. Histologic examination of pulmonary tissues from Sandoglobulin-treated animals showed no pathologic changes.     

呼吸道合胞病毒M2-1蛋白多克隆抗体的制备

目的:制备呼吸道合胞病毒(RSV)M2-1蛋白多克隆抗体, 为进一步研究RSV生物学特性奠定基础。方法:纯化RSV M2-1蛋白, 免疫新西兰家兔, Western blot检测M2-1多克隆抗体效价。结果:Western blot检测可见约48 kD的特异性条带, M2-1蛋白多克隆效价为1:1000。　结论：本实验成功的地制备了RSV M2-1蛋白多克隆抗体。     

Recurrent wheezing after respiratory syncytial virus or non-respiratory syncytial virus bronchiolitis in infancy: a 3-year follow-up

Background:  Recent studies have suggested that rhinovirus-associated early wheezing is a greater risk factor for development of recurrent wheezing in children than is early wheezing associated with respiratory syncytial virus (RSV). We determined the development of recurrent wheezing in young children within 3 years after hospitalization for RSV or non-RSV bronchiolitis.
Methods:  We identified retrospectively all children <2 years of age who were admitted to Turku University Hospital because of bronchiolitis in the months of August–December during 1988–2001. The primary outcome was recurrent wheezing that required long-term asthma medication. Data on asthma medications of the individual children were derived from the Social Insurance Institution of Finland.
Results:  Within the first year after hospitalization, 36 of 217 (16.6%) children with non-RSV bronchiolitis developed recurrent wheezing, compared with five of 199 (2.5%) children with RSV bronchiolitis [relative risk (RR) 6.6; 95% confidence interval (CI) 2.6–16.5]. The rates of recurrent wheezing were significantly increased in the non-RSV group also within 2 years (RR 2.9; 95% CI 1.7–5.1) and 3 years (RR 3.4; 95% CI 2.0–5.7) after hospitalization. The increased risk of recurrent wheezing in children with non-RSV-associated bronchiolitis was observed both in boys and girls at all time points of the 3-year follow-up, and it was not explained by the age difference between the RSV and non-RSV groups or any confounding seasonal factors.
Conclusion:  Children hospitalized with bronchiolitis caused by other viruses than RSV develop recurrent wheezing at substantially higher rates during a 3-year follow-up period than do children with RSV-induced bronchiolitis.     

Prevalence and clinical characteristics of human respiratory syncytial virus in Chinese adults with acute respiratory tract infection

Respiratory syncytial virus (RSV) is a leading cause of respiratory tract illnesses worldwide. Although the prevalence and clinical manifestations of the two subtypes, RSV‐A and RSV‐B, have been studied in some detail in infants and young children, they have not been determined in adults. To evaluate the prevalence of the RSV subtypes and disease severity between RSV‐A and RSV‐B infections in adults, nasal and throat swabs that were collected from patients ≥15 years old who sought medical care for acute respiratory infections at the Fever Clinic of the Peking Union Medical College Hospital in Beijing, China between May 2005 and April 2010. The samples were tested for RSV infection using PCR and sequencing analysis. RSV was detected in 95 (1%) of the adult patients, of whom 53 (55.8%) were positive for RSV‐A and 42 (44.2%) for RSV‐B. The incidence of RSV infections increased with age (χ² = 37.17, P = 1.66E?07). Demographic data and clinical manifestations of RSV‐A were similar to those of RSV‐B. Although RSV‐A and RSV‐B co‐circulated during the 2005–2006 and 2008–2009 seasons, RSV‐A was predominant in the 2006–2008 seasons, whereas RSV‐B was predominant in the 2009–2010 season. Upper respiratory tract infections were diagnosed in most RSV‐infected patients (n = 80, 84.2%), and three patients suffered from pulmonary infection. This is the first study to provide data on the prevalence and clinical manifestations of RSV subgroups among Chinese adults with fever and acute illness, over five successive epidemic seasons. J. Med. Virol. 85:348–353, 2013. © 2012 Wiley Periodicals, Inc.     

Systemic cell-mediated and antibody responses in infants with respiratory syncytial virus infections

In order to investigate the possible role of immunity in lower respiratory tract disease of infants produced by respiratory syncytial (RS) virus, 18 hospitalized infants were tested for cell-mediated immune (CMI) responses in a whole blood culture assay utilizing a gamma emitting tracer, 5(¹²⁵ I) Iodo-2′-deoxyuridine [¹²⁵ IUdR] to quantitate cellular proliferative responses to virus antigen. Class-specific antiviral antibody titres were determined in an indirect membrane immunofluorescence test. One infant showed a CMI response in the acute phase of illness whereas 72% responded one month later. Of the 18 infants, 14 were tested for antibody responses and 71% showed significant rises of antiviral IgG. IgM was detectable in only one acute phase specimen. A tendency for higher CMI responses following severe infection with RS virus was noted but little difference in antibody responses was respect to severity was seen. These findings are discussed in relationship to the pathogenesis of RS virus.     

The development of monoclonal antibodies to respiratory syncytial virus and their use in diagnosis by indirect immunofluorescence

Twelve clones of murine hybridoma cells secreting antibody specific for respiratory syncytial (RS) virus were classified into four groups on the basis of their pattern of staining of unfixed RS virus-infected HEp-2 cells in an indirect immunofluorescence test. Three of the groups reacted with virus antigens present on the membrane of the cells, whilst the fourth group failed to stain most live cells, suggesting specificity for an antigen expressed internally. Representative monoclonals from the membrane antigen staining groups immunoprecipitated the 86K glycoprotein (G), 50K plus 19K glycoprotein (F1,2) and a 23K non-glycosylated protein (VP23). A representative monoclonal from the fourth group that appeared to stain an internally expressed protein immunoprecipitated the virion 34K phospho-protein (P). All four monoclonals stained acetone-fixed tissue culture cells infected with either the Long strain of RS virus or with strains isolated in Newcastle during the 1965, 1972, and 1983 winter epidemics. The anti-fusion protein antibody stained acetone-fixed cells from all of 26 nasopharyngeal secretions from infants with RS virus infection. The anti-G glycoprotein antibody and the anti-VP23 antibody stained cells from secretions poorly or not at all, whilst the anti-P protein antibody stained cells in half the secretions tested but reacted with only a small proportion of cells in comparison with the anti-F or polyclonal antibodies. A pool of all four monoclonals produced more intense staining than the anti-F monoclonal alone and gave a more clearly defined staining reaction than the polyclonal antiserum used for routine diagnosis in over half the secretions. These results indicate that monoclonal antibodies will be of value in the diagnosis of RS virus by indirect immunofluorescence if care is taken in the selection of a suitable pool.