Can the early-life nasopharyngeal microbiome modify the risk of post-respiratory syncytial virus wheeze?

Published online: January 9, 2018

Infants with acute respiratory infection (ARI) due to respiratory syncytial virus (RSV) are at a higher risk of developing frequent wheezing episodes and childhood asthma. Several studies have shown that the early-life upper airway microbiome plays an important role in the short-term outcomes of RSV ARIs. However, the effect of the infant’s upper airway microbiome on RSV-associated long-term outcomes is not known.

In a recent study published in The Journal of Allergy and Clinical Immunology (JACI), Rosas-Salazar and colleagues examined the role of the nasopharyngeal microbiome in the development of childhood wheezing illnesses following RSV ARI in infancy. The authors conducted a nested cohort study of 118 previously healthy, term infants with laboratory-confirmed RSV ARI. They used next-generation sequencing of the 16S rRNA gene to characterize the nasopharyngeal microbiome of RSV-infected infants. These infants were then followed longitudinally with wheezing outcomes assessed by a validated questionnaire at age 2 years.

The authors found that both the presence and higher abundance of Lactobacillus in the nasopharynx of infants with RSV ARI was associated with a reduced risk of childhood wheezing illnesses at age 2 years. In addition, Lactobacillus was ranked first among all nasopharyngeal bacterial genera in distinguishing RSV-infected infants with and without subsequent wheeze. These results suggest that the detection of nasopharyngeal Lactobacillus during RSV ARI in infancy could be used as a biomarker for the development of post-RSV wheeze. In addition, these results could lead to the development of novel interventions aimed to prevent the onset and reduce the burden of childhood wheezing illnesses and asthma.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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