Immunology of viral respiratory tract infection in infancy.
Crowe JE, Williams JV.
Department of Pediatrics, Vanderbilt University Medical Center, D-7235 Medical
Center North, 1161 21st Avenue South, 37232-2581, Nashville, TN, USA
Respiratory viruses such as respiratory syncytial virus (RSV), parainfluenza
viruses (PIV) and the influenza viruses cause severe lower respiratory tract
disease in infants and children throughout the world. We discuss the recent
discovery of the epidemiologic importance of the human metapneumoviruses, first
reported in 2001. Experimental live-attenuated vaccines for each of these
viruses are being developed for intranasal administration in the first weeks or
months of life. The immunology of these infections in humans is poorly defined
but many studies are ongoing. A significant obstacle to successful immunisation
of infants against respiratory-virus-associated disease early in life may be the
relatively poor immune response of very young infants to primary virus
infection. This paper reviews the immune correlates of protection against
disease caused by these viruses, immune responses of infants to naturally
acquired infection or experimental infection with candidate vaccine viruses and
the genetics of susceptibility to severe disease.
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