El virus respiratorio sincicial: patógeno de niños… y de grandes

Abstract

Since respiratory syncytial virus (RSV) was identified in 1956, its impact as the main cause of severe acute lower respiratory infections in infants has been shown. Studies about RSV immunopathogenesis have demonstrated that the host immune response is important in protecting from re-infections. The presence of RSV in exacerbation of chronic diseases as COPD and bronchial asthma in adults and its severity in cases with immunodeficiency has been also related to an inadequate response. The actual knowledge on the molecular structure and functions of the virus has allowed to improve diagnosis and to develop new strategies for vaccines and antiviral drugs. The etiologic diagnosis in children is easier than in adults due to the higher viral shedding; therefore techniques based on antibody reactions (immunofluorescence, immunocromatography, etc) are good enough in this group. By contrast, in adults, highly sensitive molecular techniques are needed. Although the advances in understanding the pathogenesis process in neonates and infants, many pathogenic factors still need to be elucidated. The virus strains, viral loads and immune response have been described as important players; however, the changes on the host immunity to RSV according to age and co-morbidities associated to severity of illness needs to be explored. RSV has been known as a children pathogen, nowadays this agent is being recognized as an important agent in adults, especially in those with chronic diseases, immunodeficiency and in immune-senescence.