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Smith-Norowitz TA, Mandal M, Joks R, Norowitz LT, Weaver D, Durkin HG, Bluth MH, Kohlhoff S. IgE anti-respiratory syncytial virus antibodies detected in serum of pediatric patients with asthma. Hum Immunol 2015; 76:519-24. [PMID: 26074414 DOI: 10.1016/j.humimm.2015.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/11/2015] [Accepted: 06/02/2015] [Indexed: 12/16/2022]
Abstract
Respiratory syncytial virus (RSV) causes lower respiratory tract disease in infants and young children, and is a public health concern, as is the increase in pediatric asthma. Respiratory viral infections may trigger asthma exacerbations. However, it remains unknown whether RSV infection may have a specific association with asthma. Total serum IgE, and IgE- and IgG-anti-RSV Ab responses were studied in older asthmatic compared with non-asthmatic children (M/F, mean age: 14) (N=30, N=43, respectively). We found: (1) total serum IgE was higher in asthmatic compared with non-asthmatics (P<0.001); (2) total serum IgE did correlate with IgE anti-RSV Abs (P<0.001), and with IgG anti-RSV Abs (P=0.008) in all subjects; (3) total serum IgE levels did correlate with IgE anti-RSV in asthmatics (P=0.047), but not in non-asthmatics (P=0.13); (4) IgE anti-RSV Abs did correlate with IgG anti-RSV Abs in all subjects (P=0.001); (5) IgE- and IgG-anti RSV Abs were higher in asthma compared with no asthma (P=0.003; <0.001, respectively); (6) there was a significant association between age and IgE anti-RSV in non-asthma (P=0.008), but not in asthma (P=0.64). Our findings indicate that IgE-anti-RSV Ab responses may play important roles in RSV infection and asthma.
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Affiliation(s)
- Tamar A Smith-Norowitz
- Department of Pediatrics, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States; Center for Allergy and Asthma Research, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States.
| | - Mira Mandal
- Department of Pediatrics, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States
| | - Rauno Joks
- Center for Allergy and Asthma Research, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States; Dept. of Medicine, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States
| | - Levana T Norowitz
- Department of Pediatrics, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States
| | - Diana Weaver
- Department of Pediatrics, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States
| | - Helen G Durkin
- Center for Allergy and Asthma Research, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States; Dept. of Pathology, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States
| | - Martin H Bluth
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Stephan Kohlhoff
- Department of Pediatrics, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States; Center for Allergy and Asthma Research, S.U.N.Y. Downstate Medical Center, Brooklyn, NY, 11203, United States
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Freymuth F. Virus respiratorio sincitial, metapneumovirus y virus parainfluenza humanos: cuadro clínico y fisiopatología. EMC. PEDIATRIA 2011; 42:1-9. [PMID: 32308522 PMCID: PMC7159021 DOI: 10.1016/s1245-1789(07)70240-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
El VRSh causa la mayor parte de las bronquiolitis del lactante, infecciones respiratorias bajas que provocan trastornos respiratorios obstructivos y sibilancias. Los factores relacionados con las características del paciente (prematuridad, enfermedades asociadas, predisposición genética), con el virus (VRShA, genotipo, etc.) o el ambiente (contaminación, tabaquismo, etc.) son determinantes en la génesis de las bronquiolitis y determinan su gravedad. La mortalidad de la bronquiolitis es del 0,005-0,2% dependiendo de las características del paciente. No se conoce la fisiopatología de la bronquiolitis por VRSh. El papel directo del virus sobre el epitelio, la inmadurez del pulmón del lactante y, como se ha demostrado recientemente, el papel de la reacción inflamatoria, son factores destacados. También es probable que haya mecanismos inmunopatológicos (anticuerpos IgE, respuesta CD4+ Th2, etc.) que intervengan en ciertas bronquiolitis. La inmunidad anti-VRSh nunca llega a ser completa y las reinfecciones son frecuentes en los niños pequeños y las personas de edad avanzada, en quienes la infección por el VRSh representa aproximadamente el 5% de las afecciones respiratorias bajas. Con frecuencia se presentan con un cuadro de neumopatía infecciosa atípica con signos de bronquiolitis. Las infecciones debidas al VPIh3 suelen manifestarse por bronquiolitis, y las infecciones secundarias al VPIh1 y al 2 por laringotraqueítis. No se conoce bien la expresión clínica de las infecciones por VPIh4. El MPVh causa bronquiolitis comparables en todos sus aspectos a las que origina el VRSh.
