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01-12-2004 | Serie wetenschappelijk onderzoek

Ziekte-ernst van rsv-lageluchtweginfectie: klinische, virologische en immunologische determinanten

Auteurs: C. A. Lindemans, J. L. L. Kimpen, L. J. Bont

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 6/2004

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Samenvatting

Lageluchtweginfectie (llwi) door respiratoir syncytieel virus (rsv) is een frequente oorzaak van hospitalisatie van jonge kinderen gedurende de wintermaanden. In dit artikel wordt een overzicht gegeven van risicofactoren en pathofysiologische mechanismen die bijdragen aan ziekte-ernst tijdens rsv-llwi. De belangrijkste klinische risicofactoren voor een ernstig beloop zijn prematuriteit met of zonder chronisch longlijden, leeftijd jonger dan zes weken en congenitale hartafwijkingen. Gastheerfactoren lijken pathofysiologisch van groter belang dan virusgerelateerde factoren. Polymorfismen van genen die een rol spelen in de immuunrespons, alsook congenitale longfunctieafwijkingen zijn preëxistente determinanten die in geval van rsv-infectie de ziekte-ernst bepalen. De rol van de immuunrespons is complex. Aan de ene kant is een antivirale respons nodig voor goede klaring van rsv, wat direct beschadigend is voor de luchtwegen (cytopathologisch effect). Onrijpheid van de immuunrespons van jonge kinderen vertraagt deze antivirale immuunrespons. Aan de andere kant zijn er aanwijzingen dat een ‘overmatige’ immuunrespons ook een direct nadelig effect heeft op de luchtwegen (immunopathologisch effect). Deze suggestie van een immuungemedieerde pathogenese van rsv-llwi impliceert de mogelijkheid van gunstige therapeutische effecten van immuunmodulatie.
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Metagegevens
Titel
Ziekte-ernst van rsv-lageluchtweginfectie: klinische, virologische en immunologische determinanten
Auteurs
C. A. Lindemans
J. L. L. Kimpen
L. J. Bont
Publicatiedatum
01-12-2004
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Kindergeneeskunde / Uitgave 6/2004
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI
https://doi.org/10.1007/BF03061475