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Hurme P, Kähkönen M, Rückert B, Vahlberg T, Turunen R, Vuorinen T, Akdis M, Akdis CA, Jartti T. Disease Severity and Cytokine Expression in the Rhinovirus-Induced First Wheezing Episode. Viruses 2024; 16:924. [PMID: 38932217 PMCID: PMC11209381 DOI: 10.3390/v16060924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
Wheezing children infected with rhinovirus (RV) have a markedly increased risk of subsequently developing recurrencies and asthma. No previous studies have assessed the association between cytokine response and the severity of acute illness in the first wheezing episode in children infected with RV. Forty-seven children treated both as inpatients and as outpatients infected with RV only, aged 3-23 months, with severe first wheezing episodes were recruited. During acute illness, peripheral blood mononuclear cells (PBMCs) were isolated and stimulated with anti-CD3/anti-CD28 in vitro. A multiplex ELISA was used to quantitatively identify 56 different cytokines. The mean age of the children was 17 months, 74% were males, 79% were hospitalized, and 33% were sensitized. In adjusted analyses, the inpatient group was characterized by decreased expressions of interferon gamma (IFN-γ), interleukin 10 (IL-10), macrophage inflammatory protein 1 alpha (MIP-1α), RANTES (CCL5), and tumor necrosis factor-alpha (TNF-α) and an increased expression of ENA-78 (CXCL5) compared to the outpatient group. The cytokine response profiles from the PBMCs were different between the inpatient and outpatient groups. Our results support that firmly controlled interplay between pro-inflammatory and anti-inflammatory responses are required during acute viral infection to absolve the initial infection leading, to less severe illness.
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Affiliation(s)
- Pekka Hurme
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20520 Turku, Finland
| | - Miisa Kähkönen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20520 Turku, Finland
| | - Beate Rückert
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Christine Kühne-Center for Allergy Research and Education (CK-CARE), 7265 Davos, Switzerland
| | - Tero Vahlberg
- Department of Biostatistics, Turku University Hospital and University of Turku, 20520 Turku, Finland
| | - Riitta Turunen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20520 Turku, Finland
- New Children’s Hospital, Helsinki University Hospital and University of Helsinki, 00290 Helsinki, Finland
| | - Tytti Vuorinen
- Institute of Biomedicine, University of Turku and Turku University Hospital, 20520 Turku, Finland
- Department of Clinical Microbiology, Turku University Hospital, 20520 Turku, Finland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Christine Kühne-Center for Allergy Research and Education (CK-CARE), 7265 Davos, Switzerland
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Christine Kühne-Center for Allergy Research and Education (CK-CARE), 7265 Davos, Switzerland
| | - Tuomas Jartti
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20520 Turku, Finland
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Zhang XL, Zhang X, Hua W, Xie ZD, Liu HM, Zhang HL, Chen BQ, Chen Y, Sun X, Xu Y, Shu SN, Zhao SY, Shang YX, Cao L, Jia YH, Lin LN, Li J, Hao CL, Dong XY, Lin DJ, Xu HM, Zhao DY, Zeng M, Chen ZM, Huang LS. Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children. World J Pediatr 2024; 20:11-25. [PMID: 38064012 PMCID: PMC10828005 DOI: 10.1007/s12519-023-00777-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/26/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years, representing a major global healthcare burden. There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life. A multidisciplinary consensus development group comprising experts in epidemiology, infectious diseases, respiratory medicine, and methodology aims to develop the current consensus to address clinical issues of RSV infections in children. DATA SOURCES The evidence searches and reviews were conducted using electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, using variations in terms for "respiratory syncytial virus", "RSV", "lower respiratory tract infection", "bronchiolitis", "acute", "viral pneumonia", "neonatal", "infant" "children", and "pediatric". RESULTS Evidence-based recommendations regarding diagnosis, treatment, and prevention were proposed with a high degree of consensus. Although supportive care remains the cornerstone for the management of RSV infections, new monoclonal antibodies, vaccines, drug therapies, and viral surveillance techniques are being rolled out. CONCLUSIONS This consensus, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections. Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.
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Affiliation(s)
- Xian-Li Zhang
- Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wang Hua
- Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China
| | - Zheng-De Xie
- Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Han-Min Liu
- Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hai-Lin Zhang
- Department of Pediatric Pulmonology, the Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Bi-Quan Chen
- Department of Infectious Disease, Anhui Provincial Children's Hospital, Hefei, China
| | - Yuan Chen
- Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xin Sun
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Yi Xu
- Department of Infectious Disease, Guangzhou Women and Children's Medicine Center, Guangzhou Medicine University, Guangzhou, China
| | - Sai-Nan Shu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shun-Ying Zhao
- Department of Respiratory Disease, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yun-Xiao Shang
- Department of Pediatric Respiratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ling Cao
- Respiratory Department, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yan-Hui Jia
- Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China
| | - Luo-Na Lin
- Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Chuang-Li Hao
- Department of Respirology, Children's Hospital of Soochow University, Suzhou, China
| | - Xiao-Yan Dong
- Department of Respiratory, Children's Hospital of Shanghai, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dao-Jiong Lin
- Department of Infectious Disease, Hainan Women and Children's Medical Center, Haikou, China
| | - Hong-Mei Xu
- Department of Infectious Disease, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - De-Yu Zhao
- Department of Respiratory, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
| | - Zhi-Min Chen
- Department of Respiratory Diseases, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China.
| | - Li-Su Huang
- Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China.
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Hoshino A, Takahashi N, Oka A, Mizuguchi M. Association of IL6 and IL10 gene promotor polymorphisms with susceptibility to acute necrotizing encephalopathy. Front Neurosci 2023; 17:1231957. [PMID: 37600000 PMCID: PMC10435083 DOI: 10.3389/fnins.2023.1231957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Objective Acute necrotizing encephalopathy (ANE) is a severe complication of infectious diseases affecting the brain and systemic organs. The main pathogenesis is cytokine storm, in which interleukin-6 (IL-6) and interleukin-10 (IL-10) are candidates for key cytokines. To further elucidate their roles in the etiology and pathogenesis of ANE, we studied polymorphisms in the promotor regions of the IL6 and IL10 genes by genetic and functional analyses. Methods We first conducted a case-control association study of four IL6 and three IL10 polymorphisms. We genotyped 31 Japanese ANE cases and compared the results with those of approximately 200 Japanese controls. For the two polymorphisms showing a possible association, we next studied whether the polymorphisms alter the production of IL-6 or IL-10 by lymphoblasts upon phorbol 12-myristate 13-acetate (PMA) stimulation. Results The frequencies of IL6 rs1800796G allele and IL10 rs1800871/rs1800872 CC/CC diplotype were significantly higher in ANE cases than in controls. The IL10 CC/CC diplotype was associated with low IL-10 production, whereas the IL6 GG genotype was not associated with IL-6 production. Conclusion IL10 rs1800871/rs1800872 CC/CC diplotype may predispose Japanese children to ANE by altering IL-10 production in the early phase of infection. Etio-pathogenetic significance of IL6 rs1800796G remains to be elucidated.
