Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze

• Published in: Journal of allergy and clinical immunology Vol. 123; no. 2; pp. 398 - 403
• Main Authors: Stensballe, Lone Graff, Ravn, Henrik, Kristensen, Kim, Agerskov, Kenneth, Meakins, Tiffany, Aaby, Peter, Simões, Eric A.F.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2009; Elsevier; Elsevier Limited
• Subjects: Age; Allergy and Immunology; Antibodies, Viral - blood; Biological and medical sciences; Blood; Children & youth; Chronic illnesses; Cord blood; Denmark - epidemiology; Family physicians; Female; Fetal Blood - immunology; Fetal Blood - virology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hospitalization - statistics & numerical data; Humans; Infant; Interviews; Lung diseases; Maternal-Fetal Exchange - immunology; maternally derived antibodies; Medical sciences; Neutralization Tests; neutralizing; Patients; Pregnancy; Recurrence; recurrent wheeze; Respiratory diseases; Respiratory Sounds - diagnosis; Respiratory Sounds - immunology; respiratory syncytial virus; Respiratory Syncytial Virus Infections - diagnosis; Respiratory Syncytial Virus Infections - epidemiology; Respiratory Syncytial Virus Infections - immunology; Respiratory Syncytial Virus, Human - immunology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Studies; Surveys and Questionnaires; Womens health; Denmark; Cord blood; RSV; maternally derived antibodies; Maternally derived RSV neutralizing antibodies; IRR; neutralizing; DNBC; recurrent wheeze; ALRI; respiratory syncytial virus; Danish National Birth Cohort; Incidence rate ratio; Maternally derived respiratory syncytial virus neutralizing antibodies in cord blood; Acute lower respiratory tract infection; Human respiratory syncytial virus; Immunopathology; Relapse; Pneumovirinae; Wheezing; Hospitalization; Respiratory system; Neutralizing antibody; Blood; Paramyxoviridae; Virus; Respiratory tract; Mononegavirales; Immunology; Umbilical cord; Pneumovirus; Neutralization
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2008.10.043

Respiratory syncytial virus (RSV) hospitalization is associated with wheeze. To examine the influence of maternally derived RSV neutralizing antibodies in cord blood on RSV hospitalization and recurrent wheeze in infancy. Among children from the Danish National Birth Cohort, we selected a subcohort of 459 randomly selected children, 408 children with RSV hospitalization, 408 children with recurrent wheeze, and all 289 children who experienced both RSV hospitalization and recurrent wheeze. The influence of cord blood RSV neutralizing antibodies was examined as predictors for (1) RSV hospitalization, (2) RSV hospitalization after recurrent wheeze, (3) recurrent wheeze, and (4) recurrent wheeze after RSV hospitalization. Neutralizing antibody levels were inversely associated with RSV hospitalization in infants below 6 months of age (adjusted incidence rate ratio [IRR], 0.74; 95% CI, 0.62-0.87), and also inversely associated with RSV hospitalization in infants with recurrent wheeze (IRR, 0.83; 0.71-0.97). In contrast, neutralizing antibody levels were directly associated with an increased risk of recurrent wheeze in infants below 6 months of age (IRR, 1.28; 1.04-1.57) and with an increased risk of recurrent wheeze after RSV hospitalization in infants below 6 months of age (IRR, 1.44; 1.10-1.90). Maternally derived RSV neutralizing antibodies protect infants against RSV hospitalization, and also when the infant has recurrent wheeze. However, high maternally derived RSV neutralizing antibody levels were associated with an increased risk of recurrent wheeze.