BOSTON – A type of viral lung infection called bronchiolitis is the leading cause of hospitalizations in U.S. infants as well as a major risk factor for developing asthma. New research led by investigators at Massachusetts General Hospital (MGH) has revealed a complex interplay among the infecting virus, the airway’s microbial composition and function, and the infant’s immune response that all contribute to a child’s risk of developing asthma after bronchiolitis.
The work , which is described in the European Respiratory Journal , relies on metatranscriptome profiles, or microbes’ RNA within certain environments— in this case, the airway of infants with severe bronchiolitis.
After analyzing tissue from the nasopharynx, or the upper part of the throat, of 244 infants hospitalized for bronchiolitis, the team identified five metatranscriptome profiles based on the infecting virus and the microbial composition and function of the nasopharynx. Infants with different metatranscriptome profiles not only had distinct microbial function but also had unique immune responses in the nasopharyngeal airway at the time of bronchiolitis.
Importantly, infants had different risks of developing asthma by age five based on their metatranscriptome profile. For example, infants with one profile had an approximate 40% risk of developing asthma. Therefore, interactions among the infecting virus, bacteria residing in the nasopharynx, and the infant’s immune system likely affect a child’s risk of developing asthma after severe bronchiolitis.
“Our findings may provide an evidence base for the early identification of high-risk children during an important period of airway development—early infancy—and should facilitate further investigations into the development of metatranscriptome profile–specific strategies for asthma prevention,” says lead author Yoshihiko Raita, MD, MPH, MMSc, a research staff member in the Department of Emergency Medicine at MGH.
This work was supported by the National Institutes of Health.
About the Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2021, Mass General was named #5 in the U.S. News & World Report list of "America’s Best Hospitals."
European Respiratory Journal
Observational study
People
Nasopharyngeal metatranscriptome profiles of infants with bronchiolitis and risk of childhood asthma: a multicentre prospective study
16-Dec-2021
Conflict of interest: Yoshihiko Raita has nothing to disclose. Conflict of interest: Marcos Pérez-Losada has nothing to disclose. Conflict of interest: Robert J. Freishtat has nothing to disclose. Conflict of interest: Andrea Hahn has nothing to disclose. Conflict of interest: Eduardo Castro-Nallar has nothing to disclose. Conflict of interest: Ignacio Ramos-Tapia has nothing to disclose. Conflict of interest: Nathaniel Stearrett has nothing to disclose. Conflict of interest: Dr. Yury A. Bochkov has patents on production methods of rhinoviruses. Conflict of interest: Dr. James E. Gern is a paid consultant to AstraZeneca and Meissa Vaccines Inc., has stock options in Meissa Vaccines Inc., and has patents on production methods of rhinoviruses. Conflict of interest: Jonathan M. Mansbach has nothing to disclose. Conflict of interest: Zhaozhong Zhu has nothing to disclose. Conflict of interest: Carlos A. Camargo Jr. has nothing to disclose. Conflict of interest: Kohei Hasegawa has nothing to disclose.