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Affiliation(s)
- Ai Hoshino
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
- Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Fuchu, Japan
| | - Naoto Takahashi
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Akira Oka
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
- Department of Neurology, Saitama Children's Medical Center, Saitama, Japan
| | - Masashi Mizuguchi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Pediatrics, National Rehabilitation Center for Children with Disabilities, Tokyo, Japan
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Cortegano I, Rodríguez M, Hernángómez S, Arrabal A, Garcia-Vao C, Rodríguez J, Fernández S, Díaz J, de la Rosa B, Solís B, Arribas C, Garrido F, Zaballos A, Roa S, López V, Gaspar ML, de Andrés B. Age-dependent nasal immune responses in non-hospitalized bronchiolitis children. Front Immunol 2022; 13:1011607. [PMID: 36561744 PMCID: PMC9763932 DOI: 10.3389/fimmu.2022.1011607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Bronchiolitis in children is associated with significant rates of morbidity and mortality. Many studies have been performed using samples from hospitalized bronchiolitis patients, but little is known about the immunological responses from infants suffering from mild/moderate bronchiolitis that do not require hospitalization. We have studied a collection of nasal lavage fluid (NLF) samples from outpatient bronchiolitis children as a novel strategy to unravel local humoral and cellular responses, which are not fully characterized. The children were age-stratified in three groups, two of them (GI under 2-months, GII between 2-4 months) presenting a first episode of bronchiolitis, and GIII (between 4 months and 2 years) with recurrent respiratory infections. Here we show that elevated levels of pro-inflammatory cytokines (IL1β, IL6, TNFα, IL18, IL23), regulatory cytokines (IL10, IL17A) and IFNγ were found in the three bronchiolitis cohorts. However, little or no change was observed for IL33 and MCP1, at difference to previous results from bronchiolitis hospitalized patients. Furthermore, our results show a tendency to IL1β, IL6, IL18 and TNFα increased levels in children with mild pattern of symptom severity and in those in which non RSV respiratory virus were detected compared to RSV+ samples. By contrast, no such differences were found based on gender distribution. Bronchiolitis NLFs contained more IgM, IgG1, IgG3 IgG4 and IgA than NLF from their age-matched healthy controls. NLF from bronchiolitis children predominantly contained neutrophils, and also low frequency of monocytes and few CD4+ and CD8+ T cells. NLF from infants older than 4-months contained more intermediate monocytes and B cell subsets, including naïve and memory cells. BCR repertoire analysis of NLF samples showed a biased VH1 usage in IgM repertoires, with low levels of somatic hypermutation. Strikingly, algorithmic studies of the mutation profiles, denoted antigenic selection on IgA-NLF repertoires. Our results support the use of NLF samples to analyze immune responses and may have therapeutic implications.
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Affiliation(s)
- Isabel Cortegano
- Immunobiology Department, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mercedes Rodríguez
- Immunobiology Department, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Alejandro Arrabal
- Immunobiology Department, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Javier Rodríguez
- Pediatrics Department, Atención Primaria Galapagar, Madrid, Spain
| | - Sandra Fernández
- Pediatrics Department, Atención Primaria Galapagar, Madrid, Spain
| | - Juncal Díaz
- Pediatrics Department, Atención Primaria Galapagar, Madrid, Spain
| | | | - Beatriz Solís
- Pediatrics Department, Hospital Puerta de Hierro, Madrid, Spain
| | - Cristina Arribas
- Pediatrics Department, Clínica Universitaria de Navarra, Madrid, Spain
| | - Felipe Garrido
- Pediatrics Department, Clínica Universitaria de Navarra, Madrid, Spain
| | - Angel Zaballos
- Genomics Central Core, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Sergio Roa
- Biochemistry and Genetics Department, Universidad de Navarra, Pamplona, Spain
| | - Victoria López
- Chronic Disease Programme Unidad de Investigación de Enfermedades Crónicas (UFIEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Maria-Luisa Gaspar
- Immunobiology Department, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,*Correspondence: Belén de Andrés, ; Maria-Luisa Gaspar,
| | - Belén de Andrés
- Immunobiology Department, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,*Correspondence: Belén de Andrés, ; Maria-Luisa Gaspar,
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5
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Makrinioti H, Maggina P, Lakoumentas J, Xepapadaki P, Taka S, Megremis S, Manioudaki M, Johnston SL, Tsolia M, Papaevangelou V, Papadopoulos NG. Recurrent Wheeze Exacerbations Following Acute Bronchiolitis-A Machine Learning Approach. FRONTIERS IN ALLERGY 2022; 2:728389. [PMID: 35387034 PMCID: PMC8974688 DOI: 10.3389/falgy.2021.728389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/29/2021] [Indexed: 01/01/2023] Open
Abstract
Introduction: Acute bronchiolitis is one of the most common respiratory infections in infancy. Although most infants with bronchiolitis do not get hospitalized, infants with hospitalized bronchiolitis are more likely to develop wheeze exacerbations during the first years of life. The objective of this prospective cohort study was to develop machine learning models to predict incidence and persistence of wheeze exacerbations following the first hospitalized episode of acute bronchiolitis. Methods: One hundred thirty-one otherwise healthy term infants hospitalized with the first episode of bronchiolitis at a tertiary pediatric hospital in Athens, Greece, and 73 age-matched controls were recruited. All patients/controls were followed up for 3 years with 6-monthly telephone reviews. Through principal component analysis (PCA), a cluster model was used to describe main outcomes. Associations between virus type and the clusters and between virus type and other clinical characteristics and demographic data were identified. Through random forest classification, a prediction model with smallest classification error was identified. Primary outcomes included the incidence and the number of caregiver-reported wheeze exacerbations. Results: PCA identified 2 clusters of the outcome measures (Cluster 1 and Cluster 2) that were significantly associated with the number of recurrent wheeze episodes over 3-years of follow-up (Chi-Squared, p < 0.001). Cluster 1 included infants who presented higher number of wheeze exacerbations over follow-up time. Rhinovirus (RV) detection was more common in Cluster 1 and was more strongly associated with clinical severity on admission (p < 0.01). A prediction model based on virus type and clinical severity could predict Cluster 1 with an overall error 0.1145 (sensitivity 75.56% and specificity 91.86%). Conclusion: A prediction model based on virus type and clinical severity of first hospitalized episode of bronchiolitis could predict sensitively the incidence and persistence of wheeze exacerbations during a 3-year follow-up. Virus type (RV) was the strongest predictor.
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Affiliation(s)
- Heidi Makrinioti
- West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, Isleworth, United Kingdom.,Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Paraskevi Maggina
- Allergy and Clinical Immunology Laboratory, Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece
| | - John Lakoumentas
- Allergy and Clinical Immunology Laboratory, Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece
| | - Paraskevi Xepapadaki
- Allergy and Clinical Immunology Laboratory, Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece
| | - Stella Taka
- Allergy and Clinical Immunology Laboratory, Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece
| | - Spyridon Megremis
- Division of Evolution, Infection and Genomics, University of Manchester, Manchester, United Kingdom
| | - Maria Manioudaki
- Allergy and Clinical Immunology Laboratory, Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece
| | - Sebastian L Johnston
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Maria Tsolia
- Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos G Papadopoulos
- Allergy and Clinical Immunology Laboratory, Second Department of Pediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece.,Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
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Barnes MVC, Openshaw PJM, Thwaites RS. Mucosal Immune Responses to Respiratory Syncytial Virus. Cells 2022; 11:cells11071153. [PMID: 35406717 PMCID: PMC8997753 DOI: 10.3390/cells11071153] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022] Open
Abstract
Despite over half a century of research, respiratory syncytial virus (RSV)-induced bronchiolitis remains a major cause of hospitalisation in infancy, while vaccines and specific therapies still await development. Our understanding of mucosal immune responses to RSV continues to evolve, but recent studies again highlight the role of Type-2 immune responses in RSV disease and hint at the possibility that it dampens Type-1 antiviral immunity. Other immunoregulatory pathways implicated in RSV disease highlight the importance of focussing on localised mucosal responses in the respiratory mucosa, as befits a virus that is essentially confined to the ciliated respiratory epithelium. In this review, we discuss studies of mucosal immune cell infiltration and production of inflammatory mediators in RSV bronchiolitis and relate these studies to observations from peripheral blood. We also discuss the advantages and limitations of studying the nasal mucosa in a disease that is most severe in the lower airway. A fresh focus on studies of RSV pathogenesis in the airway mucosa is set to revolutionise our understanding of this common and important infection.
