Skip to main content
PMC home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1987 Dec;31(12):1882–1886. doi: 10.1128/aac.31.12.1882

Intravenous immunoglobulin treatment of respiratory syncytial virus infections in infants and young children.

V G Hemming 1, W Rodriguez 1, H W Kim 1, C D Brandt 1, R H Parrott 1, B Burch 1, G A Prince 1, P A Baron 1, R J Fink 1, G Reaman 1
PMCID: PMC175820  PMID: 3439796

Abstract

Respiratory syncytial virus (RSV)-infected cotton rats (Sigmadon hispidus) and owl monkeys (Aotus trivirgatus) showed significant reductions in RSV shedding from their respiratory tracts following parenteral therapy with human intravenous immunoglobulin (IVIG) containing high titers of RSV-neutralizing antibody. Because this therapy was well tolerated and appeared safe, a double-blind, placebo-controlled IVIG immunotherapy pilot study was performed on 35 hospitalized, RSV-infected infants and children. The treatment was well tolerated and resulted in significant reductions in nasal RSV shedding and in improvements in transcutaneous oximetry readings. However, the mean duration of hospitalization was not reduced by IVIG treatment. Followup to date has revealed no harmful effects resulting from immunotherapy of RSV infections. These studies appear to refute the hypothesis that passively acquired antibody may exacerbate RSV bronchiolitis or pneumonia in infants. Studies with larger numbers of seriously ill children will be required to determine if immunoglobulin G immunotherapy of RSV infections in infants is of clinical value.

