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Early-life respiratory infections and developmental immunity determine lifelong lung health

Nature Immunology volume 24, pages 1234–1243 (2023)Cite this article

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Abstract

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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Fig. 1: Lung function trajectories from birth to adulthood.
Fig. 2: Microbial communities colonize distinct areas of the respiratory tract in health and disease.
Fig. 3: Pulmonary immunity and microbiome are influenced by a range of intrinsic and extrinsic factors.
Fig. 4: Interactions between early-life respiratory infections, environmental exposures, host immune responses and lifelong lung health.

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Acknowledgements

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.

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  1. National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK

    Clare M. Lloyd & Sejal Saglani

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  1. Clare M. Lloyd
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C.M.L. and S.S. contributed equally to this Review.

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Correspondence to Clare M. Lloyd or Sejal Saglani.

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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

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