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Sánchez García L, Pellicer A, López-Martínez C, García-García ML, Casas I, Pozo F, Calvo C. Respiratory morbidity associated with viral respiratory infections during neonatal stage in premature infants. Pediatr Pulmonol 2021; 56:967-973. [PMID: 33406309 DOI: 10.1002/ppul.25241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/08/2020] [Accepted: 12/12/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Very low birth weight (VLBW) infants are highly susceptible to viral respiratory infections (VRIs), even during admission to the neonatal intensive care unit (NICU). Although the role of VRI in childhood in the development of recurrent wheezing and long-term asthma is well known, information on the impact in later morbidity of VRI in the neonatal period is lacking. We aimed to explore the occurrence of recurrent wheezing over the first 2 years of life according to VRI status during NICU admission. METHODS During April 2016 and December 2017, infants below 32 weeks of gestation were prospectively studied in VRI surveillance during NICU admission. Families were contacted between September 2018 and May 2019 by a telephone questionnaire. RESULTS A total of 99 patients were enrolled. The mean gestational age and birth weight were 28.8 (1.9) weeks and 1118 (329) g, respectively. During the first 2 years of life, neither episodes of wheezing nor the respiratory impairment-related hospital admissions differed between positive and negative VRI infants. Episodes of wheezing and respiratory impairment-related hospital admissions, as well as specific respiratory treatment prescription, were more frequent within the first 2 years in infants who had suffered symptomatic VRI during NICU admission. CONCLUSION Symptomatic VRI in VLBW infants is associated with long-term respiratory morbidity. The early surveillance of VRI in the preterm infant during NICU admission is justified for prognostic counseling and closely monitoring after discharge. Routine instruction on asthma-related risk factors and early prescription of antiasthmatic treatments, when indicated, should be established.
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Affiliation(s)
- Laura Sánchez García
- Department of Neonatology, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
| | - Adelina Pellicer
- Department of Neonatology, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
| | - Clara López-Martínez
- Department of Neonatology, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
| | | | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Center of Microbiology, Madrid, Spain
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Center of Microbiology, Madrid, Spain
| | - Cristina Calvo
- Department of Pediatric Infectious Diseases, IdiPaz Foundation, Traslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain.,TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Pavia, Italy.,Department of Pediatric Infectious Diseases, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
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8
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Association of polymorphisms in inflammatory cytokines encoding genes with severe cases of influenza A/H1N1 and B in an Iranian population. Virol J 2019; 16:79. [PMID: 31196204 PMCID: PMC6567579 DOI: 10.1186/s12985-019-1187-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/30/2019] [Indexed: 02/05/2023] Open
Abstract
Background The increased levels of blood cytokines is the main immunopathological process that were attributed to severe clinical outcomes in cases of influenza A, influenza B and people with influenza-like illness (ILI). Functional genetic polymorphisms caused by single nucleotide polymorphisms (SNPs) in inflammatory cytokines genes can influence their functions either qualitatively or quantitatively, which is associated with the possibility of severe influenza infections. The aim of the present case-control study was to investigate the association of polymorphisms in inflammatory cytokines genes with influenza patients and ILI group in an Iranian population. Methods Total number of 30 influenza B, 50 influenza A (H1N1) and 96 ILI inpatient individuals were confirmed by Real-time RT-PCR and HI assays. The genotype determination was assessed for defined SNPs in IL-1β, IL-17, IL-10 and IL-28 genes. Results The frequencies of the IL-1β rs16944 (P = 0.007) and IL-17 rs2275913 (P = 0.006) genotypes were associated with severe influenza disease, while the frequencies of IL-10 rs1800872 and IL-28 rs8099917 were not associated with the disease (P > 0.05). Also, the absence of A allele in IL-17 rs2275913 SNP increased the risk of influenza A (H1N1) infection (P = 0.008). Conclusions This study demonstrated that influenza A- (H1N1) and B-infected patients and also ILI controls have different profiles of immune parameters, and individuals carrying the specific cytokine-derived polymorphisms may show different immune responses towards severe outcome.
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9
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Holster A, Teräsjärvi J, Vuononvirta J, Koponen P, Peltola V, Helminen M, He Q, Korppi M, Nuolivirta K. Polymorphisms in the promoter region of IL10 gene are associated with virus etiology of infant bronchiolitis. World J Pediatr 2018; 14:594-600. [PMID: 29802545 DOI: 10.1007/s12519-018-0161-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 05/09/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bronchiolitis is the most common infection leading to hospitalization in infancy. Interleukin-10 (IL-10) is an anti-inflammatory cytokine, and in our previous study, IL10 gene rs1800896 (- 1082A/G) polymorphism was associated with viral etiology of infant bronchiolitis. The objective of this study was to evaluate the associations between IL10 single nucleotide polymorphisms (SNPs) at rs1800890 (- 3575A/T), rs1800871 (- 819C/T) or rs1800872 (- 592C/A) either alone or combined with the SNP at rs1800896 (- 1082G/A), and the etiology and severity of infant bronchiolitis. METHODS Data on four IL10 SNPs were available from 135 full-term infants, hospitalized for bronchiolitis at age less than 6 months, and from 378 to 400 controls. Viral etiology was studied, and oxygen support, feeding support and the length of stay in hospital were recorded during bronchiolitis hospitalization. RESULTS Infants with rhinovirus bronchiolitis had the IL10 rs1800890 variant AT or TT genotype less often (18.2%) than controls (63.3%, P = 0.03), and likewise, had the IL10 rs1800896 variant AG or GG genotype less often (27.3%) than controls (65.5%, P = 0.009). Twenty-eight infants with bronchiolitis had the variant-variant Grs1800896Trs1800890 haplotype, and none of them had rhinovirus infection. The IL10 rs1800871 or rs1800872 genotypes showed no associations with viruses. No association was found between any genotypes and bronchiolitis severity measures. CONCLUSION IL10 rs1800890 and rs1800896 polymorphisms differed between infants with rhinovirus bronchiolitis and controls, but not between infants with respiratory syncytial virus bronchiolitis and controls.
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Affiliation(s)
- Annukka Holster
- Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland
| | - Johanna Teräsjärvi
- Department of Medical Microbiology and Immunology, Turku University, Turku, Finland
| | - Juho Vuononvirta
- Department of Medical Microbiology and Immunology, Turku University, Turku, Finland
| | - Petri Koponen
- Tampere Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland
| | - Ville Peltola
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and Child and Youth Research Institute, University of Turku, Turku, Finland
| | - Merja Helminen
- Tampere Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland
| | - Qiushui He
- Department of Medical Microbiology and Immunology, Turku University, Turku, Finland.,Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Matti Korppi
- Tampere Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland
| | - Kirsi Nuolivirta
- Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland.
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10
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Townsi N, Laing IA, Hall GL, Simpson SJ. The impact of respiratory viruses on lung health after preterm birth. Eur Clin Respir J 2018; 5:1487214. [PMID: 30128088 PMCID: PMC6095035 DOI: 10.1080/20018525.2018.1487214] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/03/2018] [Indexed: 12/12/2022] Open
Abstract
Children born preterm, less than 37 weeks' gestation, are at increased risk of viral respiratory infections and associated complications both during their initial birth hospitalisation and in their first years following discharge. This increased burden of viral respiratory infections is likely to have long term implications for lung health and function in individuals born preterm, particularly those with bronchopulmonary dysplasia. Several hypotheses have been put forward to explain the association between early life viral respiratory infection and development of suboptimal lung health and function later in life following preterm birth. Although preterm infants with diminished lung function, particularly small airways, might be particularly susceptible to asthma and wheezing disorders following viral infection, there is evidence that respiratory viruses can activate number of inflammatory and airway re-modelling pathways. Therefore, the aim of this review is to highlight the perinatal and early life risk factors that may contribute to increased susceptibility to viral respiratory infections among preterm infants during early life and to understand how respiratory viral infection may influence the development of abnormal lung health and function later in life.
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Affiliation(s)
- Nada Townsi
- Children’s Lung Health, Telethon Kids Institute, Perth, Australia
- Division Paediatrics, University of Western Australia, Perth, Australia
- Department of Higher Education, Ministry of Education, Riyadh, Saudi Arabia
| | - Ingrid A. Laing
- Children’s Lung Health, Telethon Kids Institute, Perth, Australia
- School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Graham L. Hall
- Children’s Lung Health, Telethon Kids Institute, Perth, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
- Centre of Child Health Research, University of Western, Perth, Australia
| | - Shannon J. Simpson
- Children’s Lung Health, Telethon Kids Institute, Perth, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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11
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Zhivaki D, Lemoine S, Lim A, Morva A, Vidalain PO, Schandene L, Casartelli N, Rameix-Welti MA, Hervé PL, Dériaud E, Beitz B, Ripaux-Lefevre M, Miatello J, Lemercier B, Lorin V, Descamps D, Fix J, Eléouët JF, Riffault S, Schwartz O, Porcheray F, Mascart F, Mouquet H, Zhang X, Tissières P, Lo-Man R. Respiratory Syncytial Virus Infects Regulatory B Cells in Human Neonates via Chemokine Receptor CX3CR1 and Promotes Lung Disease Severity. Immunity 2017; 46:301-314. [PMID: 28228284 PMCID: PMC7128247 DOI: 10.1016/j.immuni.2017.01.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/09/2016] [Accepted: 12/20/2016] [Indexed: 12/22/2022]
Abstract
Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infections in infants and is characterized by pulmonary infiltration of B cells in fatal cases. We analyzed the B cell compartment in human newborns and identified a population of neonatal regulatory B lymphocytes (nBreg cells) that produced interleukin 10 (IL-10) in response to RSV infection. The polyreactive B cell receptor of nBreg cells interacted with RSV protein F and induced upregulation of chemokine receptor CX3CR1. CX3CR1 interacted with RSV glycoprotein G, leading to nBreg cell infection and IL-10 production that dampened T helper 1 (Th1) cytokine production. In the respiratory tract of neonates with severe RSV-induced acute bronchiolitis, RSV-infected nBreg cell frequencies correlated with increased viral load and decreased blood memory Th1 cell frequencies. Thus, the frequency of nBreg cells is predictive of the severity of acute bronchiolitis disease and nBreg cell activity may constitute an early-life host response that favors microbial pathogenesis. Identified a neonatal-specific subset of regulatory B (nBreg) cells in the blood Neonatal nBreg cells are infected by RSV via the BCR and CX3CR1 RSV-infected nBreg cells produce anti-inflammatory IL-10 that dowregulates Th1 cell responses Blood nBreg cells are a biomarker of lung disease severity in RSV+ patients
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Affiliation(s)
- Dania Zhivaki
- Neonatal Immunity Group, Human Histopathology and Animal Models, Institut Pasteur, Paris 75724, France; Paris 7 Diderot University, Paris 75724, France
| | - Sébastien Lemoine
- Régulation Immunitaire et Vaccinologie, Institut Pasteur, Paris 75724, France; INSERM U1041, Paris 75724, France
| | - Annick Lim
- Departement d'Immunologie, Institut Pasteur, Paris 75724, France
| | - Ahsen Morva
- Neonatal Immunity Group, Human Histopathology and Animal Models, Institut Pasteur, Paris 75724, France
| | | | | | - Nicoletta Casartelli
- Virus et Immunité, Institut Pasteur, Paris 75724, France; UMR CNRS 3568, Paris 75724, France
| | - Marie-Anne Rameix-Welti
- INSERM U1173, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines 78180, France; AP-HP, Laboratoire de Microbiologie, Hôpital Ambroise Paré, Boulogne-Billancourt 92100, France
| | - Pierre-Louis Hervé
- Unité de Virologie et Immunologie Moléculaires, INRA, Université Paris-Saclay, Jouy-en-Josas 78350, France
| | - Edith Dériaud
- Régulation Immunitaire et Vaccinologie, Institut Pasteur, Paris 75724, France; INSERM U1041, Paris 75724, France
| | - Benoit Beitz
- Bioaster Microbiology Technology Institute, Paris 75015, France
| | | | - Jordi Miatello
- APHP, Pediatric ICU and Neonatal Medicine, Paris South University Hospitals, Le Kremlin-Bicetre 94270, France; School of Medicine, Paris South University, Le Kremlin-Bicêtre 94270, France; Institute of Integrative Biology of the Cell - UMR 9196, Paris Saclay University, Gif-sur-Yvette 91190, France
| | | | - Valerie Lorin
- Laboratory of Humoral Response to Pathogens, Department of Immunology, Institut Pasteur, Paris 75724, France; INSERM U1222, Paris 75724, France
| | - Delphyne Descamps
- Unité de Virologie et Immunologie Moléculaires, INRA, Université Paris-Saclay, Jouy-en-Josas 78350, France
| | - Jenna Fix
- Unité de Virologie et Immunologie Moléculaires, INRA, Université Paris-Saclay, Jouy-en-Josas 78350, France
| | - Jean-François Eléouët
- Unité de Virologie et Immunologie Moléculaires, INRA, Université Paris-Saclay, Jouy-en-Josas 78350, France
| | - Sabine Riffault
- Unité de Virologie et Immunologie Moléculaires, INRA, Université Paris-Saclay, Jouy-en-Josas 78350, France
| | - Olivier Schwartz
- Virus et Immunité, Institut Pasteur, Paris 75724, France; UMR CNRS 3568, Paris 75724, France
| | | | - Françoise Mascart
- Immunobiology Clinic, Hopital Erasme, Brussels 1070, Belgium; Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles, Brussels 1070, Belgium
| | - Hugo Mouquet
- Laboratory of Humoral Response to Pathogens, Department of Immunology, Institut Pasteur, Paris 75724, France; INSERM U1222, Paris 75724, France
| | - Xiaoming Zhang
- Unit of Innate Defense and Immune Modulation, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Pierre Tissières
- APHP, Pediatric ICU and Neonatal Medicine, Paris South University Hospitals, Le Kremlin-Bicetre 94270, France; School of Medicine, Paris South University, Le Kremlin-Bicêtre 94270, France; Institute of Integrative Biology of the Cell - UMR 9196, Paris Saclay University, Gif-sur-Yvette 91190, France
| | - Richard Lo-Man
- Neonatal Immunity Group, Human Histopathology and Animal Models, Institut Pasteur, Paris 75724, France.
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12
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Rossi GA, Colin AA. Respiratory syncytial virus-Host interaction in the pathogenesis of bronchiolitis and its impact on respiratory morbidity in later life. Pediatr Allergy Immunol 2017; 28:320-331. [PMID: 28339145 DOI: 10.1111/pai.12716] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 02/06/2023]
Abstract
Respiratory syncytial virus (RSV) is the most common agent of severe airway disease in infants and young children. Large epidemiologic studies have demonstrated a clear relationship between RSV infection and subsequent recurrent wheezing and asthma into childhood, thought to be predominantly related to long-term changes in neuroimmune control of airway tone rather than to allergic sensitization. These changes appear to be governed by the severity of the first RSV infection in infancy which in term depends on viral characteristics and load, but perhaps as importantly, on the genetic susceptibility and on the constitutional characteristic of the host. A variety of viral and host factors and their interplay modify the efficiency of the response to infection, including viral replication and the magnitude of structural and functional damage to the respiratory structures, and ultimately the extent, severity, and duration of subsequent wheezing.
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Affiliation(s)
- Giovanni A Rossi
- Pulmonary and Allergy Disease Pediatric Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
| | - Andrew A Colin
- Division of Pediatric Pulmonology, Miller School of Medicine, University of Miami, Miami, FL, USA
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13
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Fauroux B, Simões EAF, Checchia PA, Paes B, Figueras-Aloy J, Manzoni P, Bont L, Carbonell-Estrany X. The Burden and Long-term Respiratory Morbidity Associated with Respiratory Syncytial Virus Infection in Early Childhood. Infect Dis Ther 2017; 6:173-197. [PMID: 28357706 PMCID: PMC5446364 DOI: 10.1007/s40121-017-0151-4] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The REGAL (RSV Evidence-a Geographical Archive of the Literature) series provide a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. The objective of this fifth publication was to determine the long-term respiratory morbidity associated with RSV lower respiratory tract infection (RSV LRTI) in early life. METHODS A systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015. This was supplemented by inclusion of papers published whilst drafting the manuscript. Studies reporting data on the incidence and long-term wheezing and asthma following RSV LRTI in early life were included. Study quality and strength of evidence (SOE) were graded using recognized criteria. RESULTS A total of 2337 studies were identified of which 74 were included. Prospective, epidemiologic studies consistently demonstrated that RSV LRTI is a significant risk factor for on-going respiratory morbidity characterized by transient early wheezing and recurrent wheezing and asthma within the first decade of life and possibly into adolescence and adulthood (high SOE). RSV LRTI was also associated with impaired lung function in these children (high SOE). Respiratory morbidity has been shown to result in reduced quality of life and increased healthcare resource use (moderate SOE). The mechanisms through which RSV contributes to wheezing/asthma development are not fully understood, but appear to relate to the viral injury, preexisting abnormal lung function and/or other factors that predispose to wheezing/asthma, including genetic susceptibility, altered immunology, eosinophilia, and associated risk factors such as exposure to environmental tobacco smoke (high SOE). CONCLUSION There is growing evidence that RSV LRTI in early childhood is associated with long-term wheezing and asthma and impaired lung function. Future research should aim to fully elucidate the pathophysiological mechanisms through which RSV causes recurrent wheezing/asthma.
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Affiliation(s)
- Brigitte Fauroux
- Necker University Hospital and Paris 5 University, Paris, France
| | - Eric A F Simões
- University of Colorado School of Medicine, and Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
| | - Paul A Checchia
- Baylor College of Medicine, Texas Children's Hospital Houston, Houston, TX, USA
| | - Bosco Paes
- Department of Paediatrics (Neonatal Division), McMaster University, Hamilton, Canada
| | - Josep Figueras-Aloy
- Hospital Clínic, Catedràtic de Pediatria, Universitat de Barcelona, Barcelona, Spain
| | | | - Louis Bont
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - Xavier Carbonell-Estrany
- Hospital Clinic, Institut d'Investigacions Biomediques August Pi Suñer (IDIBAPS), Barcelona, Spain.
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14
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García-García ML, Calvo C, Moreira A, Cañas JA, Pozo F, Sastre B, Quevedo S, Casas I, Del Pozo V. Thymic stromal lymphopoietin, IL-33, and periostin in hospitalized infants with viral bronchiolitis. Medicine (Baltimore) 2017; 96:e6787. [PMID: 28471975 PMCID: PMC5419921 DOI: 10.1097/md.0000000000006787] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Much attention has recently been focused on thymic stromal lymphopoietin (TSLP), IL-33, and periostin in allergic disease, but less is known about their role in viral bronchiolitis.The aim of the study was to investigate whether infants exhibit enhanced nasal airway secretion of TSLP, IL-33, and periostin during natural respiratory viral bronchiolitis compared to healthy controls.In total, 213 infants < 2 years of age, hospitalized with bronchiolitis from October/2013 to April/2016 were enrolled alongside 45 healthy infants. Nasopharyngeal aspirates (NPA) were screened for respiratory viruses by the polymerase chain reaction. TSLP, IL-33, and periostin were measured in NPAs. Clinical data were recorded.At least 1 virus was detected in 186 (87.3%) hospitalized infants: 149 (70%) respiratory syncytial virus (RSV); 42 (19.7%) rhinovirus (HRV); 16 (7.5%) parainfluenza virus (PIV); 9 (4.2%) adenovirus; 10 (4.7%) bocavirus; and 7 (3.3%) metapneumovirus (hMPV). Infants with bronchiolitis had higher levels of TSLP (P = .02), IL-33 (P<.001), and periostin (P = .003) than healthy controls.Detectable levels of TSLP and periostin were more frequent in virus-positive than in virus-negative patients (P = .05). TSLP and IL-33 were also more common in coinfections, mainly RSV and HRV, than in single-infections (P < .05). No patient with bronchiolitis but with negative viral detection had detectable levels of nasal TSLP or IL-33. Infants with hospital stay ≥5 days were more likely to have detectable levels of nasal TSLP and periostin after adjusting by age (P = .01).Bronchiolitis by common respiratory viruses is associated with elevated nasal levels of TSLP, IL-33, and periostin, factors known to be important in the development of Th2-response. Respiratory viruses in early life might shift immune responses toward Th2, involving asthma, and allergic diseases.
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Affiliation(s)
- María Luz García-García
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Cristina Calvo
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
- TEDDY Network (European Network of Excellence for Pediatric Clinical Research)
| | - Ana Moreira
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
| | - José Antonio Cañas
- Department of Immunology, IIS-Fundación Jiménez Díaz
- CIBER de Enfermedades Respiratorias (CIBERES)
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Beatriz Sastre
- Department of Immunology, IIS-Fundación Jiménez Díaz
- CIBER de Enfermedades Respiratorias (CIBERES)
| | - Sergio Quevedo
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
| | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Victoria Del Pozo
- Department of Immunology, IIS-Fundación Jiménez Díaz
- CIBER de Enfermedades Respiratorias (CIBERES)
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15
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Openshaw PJ, Chiu C, Culley FJ, Johansson C. Protective and Harmful Immunity to RSV Infection. Annu Rev Immunol 2017; 35:501-532. [DOI: 10.1146/annurev-immunol-051116-052206] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Peter J.M. Openshaw
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
| | - Chris Chiu
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
| | - Fiona J. Culley
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
| | - Cecilia Johansson
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
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16
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Viral Bronchiolitis is Associated With Altered Cytokine Gene Expression and Lymphocyte Activation Status. Pediatr Infect Dis J 2016; 35:e326-e338. [PMID: 27434830 DOI: 10.1097/inf.0000000000001299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Disease severity in viral bronchiolitis is often difficult to predict at onset, and may be related to the host immune response. Recognizing the particular immunologic features of infants who develop severe disease might offer an opportunity for developing diagnostic tools to facilitate early intervention and improve outcomes. METHODS We compared cytokine gene expression (by real-time reverse-transcriptase polymerase chain reaction), cytokine concentrations (by enzyme-linked immunosorbent assay) and the activation status of lymphocytes (by flow cytometry) in the peripheral blood of children hospitalized with moderate and severe viral bronchiolitis and a group of age-matched controls. RESULTS Analysis was undertaken on 57 children with viral bronchiolitis and 33 controls. Interleukin-7 mRNA expression at enrollment in peripheral blood mononuclear cells differed significantly between those with moderate and severe bronchiolitis, and correlated with both the subsequent length of hospital stay and need for supplemental oxygen therapy. Serum interleukin-10 concentration also distinguished moderate from severe disease. Participants with viral bronchiolitis demonstrated a more activated γδ-T cell phenotype (Vδ1+), but a more naive TCR αβ-T cell compartment compared with controls. CONCLUSIONS Viral bronchiolitis is characterized by a distinct pattern of cytokine expression and lymphocyte activation. These changes suggest an inadequate innate response in severe disease, and may offer potential as markers of disease severity.
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17
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Asselineau D, Benlhassan K, Arosio B, Mari D, Ferri E, Casati M, Gussago C, Tedone E, Annoni G, Mazzola P, Piette F, Belmin J, Pariel S, Bornand A, Beaudeux JL, Doulazmi M, Mariani J, Bray DH. Interleukin-10 Production in Response to Amyloid-β Differs between Slow and Fast Decliners in Patients with Alzheimer's Disease. J Alzheimers Dis 2016; 46:837-42. [PMID: 26402623 DOI: 10.3233/jad-142832] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated IL-10 and IL-6 production in amyloid-β (Aβ) stimulated peripheral blood mononuclear cells (PBMCs) in twenty Alzheimer's disease (AD) patients with slow progression, eleven with fast progression, and twenty age-matched controls. Promoter polymorphisms in IL-10 (position -592, -819, -1082), IL-6 (-174), transforming growth factor-β1 (TGF-β1) (-10, -25), interferon-γ (IFN-γ) (-874), and tumor necrosis factor-α (TNF-α) (-308) genes were analyzed. IL-10 production after Aβ stimulation was high in PBMCs from slow decliners and almost completely abrogated in fast decliners. Association between AA IFN-γ low-producing genotype and fast progression was demonstrated. Investigations in a larger sample will clarify these findings.
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Affiliation(s)
- Delphine Asselineau
- ImmunoClin Ltd, London, UK.,UPMC University Paris 06, UMR 8256 Biological Adaptation and Ageing (B2A) Team Brain Development, Repair and Aging (BDRA), Paris, France.,CNRS, UMR 8256 Biological Adaptation and Ageing (B2A) Team Brain Development, Repair and Aging (BDRA), Paris, France
| | | | - Beatrice Arosio
- Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Mari
- Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Evelyn Ferri
- Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
| | - Martina Casati
- Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
| | - Cristina Gussago
- Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
| | - Enzo Tedone
- Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giorgio Annoni
- Geriatric Clinic, Department of Health Science, Milan Center for Neuroscience, University Study of Milano-Bicocca, Milan, Italy
| | - Paolo Mazzola
- Geriatric Clinic, Department of Health Science, Milan Center for Neuroscience, University Study of Milano-Bicocca, Milan, Italy
| | - Francois Piette
- AP-HP, DHU FAST GH Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Joel Belmin
- AP-HP, DHU FAST GH Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Sylvie Pariel
- AP-HP, DHU FAST GH Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Anne Bornand
- AP-HP, DHU FAST GH Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Jean-Louis Beaudeux
- UMR-S 1139 "Pathophysiology and pharmacotoxicology of human placenta", Faculty of Pharmacy, Paris Descartes, Paris, France.,Department of Medical Biochemistry, Necker Hospital, AP-HP, Paris, France
| | - Mohamed Doulazmi
- UPMC University Paris 06, UMR 8256 Biological Adaptation and Ageing (B2A) Team Brain Development, Repair and Aging (BDRA), Paris, France.,CNRS, UMR 8256 Biological Adaptation and Ageing (B2A) Team Brain Development, Repair and Aging (BDRA), Paris, France.,AP-HP, DHU FAST GH Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Jean Mariani
- UPMC University Paris 06, UMR 8256 Biological Adaptation and Ageing (B2A) Team Brain Development, Repair and Aging (BDRA), Paris, France.,CNRS, UMR 8256 Biological Adaptation and Ageing (B2A) Team Brain Development, Repair and Aging (BDRA), Paris, France.,AP-HP, DHU FAST GH Pitie-Salpêtrière-Charles Foix, Paris, France
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18
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Luo G, Nkoy FL, Stone BL, Schmick D, Johnson MD. A systematic review of predictive models for asthma development in children. BMC Med Inform Decis Mak 2015; 15:99. [PMID: 26615519 PMCID: PMC4662818 DOI: 10.1186/s12911-015-0224-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 11/26/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Asthma is the most common pediatric chronic disease affecting 9.6 % of American children. Delay in asthma diagnosis is prevalent, resulting in suboptimal asthma management. To help avoid delay in asthma diagnosis and advance asthma prevention research, researchers have proposed various models to predict asthma development in children. This paper reviews these models. METHODS A systematic review was conducted through searching in PubMed, EMBASE, CINAHL, Scopus, the Cochrane Library, the ACM Digital Library, IEEE Xplore, and OpenGrey up to June 3, 2015. The literature on predictive models for asthma development in children was retrieved, with search results limited to human subjects and children (birth to 18 years). Two independent reviewers screened the literature, performed data extraction, and assessed article quality. RESULTS The literature search returned 13,101 references in total. After manual review, 32 of these references were determined to be relevant and are discussed in the paper. We identify several limitations of existing predictive models for asthma development in children, and provide preliminary thoughts on how to address these limitations. CONCLUSIONS Existing predictive models for asthma development in children have inadequate accuracy. Efforts to improve these models' performance are needed, but are limited by a lack of a gold standard for asthma development in children.
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Affiliation(s)
- Gang Luo
- Department of Biomedical Informatics, University of Utah, Suite 140, 421 Wakara Way, Salt Lake City, UT 84108 USA
| | - Flory L. Nkoy
- Department of Pediatrics, University of Utah, 100 N Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Bryan L. Stone
- Department of Pediatrics, University of Utah, 100 N Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Darell Schmick
- Spencer S. Eccles Health Sciences Library, 10 N 1900 E, Salt Lake City, UT 84112 USA
| | - Michael D. Johnson
- Department of Pediatrics, University of Utah, 100 N Mario Capecchi Drive, Salt Lake City, UT 84113 USA
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19
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Sugai K, Kimura H, Miyaji Y, Tsukagoshi H, Yoshizumi M, Sasaki-Sakamoto T, Matsunaga S, Yamada Y, Kashiwakura JI, Noda M, Ikeda M, Kozawa K, Ryo A, Yoshihara S, Ogata H, Okayama Y. MIP-1α level in nasopharyngeal aspirates at the first wheezing episode predicts recurrent wheezing. J Allergy Clin Immunol 2015; 137:774-81. [PMID: 26494023 DOI: 10.1016/j.jaci.2015.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/11/2015] [Accepted: 08/21/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Respiratory virus-induced wheezing, such as that induced by respiratory syncytial virus (RSV) and human rhinovirus, is an important risk factor for recurrent wheezing and childhood asthma. However, no biomarkers for predicting recurrent wheezing have been identified. OBJECTIVE We searched for predictors of recurrent wheezing using nasopharyngeal aspirates obtained from patients during the first wheezing episode who were hospitalized with an acute lower respiratory tract illness. METHODS We enrolled 82 infants during the first wheezing episode (median age, 5.0 months) who were hospitalized for acute lower respiratory tract illness between August 2009 and June 2012 and followed these patients for 2.5 years. Nasopharyngeal aspirates and blood samples were obtained on the first day of hospitalization. Viral genomes were identified by using RT-PCR and sequencing. Levels of 33 cytokines, tryptase, IgE, anti-RSV IgE, and anti-RSV IgG were measured by using ELISAs or the Bio-Plex multiplex assay. Predictors of recurrent wheezing were examined by using a stepwise logistic regression model with backward elimination. RESULTS Sixty percent of the patients experienced recurrent wheezing episodes. One or more viruses were detected in the nasopharynxes of 93% of the patients during the first wheezing episode. IFN-γ, IL-2, IL-9, MIP-1α, and MIP-1β levels were significantly higher among patients with recurrent wheezing than among those without recurrent wheezing (P < .05 or .01). The stepwise model demonstrated that the MIP-1α level (odds ratio, 7.72; 95% CI, 1.50-39.77; P = .015) was the strongest independent predictor of the occurrence of recurrent wheezing. CONCLUSION An increased MIP-1α level in nasopharyngeal aspirates from patients with acute respiratory symptoms during the first wheezing episode caused by viral infections might predict recurrent wheezing.
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Affiliation(s)
- Kazuko Sugai
- Department of Pediatrics, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yumiko Miyaji
- Department of Pediatrics, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Hiroyuki Tsukagoshi
- Department of Health Science, Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Japan
| | - Masakazu Yoshizumi
- Department of Health Science, Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Japan
| | - Tomomi Sasaki-Sakamoto
- Allergy and Immunology Group, Research Institute of Medical Science, Division of Medical Education Planning and Development, Nihon University School of Medicine, Tokyo, Japan
| | - Satoko Matsunaga
- Department of Molecular Biodefence Research, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yumi Yamada
- Yamada Gastroenterology Pediatric Clinic, Tochigi, Japan
| | - Jun-ichi Kashiwakura
- Laboratory for Allergic Disease, RCAI, RIKEN Center for Integrative Medical Sciences (IMS-RCAI), Yokohama, Japan
| | - Masahiro Noda
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masanori Ikeda
- Department of Pediatrics, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan
| | - Kunihisa Kozawa
- Department of Health Science, Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Japan
| | - Akihide Ryo
- Department of Molecular Biodefence Research, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Hiromitsu Ogata
- Center for Information Research, National Institute of Public Health, Saitama, Tokyo, Japan
| | - Yoshimichi Okayama
- Allergy and Immunology Group, Research Institute of Medical Science, Division of Medical Education Planning and Development, Nihon University School of Medicine, Tokyo, Japan.
