J Pediatr Intensive Care 2012; 01(03): 127-134
DOI: 10.3233/PIC-2012-022
Review Article
Georg Thieme Verlag KG Stuttgart – New York

Immune response in RSV bronchiolitis: The key to more effective therapeutic interventions

Iolanda Jordan
a   Pediatric Intensive Care Unit, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain
,
Mònica Balaguer
a   Pediatric Intensive Care Unit, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain
› Author Affiliations

Subject Editor:
Further Information

Publication History

30 September 2010

13 December 2011

Publication Date:
28 July 2015 (online)

Abstract

Respiratory syncytial virus (RSV) is among the primary pathogens of bronchiolitis. The mortality rate among hospitalized children with RSV bronchiolitis is approximately 1 to 3%. As reported by various authors, the severity of this viral disease is linked to immune response. Thus, it is important that treatment for RSV bronchiolitis be immunologically targeted. The virus activates intracellular signaling in respiratory epithelial cells via receptors known as Toll-like receptors. After this stimulation, primary RSV infection generates a mixed Th1/Th2 response, which is regulated by gamma interferon. An exacerbated Th2 response would lead to a more severe infection. Herein we review the immunologic mechanisms behind RSV bronchiolitis in order to correlate each treatment with a corresponding immunological response.