Full text

PDF
1882

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barry W., Cockburn F., Cornall R., Price J. F., Sutherland G., Vardag A. Ribavirin aerosol for acute bronchiolitis. Arch Dis Child. 1986 Jun;61(6):593–597. doi: 10.1136/adc.61.6.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brandt C. D., Kim H. W., Arrobio J. O., Jeffries B. C., Wood S. C., Chanock R. M., Parrott R. H. Epidemiology of respiratory syncytial virus infection in Washington, D.C. 3. Composite analysis of eleven consecutive yearly epidemics. Am J Epidemiol. 1973 Nov;98(5):355–364. doi: 10.1093/oxfordjournals.aje.a121565. [DOI] [PubMed] [Google Scholar]
  3. Bruhn F. W., Yeager A. S. Respiratory syncytial virus in early infancy. Circulating antibody and the severity of infection. Am J Dis Child. 1977 Feb;131(2):145–148. doi: 10.1001/archpedi.1977.02120150027004. [DOI] [PubMed] [Google Scholar]
  4. CHANOCK R., FINBERG L. Recovery from infants with respiratory illness of a virus related to chimpanzee coryza agent (CCA). II. Epidemiologic aspects of infection in infants and young children. Am J Hyg. 1957 Nov;66(3):291–300. doi: 10.1093/oxfordjournals.aje.a119902. [DOI] [PubMed] [Google Scholar]
  5. Chanock R. M., Kapikian A. Z., Mills J., Kim H. W., Parrott R. H. Influence of immunological factors in respiratory syncytial virus disease. Arch Environ Health. 1970 Sep;21(3):347–355. doi: 10.1080/00039896.1970.10667249. [DOI] [PubMed] [Google Scholar]
  6. Conrad D. A., Christenson J. C., Waner J. L., Marks M. I. Aerosolized ribavirin treatment of respiratory syncytial virus infection in infants hospitalized during an epidemic. Pediatr Infect Dis J. 1987 Feb;6(2):152–158. doi: 10.1097/00006454-198702000-00003. [DOI] [PubMed] [Google Scholar]
  7. Gardner P. S., McQuillin J., Court S. D. Speculation on pathogenesis in death from respiratory syncytial virus infection. Br Med J. 1970 Feb 7;1(5692):327–330. doi: 10.1136/bmj.1.5692.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Glezen W. P., Paredes A., Allison J. E., Taber L. H., Frank A. L. Risk of respiratory syncytial virus infection for infants from low-income families in relationship to age, sex, ethnic group, and maternal antibody level. J Pediatr. 1981 May;98(5):708–715. doi: 10.1016/s0022-3476(81)80829-3. [DOI] [PubMed] [Google Scholar]
  9. Gruber W. C., Wilson S. Z., Throop B. J., Wyde P. R. Immunoglobulin administration and ribavirin therapy: efficacy in respiratory syncytial virus infection of the cotton rat. Pediatr Res. 1987 Mar;21(3):270–274. doi: 10.1203/00006450-198703000-00013. [DOI] [PubMed] [Google Scholar]
  10. Hall C. B., McBride J. T., Gala C. L., Hildreth S. W., Schnabel K. C. Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease. JAMA. 1985 Dec 6;254(21):3047–3051. [PubMed] [Google Scholar]
  11. Hall C. B., McBride J. T., Walsh E. E., Bell D. M., Gala C. L., Hildreth S., Ten Eyck L. G., Hall W. J. Aerosolized ribavirin treatment of infants with respiratory syncytial viral infection. A randomized double-blind study. N Engl J Med. 1983 Jun 16;308(24):1443–1447. doi: 10.1056/NEJM198306163082403. [DOI] [PubMed] [Google Scholar]
  12. Hall C. B. Prevention of infections with respiratory syncytial virus: the hopes and hurdles ahead. Rev Infect Dis. 1980 May-Jun;2(3):384–392. doi: 10.1093/clinids/2.3.384. [DOI] [PubMed] [Google Scholar]
  13. Hemming V. G., Prince G. A., Horswood R. L., London W. J., Murphy B. R., Walsh E. E., Fischer G. W., Weisman L. E., Baron P. A., Chanock R. M. Studies of passive immunotherapy for infections of respiratory syncytial virus in the respiratory tract of a primate model. J Infect Dis. 1985 Nov;152(5):1083–1087. doi: 10.1093/infdis/152.5.1083. [DOI] [PubMed] [Google Scholar]
  14. Henderson F. W., Collier A. M., Clyde W. A., Jr, Denny F. W. Respiratory-syncytial-virus infections, reinfections and immunity. A prospective, longitudinal study in young children. N Engl J Med. 1979 Mar 8;300(10):530–534. doi: 10.1056/NEJM197903083001004. [DOI] [PubMed] [Google Scholar]
  15. Kim H. W., Arrobio J. O., Brandt C. D., Jeffries B. C., Pyles G., Reid J. L., Chanock R. M., Parrott R. H. Epidemiology of respiratory syncytial virus infection in Washington, D.C. I. Importance of the virus in different respiratory tract disease syndromes and temporal distribution of infection. Am J Epidemiol. 1973 Sep;98(3):216–225. doi: 10.1093/oxfordjournals.aje.a121550. [DOI] [PubMed] [Google Scholar]
  16. Kim H. W., Arrobio J. O., Brandt C. D., Wright P., Hodes D., Chanock R. M., Parrott R. H. Safety and antigenicity of temperature sensitive (TS) mutant respiratory syncytial virus (RSV) in infants and children. Pediatrics. 1973 Jul;52(1):56–63. [PubMed] [Google Scholar]
