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. Author manuscript; available in PMC: 2023 Mar 1.
Published in final edited form as: J Allergy Clin Immunol. 2021 Sep 14;149(3):966–976. doi: 10.1016/j.jaci.2021.08.022

Figure 2.

Figure 2.

Graphical representation of the study design. First, we examined the total effect of the URT microbiome during RSV ARI in infancy on the acute local immune response (path X→M) and on short- and long-term clinical outcomes (all paths X→Y). Based on our results and those of our prior studies showing an effect of the acute local immune on short- and long-term clinical outcomes (path M→Y), we the used a causal mediation framework to assess whether the effect of the URT microbiome during RSV ARI on short- and long-term clinical outcomes (all paths X→Y) could be explained —at least in part— by the acute local immune response (path X→M→Y [indirect effect]). Our causal mediation models also took into account the interaction between the exposure and the mediator (X and M, respectively). Definition of abbreviations: ARI = Acute respiratory infection, RSV = Respiratory syncytial virus, URT = Upper respiratory tract.