Relazione tra carica virale, reazione immunitaria dell'ospite, microbiota e decorso clinico della bronchiolite acuta nei bambini con etĂ  inferiore ai 12 mesi (RMB2018) - PhDData

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Relazione tra carica virale, reazione immunitaria dell’ospite, microbiota e decorso clinico della bronchiolite acuta nei bambini con etĂ  inferiore ai 12 mesi (RMB2018)

The thesis was published by Rocca, Alessandro <1988>, in March 2023, Universita di Bologna.

Abstract:

The leading cause of hospitalization in infancy consists of acute bronchiolitis, firstly caused by Respiratory Syncytial Virus (RSV). About infection’s severity, different results are present in literature regarding the RSV load, the host inflammatory and immune response, the patient’s microbiome during acute bronchiolitis, and related to long-term outcomes such as wheezing and asthma development.
This prospective, monocentric cohort study enrolls previously healthy infants hospitalized for their first acute bronchiolitis caused by RSV or other pathogens, firstly evaluating the relationship between the clinical course and the RSV load, then analyzing the association between bronchiolitis and specific nasopharyngeal and fecal microbiome’s genera composition and evolution concerning wheezing’s development.
Up to now, 89 infants were enrolled, 68 of them with RSV bronchiolitis (76.4%), with RSV load and microbiome analysis in 41/68 cases (60.3%) and in 20/68 patients (29.4) respectively.
No significant association emerged between RSV load and outcome measures of severity as need and duration of oxygen therapy or length of stay in the hospital. A trend of association between RSV load on admission, but also the peak of RSV-RNA and the needing for high flow oxygen therapy (HFNC), and a significant relation between RSV clearance and HFNC therapy (p = 0.03) suggested that bronchiolitis clinical course and severity could be directly influenced by RSV load.
Microbiome analyses reported a lot of bacterial genera that have not yet been described in the literature to date (e.g. Alloiococcus and Leptotrichia genera in the nasopharyngeal microbiome, and salivary data, described in our study for the first time in literature). Moreover, a general increase in diversity 6 months after discharge was observed.
Future steps will consist in analyzing the inflammatory host system influence with the cytokines’ evaluation and in extending the microbiome’s study to long-term follow-up time points and outcomes such as wheezing and asthma development.



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