Respiratory infections are common in infants and young children. However, the immune system develops and matures as the child grows, thus the effects of infection during this time of dynamic change may have long-term consequences. The infant immune system develops in conjunction with the seeding of the microbiome at the respiratory mucosal surface, at a time that the lungs themselves are maturing. We are now recognizing that any disturbance of this developmental trajectory can have implications for lifelong lung health. Here, we outline our current understanding of the molecular mechanisms underlying relationships between immune and structural cells in the lung with the local microorganisms. We highlight the importance of gaining greater clarity as to what constitutes a healthy respiratory ecosystem and how environmental exposures influencing this network will aid efforts to mitigate harmful effects and restore lung immune health.
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C.M.L. is supported by the Wellcome Trust (220254/Z/20/Z). S.S. is supported by the National Institute of Health Research Efficacy and Mechanism Evaluation program (17/60/51). Figures were created with BioRender.com.
The authors declare no competing interests.
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Lloyd, C.M., Saglani, S. Early-life respiratory infections and developmental immunity determine lifelong lung health. Nat Immunol 24, 1234–1243 (2023). https://doi.org/10.1038/s41590-023-01550-w