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Affiliation(s)
- F Freymuth
- Laboratoire de virologie humaine et moléculaire, centre hospitalier universitaire, avenue Georges-Clémenceau, 14033 Caen cedex, France
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Zhang W, Lockey RF, Mohapatra SS. Respiratory syncytial virus: immunopathology and control. Expert Rev Clin Immunol 2010; 2:169-79. [PMID: 20477096 DOI: 10.1586/1744666x.2.1.169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Respiratory syncytial virus (RSV) is the primary cause of serious upper and lower respiratory tract infections in infants and children worldwide. RSV infection in infancy may lead to the onset of asthma or other health problems later in life. An effective vaccine is not yet available against RSV infection. Humans respond to RSV infection by mounting an immune response, but the antiviral immunity is incomplete, thus repeat RSV infections continue throughout life. The precise mechanism of RSV-induced infection and immunopathology remains unclear. The limited knowledge of RSV immunity is a major problem in designing a protective vaccine. In this review, the biology of RSV infection, its immunopathology, the role of innate and adaptive immunity, as well as the understanding of how to control RSV infection based on prophylactic and therapeutic approaches are discussed.
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Affiliation(s)
- Weidong Zhang
- Division of Allergy and Immunology, Department of Internal Medicine, College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA.
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Common Colds and Respiratory Viruses: Impact on Allergy and Asthma. ALLERGY FRONTIERS: CLINICAL MANIFESTATIONS 2009. [PMCID: PMC7121093 DOI: 10.1007/978-4-431-88317-3_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Dakhama A, Park JW, Taube C, Chayama K, Balhorn A, Joetham A, Wei XD, Fan RH, Swasey C, Miyahara N, Kodama T, Alvarez A, Takeda K, Gelfand EW. The role of virus-specific immunoglobulin E in airway hyperresponsiveness. Am J Respir Crit Care Med 2004; 170:952-9. [PMID: 15306536 DOI: 10.1164/rccm.200311-1610oc] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis during infancy and is associated with subsequent wheezing and asthma, but the nature of this association is not fully understood. We investigated the role of RSV-specific IgE antibodies in the pathophysiology of virus-induced airway dysfunction in a mouse model. Lung infection with RSV resulted in significant increases in mRNA expression for IgE and both of its high- and low-affinity receptors. In serum, virus-specific IgE antibodies reached peak levels by Day 21 after infection. Data from in vitro experiments show that RSV can induce mast cell degranulation, but only if these cells are sensitized with specific IgE. When passively sensitized in vivo with virus-specific IgE, mice developed exaggerated airway responsiveness to methacholine on airway infection, an effect that required the high-affinity receptor of IgE. These data suggest that RSV-specific IgE may contribute to the pathophysiology of airway dysfunction in children who develop this class of specific antibody.
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Affiliation(s)
- Azzeddine Dakhama
- Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA.
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Fonseca CDB, Grisi S. Bronchiolitis, respiratory syncytial virus, and recurrent wheezing: what is the relationship? REVISTA DO HOSPITAL DAS CLINICAS 2003; 58:39-48. [PMID: 12754590 DOI: 10.1590/s0041-87812003000100009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Various follow-up studies of children hospitalized with bronchiolitis caused by respiratory syncytial virus have demonstrated that a significant proportion of infants (50%) have recurrent wheezing during childhood. Nevertheless, the relationship between these two entities, if any, has not been established. In order to explain this observation, several hypotheses have been proposed. The first suggests that some children could have an individual predisposition to bronchiolitis caused by respiratory syncytial virus and recurrent wheezing. The virus could be a marker of this condition, and the individual predisposition could in turn be related to an individual hypersensitivity to common allergens (atopy), airway hyperreactivity, or to some disorder related to pulmonary anatomy or physiology that was present before the acute episode of bronchiolitis. Another hypothesis proposes that respiratory syncytial virus could be directly responsible for recurrent wheezing. During an episode of bronchiolitis, the damage in the airway mucosa caused by the vital inflammatory response to infection contributes to sensitivity to other allergens or exposes irritant receptors, resulting in recurrent wheezing. For this review, we analyzed the studies that discuss these hypotheses with the purpose of clarifying the mechanisms for the important issue of recurrent wheezing in childhood.