  17. Kim H. W., Canchola J. G., Brandt C. D., Pyles G., Chanock R. M., Jensen K., Parrott R. H. Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine. Am J Epidemiol. 1969 Apr;89(4):422–434. doi: 10.1093/oxfordjournals.aje.a120955. [DOI] [PubMed] [Google Scholar]
  18. Kim H. W., Wyatt R. G., Fernie B. F., Brandt C. D., Arrobio J. O., Jeffries B. C., Parrott R. H. Respiratory syncytial virus detection by immunofluorescence in nasal secretions with monoclonal antibodies against selected surface and internal proteins. J Clin Microbiol. 1983 Dec;18(6):1399–1404. doi: 10.1128/jcm.18.6.1399-1404.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lamprecht C. L., Krause H. E., Mufson M. A. Role of maternal antibody in pneumonia and bronchiolitis due to respiratory syncytial virus. J Infect Dis. 1976 Sep;134(3):211–217. doi: 10.1093/infdis/134.3.211. [DOI] [PubMed] [Google Scholar]
  20. Mills J., 5th, Van Kirk J. E., Wright P. F., Chanock R. M. Experimental respiratory syncytial virus infection of adults. Possible mechanisms of resistance to infection and illness. J Immunol. 1971 Jul;107(1):123–130. [PubMed] [Google Scholar]
  21. Ogilvie M. M., Vathenen A. S., Radford M., Codd J., Key S. Maternal antibody and respiratory syncytial virus infection in infancy. J Med Virol. 1981;7(4):263–271. doi: 10.1002/jmv.1890070403. [DOI] [PubMed] [Google Scholar]
  22. Parrott R. H., Kim H. W., Arrobio J. O., Hodes D. S., Murphy B. R., Brandt C. D., Camargo E., Chanock R. M. Epidemiology of respiratory syncytial virus infection in Washington, D.C. II. Infection and disease with respect to age, immunologic status, race and sex. Am J Epidemiol. 1973 Oct;98(4):289–300. doi: 10.1093/oxfordjournals.aje.a121558. [DOI] [PubMed] [Google Scholar]
  23. Prince G. A., Hemming V. G., Horswood R. L., Chanock R. M. Immunoprophylaxis and immunotherapy of respiratory syncytial virus infection in the cotton rat. Virus Res. 1985 Oct;3(3):193–206. doi: 10.1016/0168-1702(85)90045-0. [DOI] [PubMed] [Google Scholar]
  24. Prince G. A., Horswood R. L., Camargo E., Koenig D., Chanock R. M. Mechanisms of immunity to respiratory syncytial virus in cotton rats. Infect Immun. 1983 Oct;42(1):81–87. doi: 10.1128/iai.42.1.81-87.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Prince G. A., Horswood R. L., Chanock R. M. Quantitative aspects of passive immunity to respiratory syncytial virus infection in infant cotton rats. J Virol. 1985 Sep;55(3):517–520. doi: 10.1128/jvi.55.3.517-520.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Prince G. A., Jenson A. B., Horswood R. L., Camargo E., Chanock R. M. The pathogenesis of respiratory syncytial virus infection in cotton rats. Am J Pathol. 1978 Dec;93(3):771–791. [PMC free article] [PubMed] [Google Scholar]
  27. Rodriguez W. J., Kim H. W., Brandt C. D., Fink R. J., Getson P. R., Arrobio J., Murphy T. M., McCarthy V., Parrott R. H. Aerosolized ribavirin in the treatment of patients with respiratory syncytial virus disease. Pediatr Infect Dis J. 1987 Feb;6(2):159–163. doi: 10.1097/00006454-198702000-00004. [DOI] [PubMed] [Google Scholar]
  28. Sims D. G., Downham M. A., McQuillin J., Gardner P. S. Respiratory syncytial virus infection in north-east England. Br Med J. 1976 Nov 6;2(6044):1095–1098. doi: 10.1136/bmj.2.6044.1095. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Suffin S. C., Prince G. A., Hocko J., Chanock R. M. Immunoenzymatic examination of autoptic tissues from the outbreak of fatal infantile disease in Naples, in 1978-1979. Ann Ist Super Sanita. 1981;17(4):777–781. [PubMed] [Google Scholar]
  30. Taber L. H., Knight V., Gilbert B. E., McClung H. W., Wilson S. Z., Norton H. J., Thurson J. M., Gordon W. H., Atmar R. L., Schlaudt W. R. Ribavirin aerosol treatment of bronchiolitis associated with respiratory syncytial virus infection in infants. Pediatrics. 1983 Nov;72(5):613–618. [PubMed] [Google Scholar]
  31. Varela L. R., Black F. L., Mendizabal-Morris C. A. Tetanus antitoxin titers in women of childbearing age from nine diverse populations. J Infect Dis. 1985 May;151(5):850–853. doi: 10.1093/infdis/151.5.850. [DOI] [PubMed] [Google Scholar]
  32. Ward K. A., Lambden P. R., Ogilvie M. M., Watt P. J. Antibodies to respiratory syncytial virus polypeptides and their significance in human infection. J Gen Virol. 1983 Sep;64(Pt 9):1867–1876. doi: 10.1099/0022-1317-64-9-1867. [DOI] [PubMed] [Google Scholar]
  33. Wright P. F., Belshe R. B., Kim H. W., Van Voris L. P., Chanock R. M. Administration of a highly attenuated, live respiratory syncytial virus vaccine to adults and children. Infect Immun. 1982 Jul;37(1):397–400. doi: 10.1128/iai.37.1.397-400.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES