RSV Can Infect Nerve Cells, Triggering Damage

In addition to infecting the respiratory tract, respiratory syncytial virus (RSV) can penetrate nerve cells and trigger inflammation and subsequent nerve damage, suggest study findings published online ahead of print in The Journal of Infectious Diseases.

“Until this study, the theory was that the inflammatory response was indirectly activating the nerves,” said study corresponding author Giovanni Piedimonte, MD, FAAP, FCCP, vice president for research and professor of pediatrics, biochemistry, and molecular biology at Tulane University, New Orleans, Louisiana. “This study shows that not only does that happen, but the virus can penetrate directly into the nerves.”

The study used 3D peripheral nerve cultures grown from stem cells and rat embryos.

Researchers found that RSV infected the cultures and induced the release of chemokines causing inflammation along two distinct trajectories depending on the initial viral load.

Low-level infection was transient and induced a moderate chemokine release with transient neural hypersensitivity, according to the study. At higher levels, infection was persistent and associated with progressive degeneration of the nerve and increased neurotoxicity from excess inflammation.

Additionally, the study found that even though RSV did not have the ability to enter spinal neurons directly, the virus was able enter the spinal cord via peripheral nerves. Although more research is needed, Dr Piedimonte suspects that this method of entry allows RSV to bypass the blood-brain barrier, access the central nervous system, and infect the brain. If confirmed, it could help explain growing evidence linking RSV with neurological sequelae.

“If indeed it’s confirmed in future studies that viruses like this are able to access the central nervous system, that opens a huge Pandora’s box,” Dr Piedimonte said.

In the meantime, the findings support the importance of RSV vaccination for certain groups.

“This is the most common respiratory virus in the first years of life as well as an impactful virus among the elderly,” said Dr Piedimonte. “This adds a new dimension to the importance of RSV vaccines for both the elderly and mothers to protect their babies.”

Pollard KJ, Traina-Dorge V, Medearis SM, et al. Respiratory syncytial virus infects peripheral and spinal nerves and induces chemokine-mediated neuropathy. J Infect Dis. Published online December 22, 2023. doi:10.1093/infdis/jiad596

RSV shown to infect nerve cells, cause inflammation and damage. News release. Tulane University; January 9, 2024. Accessed January 12, 2024.