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Affiliation(s)
- Claudia de Brito Fonseca
- Children's Institute, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil
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Abstract
Respiratory syncytial virus (RSV) is a leading cause of severe respiratory infection in infants and children. RSV is an RNA virus whose genome encodes 10 proteins. The G protein is responsible for viral attachment to cells whilst the F protein promotes syncytia formation. These proteins are also important in the immune response to RSV. Both the innate and adaptive arms of the cellular immune system are involved in the immunological response to RSV. The cytopathic effects of the virus explain many of the pathological findings in RSV disease. However, there is compelling evidence to suggest that the host cell immune response also has a prominent role in disease pathogenesis. Non-immunological factors may also be important.
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Affiliation(s)
- Paul S McNamara
- Department of Child Health, Institute of Child Health, Alder Hey Children's Hospital, Liverpool, UK
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Sigurs N. Clinical perspectives on the association between respiratory syncytial virus and reactive airway disease. Respir Res 2002; 3 Suppl 1:S8-14. [PMID: 12119052 PMCID: PMC1866372 DOI: 10.1186/rr186] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2002] [Accepted: 05/30/2002] [Indexed: 11/10/2022] Open
Abstract
Asthma is a leading cause of morbidity and mortality among children worldwide, as is respiratory syncytial virus (RSV). This report reviews controlled retrospective and prospective studies conducted to investigate whether there is an association between RSV bronchiolitis in infancy and subsequent development of reactive airway disease or allergic sensitization. Findings indicate that such a link to bronchial obstructive symptoms does exist and is strongest for children who experienced severe RSV illness that requires hospitalization. However, it is not yet clear what roles genetic predisposition and environmental or other risk factors may play in the interaction between RSV bronchiolitis and reactive airway disease or allergic sensitization. Randomized, prospective studies utilizing an intervention against RSV, such as a passive immunoprophylactic agent, may determine whether preventing RSV bronchiolitis reduces the incidence of asthma.
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Affiliation(s)
- Nele Sigurs
- Department of Pediatrics, Borås Central Hospital, Borås, Sweden.
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Everard ML, Swarbrick A, Rigby AS, Milner AD. The effect of ribavirin to treat previously healthy infants admitted with acute bronchiolitis on acute and chronic respiratory morbidity. Respir Med 2001; 95:275-80. [PMID: 11316109 DOI: 10.1053/rmed.2001.1033] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The role of ribavirin in the treatment of acute bronchiolitis is controversial. It has been suggested that the use of ribavirin may be of benefit during the acute illness and may reduce subsequent recurrent respiratory morbidity. This randomized, double-blind, placebo-controlled study was designed to determine whether ribavirin administered during the acute illness would have an influence on respiratory morbidity during both the acute illness and during the following year. Bronchial reactivity 6 months after the acute illness was also assessed. Forty previously well infants with moderately severe acute bronchiolitis were recruited during three winter epidemics. Subjects received study medication for 18 h a day. Management was otherwise unaltered. Subjects were evaluated daily by the investigator and subsequently assessed at 6 weeks, 6 months and 1 year following the acute illness. Assessment of bronchial hyper-responsiveness was assessed at 6 months of age using total body plethysmography and an established ultra-sonically nebulized distilled water challenge. A total of 40 patients (21 ribavirin, 19 placebo) were entered into the study. The two groups did not differ with respect to age, gender or clinical severity on entry to the trial. No significant differences were identified in the rate of clinical improvement over the first 24 h, the time to discharge, bronchial responsiveness at 6 months of age, frequency of significant respiratory symptoms over the first year of life and the frequency of prescribed bronchodilators and inhaled steroids during the year of follow-up. This study was unable to demonstrate any clinical benefit from the use of ribavirin in the acute illness or during subsequent follow-up for 1 year.
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Affiliation(s)
- M L Everard
- Paediatric Respiratory Unit, Queens Medical Centre, Nottingham, UK.
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10
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Sigurs N. Epidemiologic and clinical evidence of a respiratory syncytial virus-reactive airway disease link. Am J Respir Crit Care Med 2001; 163:S2-6. [PMID: 11254543 DOI: 10.1164/ajrccm.163.supplement_1.2011109] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- N Sigurs
- Department of Pediatrics, Borås Central Hospital, Borås, Sweden.
