The developing immune system in preterm born infants: From contributor to potential solution for respiratory tract infections and wheezing
Allergy, vol. 79, pp. 2924–2942
Abstract
Moderate-late preterm-born infants experience more frequent and severe respiratory tract infections and wheezing compared to term-born infants. Decreasing the risk on respiratory tract infections and wheezing in this group is vital to improve quality of life and reduce medical consumption during infancy, but also to reduce the risk on asthma and COPD later in life. Until now, moderate-late preterm infants are underrepresented in research and mechanisms underlying their morbidity are largely unknown, although they represent 80% of all preterm-born infants. In order to protect these infants effectively, it is essential to understand the role of the immune system in early life respiratory health and to identify strategies to optimize immune development and respiratory health. This review elaborates on risk factors and preventative measures concerning respiratory tract infections and wheezing in preterm-born infants, exploring their impact on the immune system and microbiome. Factors discussed are early life antibiotic use, birth mode, feeding type and living environment. Further, differences in adaptive and innate immune maturation between term and preterm infants are discussed, as well as differences in local immune reactions in the lungs. Finally, preventative strategies are being explored, including microbiota transplantation, immune modulation (through pre-, pro-, syn- and postbiotics, bacterial lysates, vaccinations, and monoclonal antibodies) and antibiotic prophylaxis.
Authors 6
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Erasmus MC · Sint Franciscus Gasthuis · Erasmus MC - Sophia Children’s Hospital · Franciscus Vlietland
Affiliation as printed
Department of Paediatrics Franciscus Gasthuis & Vlietland Rotterdam The Netherlands
Department of Pediatrics, Division of Respiratory Medicine and Allergology Sophia Children's Hospital ‐ Erasmus MC Rotterdam The Netherlands
Department of Paediatrics Franciscus Gasthuis & Vlietland Rotterdam The Netherlands
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Sophia Children's Hospital - Erasmus MC, Rotterdam, The Netherlands
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Oscar R. J. van Hengel Aachen
Affiliation as printed
Leiden University Center of Infectious Disease (LU‐CID) Leiden The Netherlands
Leiden University Center of Infectious Disease (LU-CID), Leiden, The Netherlands
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Maastricht University Medical Centre · Maastricht University
Affiliation as printed
Department of Medical Microbiology, Infectious Diseases and Infection Prevention Maastricht University Medical Center+ Maastricht The Netherlands
Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University Medical Center+, Maastricht, The Netherlands
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Erasmus MC · Erasmus MC - Sophia Children’s Hospital
Affiliation as printed
Department of Pediatrics, Division of Respiratory Medicine and Allergology Sophia Children's Hospital ‐ Erasmus MC Rotterdam The Netherlands
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Sophia Children's Hospital - Erasmus MC, Rotterdam, The Netherlands
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Hermelijn H. Smits Aachen
Affiliation as printed
Leiden University Center of Infectious Disease (LU‐CID) Leiden The Netherlands
Leiden University Center of Infectious Disease (LU-CID), Leiden, The Netherlands
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Gerdien A. Tramper‐Stranders corresponding
Erasmus MC · Sint Franciscus Gasthuis · Erasmus MC - Sophia Children’s Hospital · Franciscus Vlietland
Affiliation as printed
Department of Neonatal and Pediatric Intensive Care, Division of Neonatology Sophia Children's Hospital, ErasmusMC Rotterdam The Netherlands
Department of Paediatrics Franciscus Gasthuis & Vlietland Rotterdam The Netherlands
Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Sophia Children's Hospital, ErasmusMC, Rotterdam, The Netherlands
Department of Paediatrics Franciscus Gasthuis & Vlietland Rotterdam The Netherlands
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