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Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College of Science, Technology and Medicine Medical School, Norfolk Place, London, United Kingdom
Bronchiolitis caused by respiratory syncytial virus (RSV) infection
is a major cause of hospitalization in children under 1 year of age.
RSV causes common colds in older children and adults, but can cause
serious disease in immunodeficient patients and the elderly.
Development of effective vaccines and treatments for RSV infection is
therefore a priority. Because bronchiolitis and vaccine-augmented
disease are thought to be caused by exuberant T cell activation,
attention has focused on the use of immunomodulators that affect T cell
responses. In mice, IL-12 treatment down-regulates type 2 cytokine
responses to the attachment protein G of RSV, reducing lung
eosinophilia but further enhancing illness. We now show that
CD8+ T cells are responsible for enhanced weight loss,
whereas IL-12-activated NK cells express high levels of IFN-
and
inhibit lung eosinophilia without causing illness. Moreover, unlike
immunocompetent mice, virus is detected in the mediastinal lymph nodes
after elimination of both CD8+ T cells and NK cells. These
studies show that innate immune responses to viral infections direct
the pattern of subsequent specific immunity and are critical to the
development of nonpathogenic antiviral effects. We speculate that IL-12
treatment might be beneficial and safe in T cell-deficient patients
with RSV pneumonitis.
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