title: Protective and Harmful Immunity to RSV Infection.
abstract: Respiratory syncytial virus (RSV) is an exceptional mucosal pathogen. It specializes in infection of the ciliated respiratory epithelium, causing disease of variable severity with little or no direct systemic effects. It infects virtually all children by the age of three years and then repeatedly infects throughout life; this it does despite relatively slight variations in antigenicity, apparently by inducing selective immunological amnesia. Inappropriate or dysregulated responses to RSV can be pathogenic, causing disease-enhancing inflammation that contributes to short- and long-term effects. In addition, RSV's importance as a largely unrecognized pathogen of debilitated older people is increasingly evident. Vaccines that induce nonpathogenic protective immunity may soon be available, and it is possible that different vaccines will be optimal for infants; older children; young to middle-age adults (including pregnant women); and elderly persons. At the dawn of RSV vaccination, it is timely to review what is known (and unknown) about immune responses to this fascinating virus.
authors.affiliation: Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom; email: p.openshaw@imperial.ac.uk.
authors.forename: Peter J M
authors.initials: PJM
authors.lastname: Openshaw
authors.affiliation: Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom; email: p.openshaw@imperial.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Chiu
authors.affiliation: Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom; email: p.openshaw@imperial.ac.uk.
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Culley
authors.affiliation: Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom; email: p.openshaw@imperial.ac.uk.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Johansson
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D006801:Humans; D057131:Immune Evasion; D056747:Immunomodulation; D020545:Respiratory Mucosa / Q000276:immunology* / Q000821:virology; D018357:Respiratory Syncytial Virus Infections / Q000276:immunology*; D012136:Respiratory Syncytial Viruses / Q000276:immunology*; D014765:Viral Vaccines / Q000276:immunology*
chemical_list: D014765:Viral Vaccines
keywords: bronchiolitis; immunoregulation; mucosal immunity; pediatric infections; viral lung disease