title: Inflammatory responses to respiratory syncytial virus (RSV) infection and the development of immunomodulatory pharmacotherapeutics.
abstract: Respiratory syncytial virus (RSV; Family Paramyxoviridae, Genus Pneumovirus) is a major respiratory pathogen of infants and children and an emerging pathogen of the elderly. Current management of RSV disease includes monoclonal antibody prophylaxis for infants identified as high risk and supportive care for those with active infection; there is no vaccine, although several are under study. In this manuscript, we review published findings from human autopsy studies, as well as experiments that focus on human clinical samples and mouse models of acute pneumovirus infection that elucidate basic principles of disease pathogenesis. Consideration of these data suggests that the inflammatory responses to RSV and related pneumoviral pathogens can be strong, persistent, and beyond the control of conventional antiviral and anti-inflammatory therapies, and can have profound negative consequences to the host. From this perspective, we consider the case for specific immunomodulatory strategies that may have the potential to alleviate some of the more serious sequelae of this disease.
authors.affiliation: Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. hrosenberg@niaid.nih.gov
authors.forename: H F
authors.initials: HF
authors.lastname: Rosenberg
authors.forename: J B
authors.initials: JB
authors.lastname: Domachowske
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000276:immunology / Q000378:metabolism; D004195:Disease Models, Animal; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D020319:Oligodeoxyribonucleotides, Antisense / Q000627:therapeutic use; D018111:Pneumovirus / Q000235:genetics / Q000276:immunology; D018186:Pneumovirus Infections / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000276:immunology*
chemical_list: D000911:Antibodies, Monoclonal; D000998:Antiviral Agents; D016207:Cytokines; D007155:Immunologic Factors; D020319:Oligodeoxyribonucleotides, Antisense