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11
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De Alarcon A, Walsh EE, Carper HT, La Russa JB, Evans BA, Rakes GP, Platts-Mills TA, Heymann PW. Detection of IgA and IgG but not IgE antibody to respiratory syncytial virus in nasal washes and sera from infants with wheezing. J Pediatr 2001; 138:311-7. [PMID: 11241035 DOI: 10.1067/mpd.2001.111277] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The capacity of respiratory syncytial virus (RSV) to stimulate an IgE antibody response and enhance the development of atopy and asthma remains controversial. Nasal washes and sera from 40 infants (20 with wheezing, 9 with rhinitis, and 11 without respiratory tract symptoms) were obtained to measure IgE, IgA, and IgG antibody to the immunodominant, F and G, virion proteins from RSV. STUDY DESIGN Children (aged 6 weeks to 2 years) were enrolled in the emergency department during the mid-winter months and seen at follow-up when they were asymptomatic. All nasal washes were tested for RSV antigen. Determinations of antibody isotypes (IgE, IgA, and IgG) to RSV antigens were done in nasal washes and sera by using an enzyme-linked immunosorbent assay. In a subset of nasal washes, IgE to RSV was also evaluated by using a monoclonal anti-F(c)E antibody-based assay. RESULTS Fifteen patients with wheezing, two with rhinitis, and one control subject tested positive for RSV antigen at enrollment. Thirteen patients with wheezing were <6 months old, and most (77%) were experiencing their first attack. Among the children with positive test results for RSV antigen, an increase in both nasal wash and serum IgA antibody to RSV-F(a) and G(a) was observed at the follow-up visit. However, there was no evidence for an IgE antibody response to either antigen. CONCLUSION Both IgA and IgG antibodies to the immunodominant RSV-F(a) and G(a) antigens were readily detected in the nasal washes and sera from patients in this study. We were unable to demonstrate specific IgE antibody to these antigens and conclude that the production of IgE as a manifestation of a T(H)2 lymphocyte response to RSV is unlikely.
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Affiliation(s)
- A De Alarcon
- Department of Pediatrics, University of Virginia Health System, Charlottesville 22908, USA
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12
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Affiliation(s)
- G Dutau
- Service d'allergologie et de pneumologie, hôpital des Enfants, 330, avenue de Grande-Bretagne, BP 3110, Toulouse, France
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13
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Abstract
Viral respiratory infections have been related to asthma in several ways. It is well established that viral common colds precipitate exacerbations of asthma. Severe bronchiolitis in early life is related to subsequent wheezing and therefore may represent a marker of susceptibility to asthma; alternatively, it could be involved in the initiation of the disease. Finally, it is possible that some infections may protect from the development of asthma and allergies by promoting a type-1 host response. However, whether respiratory or other viruses could mediate such a protective effect is debated. The design and implementation of novel anti- or proviral strategies targeting asthma depends on the resolution of these questions. This review presents current evidence on the epidemiologic correlations and proposed mechanisms for the involvement of viral infections in the development and progression of asthma.
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Affiliation(s)
- Nikolaos G. Papadopoulos
- BPPK Research Laboratories, Allergy & Clinical Immunology Unit, 2nd Department of Pediatrics, University of Athens, 13 Levadias Str., 11527 Goudi, Greece
| | - Sebastian L. Johnston
- National Heart and Lung Institute at St Mary’s, Imperial College School of Medicine, Norfolk Place, W2 1PG London, UK
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Dutau G, Micheau P, Rittié JL, Juchet A, Rancé F, Brémont F. [Relationship between respiratory syncytial virus bronchiolitis and asthma]. Arch Pediatr 2000; 7 Suppl 3:536s-543s. [PMID: 10941477 DOI: 10.1016/s0929-693x(00)80181-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Data of the literature over the last 20 years indicate that infantile asthma, although heterogeneous, often appears following RSV bronchiotitis, especially when sufficiently severe to justify hospitalisation. The risk of developing episodes of wheezing (bronchial obstruction syndrome) over the following 2 to 3 years is higher than 50%, but estimations vary according to the authors. Functional disturbances (pulmonary distension, nonspecific bronchial hypperreactivity, hypoxia), with or without associated clinical symptoms, may be observed several months to several years after hospitalisation for bronchiolitis. On the other hand, mild bronchiolitis, and most of the recurrent expiratory obstructive syndromes with asymptomatic free intervals between episodes do not appear to carry a risk of functional sequelae. Children suffering from severe bronchiolitis usually develop a severe bronchial obstruction syndrome. In asthma, the percentage of IgE-dependent sensitization is less than 20% before the age of 4 years. The presence of positive skin tests and/or specific serum IgE directed against the usual allergens are associated with the persistence of asthma during the childhood. Similarly, the appearance of wheezing after the age of 3 years (or recurrence after this age) is associated with the persistence of asthma. Prospective studies of cohorts followed since birth show that pre-existing functional abnormalities can promote the appearance of bronchiolitis and bronchial obstruction syndrome. Asthma in infants comprises several phenotypes with very different prognoses.
