Rosa Rodriguez-Fernandez1, Lorena I Tapia2,3, Chin-Fen Yang4,5, Juan Pablo Torres6,3, Susana Chavez-Bueno6,7, Carla Garcia6,8, Lisa M Jaramillo1, Melissa Moore-Clingenpeel9, Hasan S Jafri6,10, Mark E Peeples1, Pedro A Piedra2, Octavio Ramilo1,11, Asuncion Mejias1,11. 1. Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio. 2. Department of Molecular Virology and Microbiology, and Pediatrics, Baylor College of Medicine, Houston, Texas. 3. Department of Pediatrics and Virology Program, Facultad de Medicina, Universidad de Chile, Santiago. 4. Department of Research, Medimmune LLC, Mountain View, California. 5. Enimmune Corporation, Taiwan. 6. Division of Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, Dallas. 7. Children's Mercy Hospital, Kansas City, Missouri. 8. PID Associates, Carrollton, Texas. 9. Center for Biostatistics. 10. Medimmune /AztraZeneca. 11. Division of Pediatric Infectious Diseases, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus.
Abstract
Background: Data on how respiratory syncytial virus (RSV) genotypes influence disease severity and host immune responses is limited. Here, we characterized the genetic variability of RSV during 5 seasons, and evaluated the role of RSV subtypes, genotypes, and viral loads in disease severity and host transcriptional profiles. Methods: A prospective, observational study was carried out, including a convenience sample of healthy infants hospitalized with RSV bronchiolitis. Nasopharyngeal samples for viral load quantitation, typing, and genotyping, and blood samples for transcriptome analyses were obtained within 24 hours of hospitalization. Multivariate models were constructed to identify virologic and clinical variables predictive of clinical outcomes. Results: We enrolled 253 infants (median age 2.1 [25%-75% interquartile range] months). RSV A infections predominated over RSV B and showed greater genotype variability. RSV A/GA2, A/GA5, and RSV B/BA were the most common genotypes identified. Compared to GA2 or BA, infants with GA5 infections had higher viral loads. GA5 infections were associated with longer hospital stay, and with less activation of interferon and increased overexpression of neutrophil genes. Conclusions: RSV A infections were more frequent than RSV B, and displayed greater variability. GA5 infections were associated with enhanced disease severity and distinct host immune responses.
Background: Data on how respiratory syncytial virus (RSV) genotypes influence disease severity and host immune responses is limited. Here, we characterized the genetic variability of RSV during 5 seasons, and evaluated the role of RSV subtypes, genotypes, and viral loads in disease severity and host transcriptional profiles. Methods: A prospective, observational study was carried out, including a convenience sample of healthy infants hospitalized with RSV bronchiolitis. Nasopharyngeal samples for viral load quantitation, typing, and genotyping, and blood samples for transcriptome analyses were obtained within 24 hours of hospitalization. Multivariate models were constructed to identify virologic and clinical variables predictive of clinical outcomes. Results: We enrolled 253 infants (median age 2.1 [25%-75% interquartile range] months). RSV A infections predominated over RSV B and showed greater genotype variability. RSV A/GA2, A/GA5, and RSV B/BA were the most common genotypes identified. Compared to GA2 or BA, infants with GA5 infections had higher viral loads. GA5 infections were associated with longer hospital stay, and with less activation of interferon and increased overexpression of neutrophil genes. Conclusions: RSV A infections were more frequent than RSV B, and displayed greater variability. GA5 infections were associated with enhanced disease severity and distinct host immune responses.
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