Presence of maternal antibody at initial respiratory syncytial virus (RSV) infection shapes innate and adaptive responses following repeat RSV exposure

Abstract

Abstract RSV is the leading cause of childhood hospitalization due to bronchiolitis and a significant risk factor for the development of allergic airway responses. Maternal vaccination has emerged as a promising strategy to protect infants against severe disease. However, the presence of maternal antibody (matAb) at primary RSV infection has been linked to development of wheeze later in life. Therefore, we sought to understand how high levels of matAb during early life RSV infection shapes innate and adaptive immune responses on repeat RSV exposure. Using a murine model of maternal vaccination, we assessed immune responses following adult RSV re-challenge of infants born to unvaccinated and RSV preF-vaccinated dams. Presence of matAb at primary RSV infection resulted in differential activation of resident lung populations at 4 days post-secondary infection (DPSI). Specifically, proliferation of IL-5+ and IL-13+ type 2 innate lymphoid cells were increased in association with elevated numbers of eosinophils in the alveolar space. At 8 DPSI, IL-4-, IL-5-, and IL-13-producing, but not IFNγ-producing, CD4+ T cells were significantly increased, indicating a dominant Th2 response in mice born to vaccinated dams. Importantly, lung inflammation and mucus production were similarly elevated in mice born to immunized and unimmunized dams, suggesting that maternal vaccination did not prevent pathology on repeat infection. Taken together, these data demonstrate that the presence of matAb at primary RSV infection differentially alters innate and adaptive immune responses on secondary RSV exposure. Understanding the mechanisms that drive differential cell activation in the presence of matAb will guide future maternal immunization strategies.