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Larkin EK, Gebretsadik T, Moore ML, Anderson LJ, Dupont WD, Chappell JD, Minton PA, Peebles RS, Moore PE, Valet RS, Arnold DH, Rosas-Salazar C, Das SR, Polack FP, Hartert TV. Objectives, design and enrollment results from the Infant Susceptibility to Pulmonary Infections and Asthma Following RSV Exposure Study (INSPIRE). BMC Pulm Med 2015; 15:45. [PMID: 26021723 PMCID: PMC4506623 DOI: 10.1186/s12890-015-0040-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/16/2015] [Indexed: 12/25/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) during infancy has been consistently associated with an increased risk of childhood asthma. In addition, evidence supports that this relationship is causal. However, the mechanisms through which RSV contributes to asthma development are not understood. The INSPIRE (Infant Susceptibility to Pulmonary Infections and Asthma Following RSV Exposure) study objectives are to: 1) characterize the host phenotypic response to RSV infection in infancy and the risk of recurrent wheeze and asthma, 2) identify the immune response and lung injury patterns of RSV infection that are associated with the development of early childhood wheezing illness and asthma, and 3) determine the contribution of specific RSV strains to early childhood wheezing and asthma development. This article describes the INSPIRE study, including study aims, design, recruitment results, and enrolled population characteristics. Methods/design The cohort is a population based longitudinal birth cohort of term healthy infants enrolled during the first months of life over a two year period. Respiratory infection surveillance was conducted from November to March of the first year of life, through surveys administered every two weeks. In-person illness visits were conducted if infants met pre-specified criteria for a respiratory illness visit. Infants will be followed annually to ages 3-4 years for assessment of the primary endpoint: wheezing illness. Nasal, urine, stool and blood samples were collected at various time points throughout the study for measurements of host and viral factors that predict wheezing illness. Nested case-control studies will additionally be used to address other primary and secondary hypotheses. Discussion In the INSPIRE study, 1952 infants (48% female) were enrolled during the two enrollment years and follow-up will continue through 2016. The mean age of enrollment was 60 days. During winter viral season, more than 14,000 surveillance surveys were carried out resulting in 2,103 respiratory illness visits on 1189 infants. First year follow-up has been completed on over 95% percent of participants from the first year of enrollment. With ongoing follow-up for wheezing and childhood asthma outcomes, the INSPIRE study will advance our understanding of the complex causal relationship between RSV infection and early childhood wheezing and asthma.
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Affiliation(s)
- Emma K Larkin
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Martin L Moore
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Larry J Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - William D Dupont
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - James D Chappell
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Patricia A Minton
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - R Stokes Peebles
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Paul E Moore
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Robert S Valet
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Donald H Arnold
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | | | - Suman R Das
- Virology Department, J. Craig Venter Institute, Rockville, MD, USA.
| | - Fernando P Polack
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Tina V Hartert
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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Abstract
Respiratory syncytial virus (RSV) can induce severe lower respiratory tract infections in infants and is the leading cause of bronchiolitis in children worldwide. RSV-induced inflammation is believed to contribute substantially to the severity of disease. T helper (Th)2-, Th9-, and Th17-related cytokines are all observed in infants hospitalized following a severe RSV infection. These cytokines cause an influx of inflammatory cells, resulting in mucus production and reduced lung function. Consistent with the data from RSV-infected infants, CD4 T cell production of Interleukin (IL)-9, IL-13, and IL-17 has all been shown to contribute to RSV-induced disease in a murine model of RSV infection. Conversely, murine studies indicate that the combined actions of regulatory factors such as CD4 regulatory T cells and IL-10 inhibit the inflammatory cytokine response and limit RSV-induced disease. In support of this, IL-10 polymorphisms are associated with susceptibility to severe disease in infants. Insufficient regulation and excess inflammation not only impact disease following primary RSV infection it can also have a major impact following vaccination. Prior immunization with a formalin-inactivated (FI-RSV) vaccine resulted in enhanced disease in infants following a natural RSV infection. A Th2 CD4 T cell response has been implicated to be a major contributor in mediating vaccine-enhanced disease. Thus, future RSV vaccines must induce a balanced CD4 T cell response in order to facilitate viral clearance while inducing proper regulation of the immune response.
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22
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Zdrenghea MT, Makrinioti H, Muresan A, Johnston SL, Stanciu LA. The role of macrophage IL-10/innate IFN interplay during virus-induced asthma. Rev Med Virol 2014; 25:33-49. [PMID: 25430775 PMCID: PMC4316183 DOI: 10.1002/rmv.1817] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/25/2014] [Accepted: 10/14/2014] [Indexed: 12/18/2022]
Abstract
Activation through different signaling pathways results in two functionally different types of macrophages, the pro-inflammatory (M1) and the anti-inflammatory (M2). The polarization of macrophages toward the pro-inflammatory M1 phenotype is considered to be critical for efficient antiviral immune responses in the lung. Among the various cell types that are present in the asthmatic airways, macrophages have emerged as significant participants in disease pathogenesis, because of their activation during both the inflammatory and resolution phases, with an impact on disease progression. Polarized M1 and M2 macrophages are able to reversibly undergo functional redifferentiation into anti-inflammatory or pro-inflammatory macrophages, respectively, and therefore, macrophages mediate both processes. Recent studies have indicated a predominance of M2 macrophages in asthmatic airways. During a virus infection, it is likely that M2 macrophages would secrete higher amounts of the suppressor cytokine IL-10, and less innate IFNs. However, the interactions between IL-10 and innate IFNs during virus-induced exacerbations of asthma have not been well studied. The possible role of IL-10 as a therapy in allergic asthma has already been suggested, but the divergent roles of this suppressor molecule in the antiviral immune response raise concerns. This review attempts to shed light on macrophage IL-10-IFNs interactions and discusses the role of IL-10 in virus-induced asthma exacerbations. Whereas IL-10 is important in terminating pro-inflammatory and antiviral immune responses, the presence of this immune regulatory cytokine at the beginning of virus infection could impair the response to viruses and play a role in virus-induced asthma exacerbations.
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Affiliation(s)
- Mihnea T Zdrenghea
- Ion Chiricuta Oncology InstituteCluj-Napoca, Romania
- Iuliu Hatieganu, University of Medicine and PharmacyCluj-Napoca, Romania
| | - Heidi Makrinioti
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College LondonLondon, UK
- Medical Research Council and Asthma UK Centre in Allergic Mechanisms of AsthmaLondon, UK
- Centre for Respiratory InfectionsLondon, UK
| | - Adriana Muresan
- Iuliu Hatieganu, University of Medicine and PharmacyCluj-Napoca, Romania
| | - Sebastian L Johnston
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College LondonLondon, UK
- Medical Research Council and Asthma UK Centre in Allergic Mechanisms of AsthmaLondon, UK
- Centre for Respiratory InfectionsLondon, UK
| | - Luminita A Stanciu
- Iuliu Hatieganu, University of Medicine and PharmacyCluj-Napoca, Romania
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College LondonLondon, UK
- Medical Research Council and Asthma UK Centre in Allergic Mechanisms of AsthmaLondon, UK
- Centre for Respiratory InfectionsLondon, UK
- *
Correspondence to: Dr. L. A. Stanciu, MD, PhD, Airway Disease Infection Section, Imperial College London, London, UK., E-mail:
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Lambert L, Sagfors AM, Openshaw PJM, Culley FJ. Immunity to RSV in Early-Life. Front Immunol 2014; 5:466. [PMID: 25324843 PMCID: PMC4179512 DOI: 10.3389/fimmu.2014.00466] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/12/2014] [Indexed: 02/01/2023] Open
Abstract
Respiratory Syncytial Virus (RSV) is the commonest cause of severe respiratory infection in infants, leading to over 3 million hospitalizations and around 66,000 deaths worldwide each year. RSV bronchiolitis predominantly strikes apparently healthy infants, with age as the principal risk factor for severe disease. The differences in the immune response to RSV in the very young are likely to be key to determining the clinical outcome of this common infection. Remarkable age-related differences in innate cytokine responses follow recognition of RSV by numerous pattern recognition receptors, and the importance of this early response is supported by polymorphisms in many early innate genes, which associate with bronchiolitis. In the absence of strong, Th1 polarizing signals, infants develop T cell responses that can be biased away from protective Th1 and cytotoxic T cell immunity toward dysregulated, Th2 and Th17 polarization. This may contribute not only to the initial inflammation in bronchiolitis, but also to the long-term increased risk of developing wheeze and asthma later in life. An early-life vaccine for RSV will need to overcome the difficulties of generating a protective response in infants, and the proven risks associated with generating an inappropriate response. Infantile T follicular helper and B cell responses are immature, but maternal antibodies can afford some protection. Thus, maternal vaccination is a promising alternative approach. However, even in adults adaptive immunity following natural infection is poorly protective, allowing re-infection even with the same strain of RSV. This gives us few clues as to how effective vaccination could be achieved. Challenges remain in understanding how respiratory immunity matures with age, and the external factors influencing its development. Determining why some infants develop bronchiolitis should lead to new therapies to lessen the clinical impact of RSV and aid the rational design of protective vaccines.
