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Editorial
Neutrophils and RSV: differences with age
  1. Zoe Rooke1,
  2. Noreen Zainal Abidin1,
  3. Caroline Harris1,
  4. Malcolm Brodlie1,2
  1. 1Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2Translational and Clinical Research Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
  1. Correspondence to Dr Malcolm Brodlie, Translational and Clinical Research Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK; malcolm.brodlie{at}ncl.ac.uk

https://doi.org/10.1136/thorax-2023-221177

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    Respiratory syncytial virus (RSV) remains the leading cause of bronchiolitis in infants and young children.1 RSV is highly transmissible, and in temperate climate zones, seasonal epidemics occur during autumn and winter months.2 Worldwide bronchiolitis places a substantial burden on healthcare resources.1 Each year, RSV is estimated to cause 30 million cases of lower respiratory tract infection in children under 5 years of age and be responsible for over 3 million hospitalisations.1 3 Around 200 000 deaths occur mainly in lower-income countries.1 3 In high-income countries, bronchiolitis is the most common reason for infants to be admitted to hospital.4

    A spectrum of disease occurs in RSV bronchiolitis. This ranges from a mild illness not requiring any intervention to more significant problems needing hospitalisation for supportive treatment to maintain hydration and/or oxygenation.1 4 Effective specific treatments for RSV bronchiolitis remain elusive.5 6 Vaccination (passive, active or maternal) holds great promise to limit disease in young children and older adults but has previously been limited to passive immunisation in high-risk groups.7–9 Two products are now licensed for protective immunisation, and it is highly probable that one will be employed in the paediatric population in the UK in winter 2024/25.8 10 11

    Airway pathophysiology associated with RSV bronchiolitis is focused on the distal bronchioles where obstruction and distal atelectasis occurs.1 Release of proinflammatory mediators generates acute inflammation …

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    Footnotes

    • Twitter @ZoeAnnRooke1, @malc_brod

    • Contributors ZR, NZA and CH: contributed to the planning and writing of the article. MB is responsible for the overall content and final version and will act as guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests MB: not related to this work, investigator-led research grants from Pfizer and Roche Diagnostics and speaker fees paid to Newcastle University from Novartis, Roche Diagnostics, Vertex Pharmaceuticals and TEVA. Travel expenses to educational meetings, Boehringer Ingelheim and Vertex Pharmaceuticals. Other authors: none.

    • Provenance and peer review Commissioned; externally peer reviewed.

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