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Affiliation(s)
- G Dutau
- Hôpital des Enfants (allergologie et pneumologie), Toulouse, France
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Blanco-Quirós A, González H, Arranz E, Lapeña S. Decreased interleukin-12 levels in umbilical cord blood in children who developed acute bronchiolitis. Pediatr Pulmonol 1999; 28:175-80. [PMID: 10495333 DOI: 10.1002/(sici)1099-0496(199909)28:3<175::aid-ppul3>3.0.co;2-u] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Respiratory syncytial virus (RSV) infection is common in young children, but only a few develop severe bronchiolitis. The relationship between bronchiolitis, asthma, and atopy has been debated for a long time, but the pathogenesis of wheezing remains unclear. A Th1 and Th2-type lymphocyte imbalance seems to be involved in asthma and atopic disease. Serum interleukin-12 (IL-12), IL-10, and soluble CD30 (sCD30) levels were measured by enzyme-linked immunosorbent assay (ELISA) in 23 cord blood samples kept frozen since birth: 11 from normal term newborns who several months later were admitted to the hospital with bronchiolitis, and 12 from newborns who did not develop the disease (controls). The study was also performed on 28 additional children (1-16 months old) suffering an episode of acute bronchiolitis. IL-12 was clearly increased in all cases at birth, but newborns who later developed bronchiolitis showed low IL-12 levels in cord blood compared to newborns who did not develop the disease (median 295 vs. 507 pg/mL; P = 0.001). sCD30 levels were also decreased in the first group (15 vs. 26 U/mL; P = 0.007). During episodes of bronchiolitis, a clear rise of IL-12, IL-10, and sCD30 was observed. None of the factors studied in the acute phase showed statistical differences in children who were later readmitted to the hospital due to repeated wheezing crises. Children who develop acute bronchiolitis with wheezing may have an immunological imbalance that is expressed at the time of delivery by a lower concentration of serum IL-12.
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Affiliation(s)
- A Blanco-Quirós
- Department of Pediatrics and Immunology, University of Valladolid, Spain.
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Affiliation(s)
- M L Everard
- Department of Respiratory Medicine, Sheffield Children's Hospital, UK
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17
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Dutau G, Brémont F, Rancé F, Juchet A, Rittié J, Nouilhan P. Rôle de l'infection virale dans la genèse de l'asthme et de l'allergie respiratoire chez l'enfant. ACTA ACUST UNITED AC 1998. [DOI: 10.1016/s0335-7457(98)80037-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Strannegård O, Cello J, Bjarnason R, Sigurbergsson F, Sigurs N. Association between pronounced IgA response in RSV bronchiolitis and development of allergic sensitization. Pediatr Allergy Immunol 1997; 8:1-6. [PMID: 9260211 DOI: 10.1111/j.1399-3038.1997.tb00134.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Forty-five children who had been hospitalized with bronchiolitis caused by respiratory syncytial virus (RSV) at a mean age of 4 months, and 90 matched control children, were tested for occurrence of RSV antibodies at one year of age. Of the children who had suffered from bronchiolitis, forty had demonstrable IgG antibodies, whereas the remaining five only had IgA antibodies against RSV. In the control group, 42% were RSV seropositive. The anti-RSV IgA antibody titres tended to be higher in patients with bronchiolitis than in controls and a larger proportion of the seropositive children in the former than in the latter group had demonstrable IgG antibodies. These findings suggest that RSV infections causing bronchiolitis are more often associated with a strong antibody response than are mild cases of the infection. Follow-up of the children at 3 years of age showed that allergic sensitization and development of asthma had occurred much more frequently in children with past RSV bronchiolitis than in controls. Children with past RSV bronchiolitis who later developed allergic sensitization had elevated RSV IgA antibody titres at one year of age more frequently than children with past RSV-bronchiolitis, who were not sensitized (p = 0.015). No significant differences regarding IgG antibody titres were observed. Since IgA, similarly as IgE, antibody formation is strongly Th2 cell dependent, the results are compatible with other findings suggesting that RSV has an unusual propensity to activate the Th2 cell system. This may contribute to the pathological picture of bronchiolitis in small children and at the same time render the infected child predisposed for later development of allergic sensitization. RSV bronchiolitis may thus be an important risk factor for later development of atopic disease although it cannot be excluded that the bronchiolitis simply serves as a marker that predict later development of atopy.
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Affiliation(s)
- O Strannegård
- Department of Clinical Virology, Medical Faculty, University of Göteborg, Sweden
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