Clinical Features and Gene Expression Patterns in Adults Hospitalized With Respiratory Syncytial Virus and Human Metapneumovirus Infection - Report - MDSpire
Advertisement
Clinical Features and Gene Expression Patterns in Adults Hospitalized With Respiratory Syncytial Virus and Human Metapneumovirus Infection
Clinical Characteristics and Gene Expression in Adults with RSV and HMPV Infections
Overview
This study compared clinical features and peripheral blood gene expression profiles in hospitalized adults infected with respiratory syncytial virus (RSV) versus human metapneumovirus (HMPV). HMPV patients exhibited more flu-like symptoms and viral pneumonia, while gene expression differed significantly between the two groups, reflecting distinct immune responses.
Background
RSV and HMPV are closely related Pneumoviridae family viruses causing acute respiratory infections across all ages. RSV is known to cause substantial morbidity and mortality in adults, with several vaccines now licensed, whereas HMPV's impact is less well characterized despite its similar seasonality and clinical presentation. Both viruses share structural similarities but differ in their expression of nonstructural proteins that modulate interferon signaling. Understanding clinical and immunologic differences between RSV and HMPV infections can guide vaccine development and therapeutic strategies.
Data Highlights
Parameter
RSV (n=127)
HMPV (n=90)
Prevalence among illnesses
6.6%
4.7%
Active tobacco use
Higher
Significantly less
Underlying heart/lung disease
More frequent (numerically)
Less frequent (numerically)
Sore throat
Less frequent
Significantly more frequent
Temperature >38°C
Less frequent
Significantly more frequent
Clinically adjudicated pneumonia
Less frequent
Significantly more frequent
Differentially expressed genes (viral only cases)
197 genes identified
Genes upregulated in HMPV
Associated with antigen binding, immunoglobulin production, adaptive immunity
Genes upregulated in RSV
Associated with natural killer T cell activity
Key Findings
Among 1914 adult ARI hospitalizations, 6.6% had RSV and 4.7% had HMPV as sole viral pathogens.
HMPV-infected adults had significantly less active tobacco use and fewer underlying heart and lung diseases compared to RSV-infected adults.
Clinical symptoms such as sore throat, fever >38°C, and viral pneumonia were more common in HMPV infections.
Gene expression profiling revealed 197 differentially expressed genes between RSV and HMPV infections in viral-only cases.
HMPV infection was associated with increased expression of genes related to antigen binding, immunoglobulin production, and adaptive immune responses.
RSV infection showed higher expression of genes linked to natural killer T cell activity.
Clinical Implications
Clinicians should recognize that HMPV infection in adults may present with more pronounced flu-like symptoms and viral pneumonia compared to RSV. The distinct gene expression profiles suggest differing host immune responses, which could influence future vaccine design and targeted therapies. Awareness of these differences may improve diagnostic accuracy and patient management strategies.
Conclusion
Although RSV and HMPV are closely related viruses causing adult respiratory infections, they differ in clinical presentation and host immune gene expression profiles. These findings enhance understanding of their pathogenesis and support tailored approaches to prevention and treatment.
References
Falsey et al. 2024 -- Clinical Characteristics and Gene Expression Profiles in Adults Admitted for Respiratory Syncytial Virus and Human Metapneumovirus Infections
by Colin Samoriski, Chin-Yi Chu, Ann R Falsey, Derick Peterson, Soumyaroop Bhattacharya, Daniel P Croft, Angela R Branche, Michael Peasley, Andrea Baran, Anthony Corbett, John Ashton, Thomas J Mariani, Edward E Walsh
