A well-known source of misery for immunocompetent people, respiratory viruses are a major cause of morbidity and mortality in immunocompromised patients. We seek to improve prevention, diagnosis and treatment strategies for respiratory virus infections by defining the frequency, timing and concurrent disease associations of asymptomatic and symptomatic shedding of community-acquired respiratory viruses (e.g. respiratory syncytial virus, parainfluenza viruses, influenza A and B, adenovirus, human metapneumovirus, rhinoviruses, coronavirus, and enteroviruses) after hematopoietic cell transplant (HCT). We hope to identify epidemiologic risk factors and correlates between viral shedding and symptomatic infection. Using RNA detection in blood compartments, we are also looking for biomarkers for disease severity and outcome. As part of this effort, we are optimizing and validating simple self collection sampling methods for respiratory viruses that can be used by patients at home.
To better understand the biology and pathophysiology of respiratory virus infection after HCT, we are studying respiratory virus infection and airflow obstruction, as well as a possible role for pro- or anti-inflammatory cytokines, chemokines or leukotrienes in the pathogenesis of respiratory virus-induced lung injury. In addition, we are exploring the role of humoral and cellular immunity in protecting against respiratory virus infection and infectious complications.