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Respir. Crit. Care Med. 160, 1263–1268. , and Marshall-Clarke, S. (2004). Neonatal adaptive immunity comes of age. Nat. Rev. Immunol. 4, 553–564. Awomoyi, A. , Pollin, T. , Sztein, M. , Boukhvalova, M. , Hemming, V. , Blanco, J. , and Vogel, S. N. (2007). Association of TLR4 Polymorphisms with Symptomatic Respiratory Syncytial Virus Infection in High-Risk Infants and Young Children. J. Immunol. 179, 3171–3177. , and Rabatic, S. (2000). Predominant type-2 response in infants with respiratory syncytial virus (RSV) infection demonstrated by cytokine flow cytometry.
In fact, this may partially explain why many positive findings in the literature still await confirmation. Finally, statistical analysis becomes increasingly complex as more genes are studied simultaneously. Use of differing statistical techniques may 34 L. Bont confuse things further. While acknowledging these limitations, it is clear that genetic studies have raised several fascinating new hypotheses, which may eventually lead to a better understanding of the pathogenesis of RSV bronchiolitis.
These studies have not attempted to identify Table 1 Genetic polymorphisms associated with risk of RSV bronchiolitis Innate immunity Adaptive immunity TLR-4 CD14 IL-8 Surfactants A, B, D CCR5 VDR JUN IFNA5 NOS2A IL-4 IL-4Ra IL-10 FCER1A Current Concepts of the Pathogenesis of RSV Bronchiolitis 33 genes facilitating infection itself, since virtually all children are infected with the virus. Practically all genetic studies have focused on single nucleotide polymorphisms (SNP) of genes involved in the immune and pulmonary systems.