Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze
Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze
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DOI：
10.1016/j.jaci.2008.10.043
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发表时间：
2009-02-01
影响因子：
14.2
通讯作者：
Simoes, Eric A. F.
中科院分区：
文献类型：
--
作者：
Stensballe, Lone Graff;Ravn, Henrik;Simoes, Eric A. F.
背景：呼吸道合胞病毒 (RSV) 住院与喘息相关。目的：探讨脐带血中母源 RSV 中和抗体对 RSV 住院和婴儿期反复喘息的影响。方法：在丹麦国家出生队列的儿童中，我们随机选择了 459 名儿童、408 名 RSV 住院儿童、408 名反复喘息儿童以及所有儿童。 289 名儿童因 RSV 住院且反复出现喘息。检查脐带血 RSV 中和抗体的影响，作为 (1) RSV 住院、(2) 反复喘息后 RSV 住院、(3) 反复喘息和 (4) RSV 住院后反复喘息的预测因子。 结果：中和抗体水平与 6 个月以下婴儿的 RSV 住院呈负相关（调整后的发病率比 [IRR]，0.74；95% CI， 0.62-0.87），也与反复喘息婴儿的 RSV 住院呈负相关（IRR，0.83；0.71-0.97）。相比之下，中和抗体水平与 6 个月以下婴儿反复喘息的风险增加直接相关 (IRR，1.28；1.04-1.57)，并且与 6 个月以下婴儿因 RSV 住院后反复喘息的风险增加直接相关 (IRR，1.44；1.10-1.90)。 结论：母源 RSV 中和抗体可保护婴儿免受 RSV 感染住院治疗，以及婴儿反复喘息时。然而，母体来源的 RSV 中和抗体水平较高与反复喘息的风险增加相关。 （过敏临床免疫杂志 2009 年；123：398-403。）
Background: Respiratory syncytial virus (RSV) hospitalization is associated with wheeze.Objective: To examine the influence of maternally derived RSV neutralizing antibodies in cord blood on RSV hospitalization and recurrent wheeze in infancy.Methods: Among children from the Danish National Birth Cohort, we selected a subcohort of 459 randomly selected children, 408 children with RSV hospitalization, 408 children with recurrent wheeze, and all 289 children who experienced both RSV hospitalization and recurrent wheeze. The influence of cord blood RSV neutralizing antibodies was examined as predictors for (1) RSV hospitalization, (2) RSV hospitalization after recurrent wheeze, (3) recurrent wheeze, and (4) recurrent wheeze after RSV hospitalization.Results: Neutralizing antibody levels were inversely associated with RSV hospitalization in infants below 6 months of age (adjusted incidence rate ratio [IRR], 0.74; 95% CI, 0.62-0.87), and also inversely associated with RSV hospitalization in infants with recurrent wheeze (IRR, 0.83; 0.71-0.97). In contrast, neutralizing antibody levels were directly associated with an increased risk of recurrent wheeze in infants below 6 months of age (IRR, 1.28; 1.04-1.57) and with an increased risk of recurrent wheeze after RSV hospitalization in infants below 6 months of age (IRR, 1.44; 1.10-1.90).Conclusion: Maternally derived RSV neutralizing antibodies protect infants against RSV hospitalization, and also when the infant has recurrent wheeze. However, high maternally derived RSV neutralizing antibody levels were associated with an increased risk of recurrent wheeze. (J Allergy Clin Immunol 2009;123:398-403.)