Does respiratory syncytial virus lower respiratory illness in early life cause recurrent wheeze of early childhood and asthma? Critical review of the evidence and guidance for future studies from a World Health Organization-sponsored meeting
| Autor: | Patrick K. Munywoki, S. Hasan Arshad, Janet A. Englund, Nienke M Scheltema, Eric A. F. Simões, Amanda J. Driscoll, Bruce L. Innis, Steven M. Brunwasser, Pete Smith, Harish Nair, Daniel R. Feikin, Deshayne B. Fell, Ruth A. Karron, Louis Bont, Justin R. Ortiz, E. Kim Mulholland, Gayle E Langley, Fred Were, Thomas Cherian, Heather J. Zar, Laura L. Hammitt, Tina V. Hartert, David A. Savitz |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Monoclonal antibody
medicine.medical_specialty Respiratory Tract Diseases Psychological intervention Respiratory Syncytial Virus Infections Disease Respiratory syncytial virus World Health Organization Article 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Wheeze Lower respiratory tract infection medicine Humans 030212 general & internal medicine Early childhood Child Intensive care medicine Randomized Controlled Trials as Topic Respiratory Sounds Asthma General Veterinary General Immunology and Microbiology business.industry Public health Public Health Environmental and Occupational Health Infant medicine.disease respiratory tract diseases Causality Observational Studies as Topic Infectious Diseases Child Preschool Molecular Medicine Observational study medicine.symptom business Vaccine Switzerland |
| Zdroj: | Driscoll, A J, Arshad, S H, Bont, L, Brunwasser, S M, Cherian, T, Englund, J A, Fell, D B, Hammitt, L L, Hartert, T V, Innis, B L, Karron, R A, Langley, G E, Mulholland, E K, Munywoki, P K, Nair, H, Ortiz, J R, Savitz, D A, Scheltema, N M, Simões, E A F, Smith, P G, Were, F, Zar, H J & Feikin, D R 2020, ' Does respiratory syncytial virus lower respiratory illness in early life cause recurrent wheeze of early childhood and asthma? Critical review of the evidence and guidance for future studies from a World Health Organization-sponsored meeting ', Vaccine . https://doi.org/10.1016/j.vaccine.2020.01.020 Vaccine |
| ISSN: | 0264-410X |
| Popis: | Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI) and hospitalization in infants and children globally. Many observational studies have found an association between RSV LRTI in early life and subsequent respiratory morbidity, including recurrent wheeze of early childhood (RWEC) and asthma. Conversely, two randomized placebo-controlled trials of efficacious anti-RSV monoclonal antibodies (mAbs) in heterogenous infant populations found no difference in physician-diagnosed RWEC or asthma by treatment group. If a causal association exists and RSV vaccines and mAbs can prevent a substantial fraction of RWEC/asthma, the full public health value of these interventions would markedly increase. The primary alternative interpretation of the observational data is that RSV LRTI in early life is a marker of an underlying predisposition for the development of RWEC and asthma. If this is the case, RSV vaccines and mAbs would not necessarily be expected to impact these outcomes. To evaluate whether the available evidence supports a causal association between RSV LRTI and RWEC/asthma and to provide guidance for future studies, the World Health Organization convened a meeting of subject matter experts on February 12-13, 2019 in Geneva, Switzerland. After discussing relevant background information and reviewing the current epidemiologic evidence, the group determined that: (i) the evidence is inconclusive in establishing a causal association between RSV LRTI and RWEC/asthma, (ii) the evidence does not establish that RSV mAbs (and, by extension, future vaccines) will have a substantial effect on these outcomes and (iii) regardless of the association with long-term childhood respiratory morbidity, severe acute RSV disease in young children poses a substantial public health burden and should continue to be the primary consideration for policy-setting bodies deliberating on RSV vaccine and mAb recommendations. Nonetheless, the group recognized the public health importance of resolving this question and suggested good practice guidelines for future studies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect