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Upregulation of neuropeptides and infant obstructive airway disorder in post-RSV wheezing and NEHI
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  • Bin Wang,
  • Monica Cardenas,
  • Mariana Bedoya,
  • Giovanni Rossi,
  • Andrew Colin
Bin Wang
Jackson Memorial Hospital

Corresponding Author:[email protected]

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Monica Cardenas
University of Miami
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Mariana Bedoya
University of Miami
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Giovanni Rossi
G. Gaslini Institute
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Andrew Colin
Director, Division of Pediatric Pulmonology
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Obstructive airway disorders are common in infancy and early childhood. The leading example of such disorder is post-viral wheezing, predominantly the well characterized disorder that follows respiratory syncytial virus (RSV) infection and leads to intermittent, long-term wheezing. The underlying mechanisms of the airway reactivity related to RSV infection have been extensively studies and are associated with dysregulation of the nonadrenergic-noncholinergic (NANC) system, via upregulation of neurotransmitters, typically Substance P. Neuroendocrine hyperplasia of infancy (NEHI), while a less common entity, is a disorder of infancy characterized by more severe and long-term obstructive airway disease. NEHI is pathophysiologically characterized by abundance of neuroendocrine cells in the airways containing the neuroimmune mediator bombesin, the release of which is presumed to be the driver of the persistent small airway obstruction and functional air-trapping. Here we review the NANC and NEC neurotransmitter systems and their studied roles in pulmonary diseases with a focus on their role in lung development, and subsequent various pediatric lung diseases. We focus on the juxtaposition of the separate neuroimmune mechanisms underlying the pathogenesis of post-RSV recurrent wheezing and NEHI persistent small airway obstruction. We finally raise the question whether substance P is indeed specific to post-RSV infection and bombesin to NEHI and then propose a unifying concept of post-viral spectrum of respiratory disorders that may encompass these two entities and possibly others.
29 Jul 2020Submitted to Pediatric Pulmonology
30 Jul 2020Submission Checks Completed
30 Jul 2020Assigned to Editor
31 Jul 2020Reviewer(s) Assigned
26 Aug 2020Review(s) Completed, Editorial Evaluation Pending
27 Aug 2020Editorial Decision: Revise Major
17 Nov 20201st Revision Received
26 Nov 2020Submission Checks Completed
26 Nov 2020Assigned to Editor
26 Nov 2020Reviewer(s) Assigned
22 Dec 2020Review(s) Completed, Editorial Evaluation Pending
23 Dec 2020Editorial Decision: Revise Minor
31 Dec 20202nd Revision Received
04 Jan 2021Assigned to Editor
04 Jan 2021Submission Checks Completed
04 Jan 2021Reviewer(s) Assigned
11 Jan 2021Review(s) Completed, Editorial Evaluation Pending
12 Jan 2021Editorial Decision: Accept