PDF(Sci-hub)
Abstract：
Respiratory syncytial virus (RSV) is amongst the most important pathogenic infections of childhood and is associated with significant morbidity and mortality. Although there have been extensive studies of epidemiology, clinical manifestations, diagnostic techniques, animal models and the immunobiology of infection, there is not yet a convincing and safe vaccine available. The major histopathologic characteristics of RSV infection are acute bronchiolitis, mucosal and submucosal edema, and luminal occlusion by cellular debris of sloughed epithelial cells mixed with macrophages, strands of fibrin, and some mucin. There is a single RSV serotype with two major antigenic subgroups, A and B. Strains of both subtypes often co-circulate, but usually one subtype predominates. In temperate climates, RSV infections reflect a distinct seasonality with onset in late fall or early winter. It is believed that most children will experience at least one RSV infection by the age of 2 years. There are several key animal models of RSV. These include a model in mice and, more importantly, a bovine model; the latter reflects distinct similarity to the human disease. Importantly, the prevalence of asthma is significantly higher amongst children who are hospitalized with RSV in infancy or early childhood. However, there have been only limited investigations of candidate genes that have the potential to explain this increase in susceptibility. An atopic predisposition appears to predispose to subsequent development of asthma and it is likely that subsequent development of asthma is secondary to the pathogenic inflammatory response involving cytokines, chemokines and their cognate receptors. Numerous approaches to the development of RSV vaccines are being evaluated, as are the use of newer antiviral agents to mitigate disease. There is also significant attention being placed on the potential impact of co-infection and defining the natural history of RSV. Clearly, more research is required to define the relationships between RSV bronchiolitis, other viral induced inflammatory responses, and asthma.
摘要：
呼吸道合胞病毒(RSV)是儿童期最重要的病原性感染之一,并且与显著的发病率和死亡率相关。尽管已经对流行病学进行了广泛的研究，临床表现，诊断技术,动物模型和感染的免疫生物学，目前还没有令人信服和安全的疫苗。RSV感染的主要组织病理学特征是急性细支气管炎，粘膜和粘膜下水肿，和管腔阻塞脱落的上皮细胞与巨噬细胞混合的细胞碎片，纤维蛋白链，还有一些黏蛋白.有一个单一的RSV血清型与两个主要的抗原亚群，A和B两种亚型的菌株经常共同循环，但通常一种亚型占主导地位。在温带气候下,RSV感染反映出明显的季节性，在秋末或初冬发作。据信大多数儿童到2岁时将经历至少一种RSV感染。有几种关键的RSV动物模型。这些包括小鼠模型，更重要的是,牛模型；后者反映了与人类疾病的明显相似性。重要的是,在婴儿期或儿童早期因RSV住院的儿童中,哮喘的患病率明显较高.然而,对有可能解释这种易感性增加的候选基因的研究有限.特应性易感性似乎易患哮喘的后续发展，并且哮喘的后续发展可能继发于涉及细胞因子的致病性炎症反应。趋化因子及其同源受体。正在评估许多开发RSV疫苗的方法，以及使用较新的抗病毒药物来减轻疾病。同时感染的潜在影响和定义RSV的自然史也受到了极大的关注。显然,需要更多的研究来定义RSV毛细支气管炎之间的关系，其他病毒诱导的炎症反应，和哮喘。
