• Kedir N Turi, Jyoti Shankar, Larry J Anderson, Devi Rajan, Kelsey Gaston, Tebeb Gebretsadik, Suman R Das, Cosby Stone, Emma K Larkin, Christian Rosas-Salazar, Steven M Brunwasser, Martin L Moore, R Stokes Peebles, and Tina V Hartert.
• 1 Division of Allergy, Pulmonary, and Critical Care Medicine and.
• Am. J. Respir. Crit. Care Med. 2018 Oct 15; 198 (8): 106410731064-1073.

RationaleRecurrent wheeze and asthma are thought to result from alterations in early life immune development following respiratory syncytial virus (RSV) infection. However, prior studies of the nasal immune response to infection have assessed only individual cytokines, which does not capture the whole spectrum of response to infection.ObjectivesTo identify nasal immune phenotypes in response to RSV infection and their association with recurrent wheeze.MethodsA birth cohort of term healthy infants born June to December were recruited and followed to capture the first infant RSV infection. Nasal wash samples were collected during acute respiratory infection, viruses were identified by RT-PCR, and immune-response analytes were assayed using a multianalyte bead-based panel. Immune-response clusters were identified using machine learning, and association with recurrent wheeze at age 1 and 2 years was assessed using logistic regression.Measurements And Main ResultsWe identified two novel and distinct immune-response clusters to RSV and human rhinovirus. In RSV-infected infants, a nasal immune-response cluster characterized by lower non-IFN antiviral immune-response mediators, and higher type-2 and type-17 cytokines was significantly associated with first and second year recurrent wheeze. In comparison, we did not observe this in infants with human rhinovirus acute respiratory infection. Based on network analysis, type-2 and type-17 cytokines were central to the immune response to RSV, whereas growth factors and chemokines were central to the immune response to human rhinovirus.ConclusionsDistinct immune-response clusters during infant RSV infection and their association with risk of recurrent wheeze provide insights into the risk factors for and mechanisms of asthma development.

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