A recent study suggests that RSV can directly infect nerve cells, potentially causing neurological symptoms in young children.
- Respiratory syncytial virus (RSV) is a virus that
primarily impacts young children and older adults and may cause severe
symptoms.
- Data from a recent study suggests that RSV can
directly infect peripheral nerve cells, potentially damaging the nervous
system.
- Further research is needed to understand the full
neurological effects of RSV and any long-term consequences.
Respiratory syncytial virus
(RSV) is a virus that affects
the respiratory tract, leading to a wide range of symptoms.
Children and older
adults are typically most at risk for RSV, even though older children and
adults of all ages can also contract this virus.
The Centers for Disease
Control and Prevention (CDC) estimates between 58,000 and 80,000 children less than 5 years old are hospitalized because
of RSV infection.
Most of the focus has
been on how RSV impacts the respiratory system. However, researchers are also
interested in learning how the virus affects other systems in the body.
A recent study published
in The Journal of Infectious
Diseases examined the impact
of RSV on the nervous system using peripheral nerve and spinal cord cultures.
Researchers
found that the virus affected peripheral nerve cells directly and indirectly.
They found that a critical component is that RSV leads to inflammation and then
to nerve damage.
RSV also somewhat
affected the spinal cord cultures, infecting microglia and dendritic cells,
contributing to inflammation. However, RSV did not infect spinal neurons
directly.
The results indicate the
need for more research on the neurological effects of RSV and the best options
for protection from the virus.
Study author Dr. Giovanni Piedimonte, vice president for Research Institutional Official,
research integrity officer at Tulane University, and professor of Pediatrics,
Biochemistry & Molecular Biology at Tulane School of Medicine, explained
to Medical News Today:
“Our
study is the first to prove that RSV, one of the most common respiratory
viruses in young children and the elderly, can infect peripheral nerves and may
provide the clearest link between RSV and reported neurological symptoms. RSV
infection was associated with a strong inflammatory response and changes in the
conduction of electric signals within the nerves.”
What are the
neurological complications of RSV?
For the study,
researchers wanted to understand more about the particular effects of RSV on
the nervous system.
They used cultures of
nerve tissue from rats and human-induced pluripotent stem cells.
They were able to look
at how RSV impacted these cells. The main focus was to examine the impact on
peripheral nerve and spinal cord cells. They examined and analyzed the samples
on days 1, 8, and 30 after infection to help understand the effects.
There were several
components to the results. They found that RSV infected certain cells but not
others.
For example, they found
that RSV did not infect astrocytes, oligodendrocytes, or Schwann cells, all
specific cell types that researchers were able to examine.
In the spinal cord
cultures, RSV infected specific cells called microglia and dendritic cells but
did not infect neurons.
In the
peripheral nerve cultures, RSV infected the neurons, dendritic cells, and
macrophages. Macrophages are part of the body’s immune response and are
involved in the inflammation response.
Dr. Piedimonte noted the
significant element of the results was the inflammatory response and the
resulting nerve damage. This had to do with chemokine release.
Chemokines are
specific proteins involved in inflammation. Results were also related to the
level of infection with RSV.
“With low levels of RSV
infection, the nerves became hyperreactive to stimulation, whereas at higher
levels, nerves underwent progressive degeneration and increased neurotoxicity
due to excess inflammation,” Dr. Piedimonte explained.
“The nerve
hyperreactivity could explain why children who get RSV are later more likely to
have asthmatic symptoms.”
“The
study also found that RSV could enter the spinal cord via peripheral nerves
despite not having the ability to enter the spinal neurons directly. More
research is needed to explore that mechanism, but we theorize that by using the
peripheral nerves to enter the spinal cord, RSV can bypass the blood-brain
barrier, enter the central nervous system, and cause the neurologic
complications seen in the patients.”— Dr. Giovanni Piedimonte, study author
More
research on the neurological effects of RSV needed
The new study highlights
the potential neurological damage that RSV can cause.
However, it also has
certain limitations. This research involved looking at cultures from stem cells
and rat embryos, meaning more data is required to confirm the findings.
Researchers note
that they didn’t identify which receptor or receptors RSV used to enter neural
and non-neural cells in their data collection. The complexity of the
interaction could be the focus of later studies.
Despite this, the data
points to the potential ways RSV can impact the nervous system.
Non-study author Dr. Arturo Casadevall, PhD, a microbiology and immunology expert with Johns
Hopkins Medicine, commented with his thoughts on the study to MNT:
“This
is a very interesting study providing evidence that RSV has the potential to
damage nerves with the caveat that the observations were made in animal cells.
The implications of the work is that RSV may have neurological effects apart
from its well known effects on the respiratory system. However, the results
need to be validated in humans.”
What
to know about RSV in children
RSV is a virus that
poses a particular risk to young children’s health.
Non-study author Dr. Sherry Ross, a board certified OB-GYN and Women’s Health Expert
at Providence Saint John’s Health Center in Santa Monica, CA, noted the following
to MNT:
“RSV,
also known as the respiratory syncytial virus, attacks the lungs and is
dangerous to newborns, babies, and younger children. It’s well known [that]
“RSV is the leading cause of infant hospitalization in the U.S.,” especially
for those who are severely immunocompromised, have chronic lung disease being
born prematurely and those with cystic fibrosis.”
People with RSV may experience symptoms such
as:
Infants may experience difficulty breathing and may also develop bronchiolitis or pneumonia.
Treatment for RSV often
involves supportive measures to assist with breathing and comfort. Sometimes,
children and infants may require hospitalization to receive appropriate care.
Doctors may give
supplemental oxygen to keep oxygen levels up and IV fluids to help with dehydration. In more extreme
situations, someone with RSV may need to be intubated for breathing
assistance.
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