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Affiliation(s)
- Laura Lambert
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Agnes M. Sagfors
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Fiona J. Culley
- National Heart and Lung Institute, Imperial College London, London, UK
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24
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A systematic review of predictive modeling for bronchiolitis. Int J Med Inform 2014; 83:691-714. [PMID: 25106933 DOI: 10.1016/j.ijmedinf.2014.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/20/2014] [Accepted: 07/16/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE Bronchiolitis is the most common cause of illness leading to hospitalization in young children. At present, many bronchiolitis management decisions are made subjectively, leading to significant practice variation among hospitals and physicians caring for children with bronchiolitis. To standardize care for bronchiolitis, researchers have proposed various models to predict the disease course to help determine a proper management plan. This paper reviews the existing state of the art of predictive modeling for bronchiolitis. Predictive modeling for respiratory syncytial virus (RSV) infection is covered whenever appropriate, as RSV accounts for about 70% of bronchiolitis cases. METHODS A systematic review was conducted through a PubMed search up to April 25, 2014. The literature on predictive modeling for bronchiolitis was retrieved using a comprehensive search query, which was developed through an iterative process. Search results were limited to human subjects, the English language, and children (birth to 18 years). RESULTS The literature search returned 2312 references in total. After manual review, 168 of these references were determined to be relevant and are discussed in this paper. We identify several limitations and open problems in predictive modeling for bronchiolitis, and provide some preliminary thoughts on how to address them, with the hope to stimulate future research in this domain. CONCLUSIONS Many problems remain open in predictive modeling for bronchiolitis. Future studies will need to address them to achieve optimal predictive models.
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Drysdale SB, Prendergast M, Alcazar M, Wilson T, Smith M, Zuckerman M, Broughton S, Rafferty GF, Johnston SL, Hodemaekers HM, Janssen R, Bont L, Greenough A. Genetic predisposition of RSV infection-related respiratory morbidity in preterm infants. Eur J Pediatr 2014; 173:905-12. [PMID: 24487983 DOI: 10.1007/s00431-014-2263-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 12/19/2013] [Accepted: 01/06/2014] [Indexed: 11/24/2022]
Abstract
UNLABELLED The aim of this study was to assess whether prematurely born infants have a genetic predisposition to respiratory syncytial virus (RSV) infection-related respiratory morbidity. One hundred and forty-six infants born at less than 36 weeks of gestation were prospectively followed. Nasopharygeal aspirates were obtained on every occasion the infants had a lower respiratory tract infection (LRTI) regardless of need for admission. DNA was tested for 11 single-nucleotide polymorphisms (SNPs). Chronic respiratory morbidity was assessed using respiratory health-related questionnaires, parent-completed diary cards at a corrected age of 1 year and review of hospital notes. Lung function was measured at a post menstrual age (PMA) of 36 weeks and corrected age of 1 year. A SNP in ADAM33 was associated with an increased risk of developing RSV LRTIs, but not with significant differences in 36-week PMA lung function results. SNPs in several genes were associated with increased chronic respiratory morbidity (interleukin 10 (IL10), nitric oxide synthase 2A (NOS2A), surfactant protein C (SFTPC), matrix metalloproteinase 16 (MMP16) and vitamin D receptor (VDR)) and reduced lung function at 1 year (MMP16, NOS2A, SFTPC and VDR) in infants who had had RSV LRTIs. CONCLUSIONS Our results suggest that prematurely born infants may have a genetic predisposition to RSV LRTIs and subsequent respiratory morbidity which is independent of premorbid lung function.
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Affiliation(s)
- Simon B Drysdale
- Division of Asthma, Allergy and Lung Biology, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK
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Clinical and epidemiologic factors related to subsequent wheezing after virus-induced lower respiratory tract infections in hospitalized pediatric patients younger than 3 years. Eur J Pediatr 2014; 173:959-66. [PMID: 24535712 DOI: 10.1007/s00431-014-2277-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 10/23/2013] [Accepted: 01/27/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Most wheezing episodes in infants are caused and exacerbated by virus-induced lower respiratory tract infections. However, there are few reports of epidemiologic and clinical virus-specific research with a focus on virus-induced wheezing. The purpose of the current study was to characterize the clinical presentation of virus-induced wheezing in pediatric patients <3 years of age who were hospitalized with lower respiratory tract infections. Of the 412 patients in the study, 216 were followed for 3 years. Nasopharyngeal aspirates collected from the patients at the time of admission were examined for the presence of respiratory syncytial virus (RSV), rhinovirus (RV), parainfluenza-3 virus (PIV-3), human metapneumovirus (hMPV), and influenza virus (Flu) using reverse-transcription polymerase chain reaction and rapid diagnostic tests. Clinical signs were assessed using a severity scoring system. In patients with wheezing at the time of admission, RSV, RV, RSV+RV, Flu, PIV-3, and hMPV were detected in 33, 14, 8, 8, 5, and 3 % of samples, respectively. There were no differences in age and severity scores between patients harboring more prevalent viruses (RSV and RV) and those with less common infections. Patients with wheezing and RV-positive aspirates at the time of admission were more likely to develop subsequent wheezing during the following 3 years. CONCLUSION RSV and RV infections are factors in the development and exacerbation of wheezing after virus-induced lower respiratory tract infections. Moreover, RV-induced wheezing may be associated with subsequent recurrent wheezing and the development of asthma.
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Zomer-Kooijker K, van der Ent CK, Ermers MJJ, Uiterwaal CSPM, Rovers MM, Bont LJ. Increased risk of wheeze and decreased lung function after respiratory syncytial virus infection. PLoS One 2014; 9:e87162. [PMID: 24498037 PMCID: PMC3909049 DOI: 10.1371/journal.pone.0087162] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 12/18/2013] [Indexed: 01/27/2023] Open
Abstract
Background A relationship between hospitalization for respiratory syncytial virus (RSV) bronchiolitis and asthma development has been suggested in case-control studies. Objective The aim of this study was to assess the risk of current wheeze, asthma, and lung function at school age in infants previously hospitalized for RSV bronchiolitis compared to non-hospitalized children. Methods For this study, data from a prospective birth cohort of unselected, term-born infants (n = 553), of whom 4 (0.7%) were hospitalized for RSV bronchiolitis, and a prospective patient cohort of 155 term infants hospitalized for RSV bronchiolitis were used. Respiratory outcomes at age 6 in children hospitalized for RSV bronchiolitis were compared to non-hospitalized children. Results The risk of current wheeze was higher in hospitalized patients (n = 159) compared to non-hospitalized children (n = 549) (adjusted odds ratio (OR) 3.2 (95% CI 1.2–8.1). Similarly, the risk of current asthma, defined as a doctor’s diagnosis of asthma plus current symptoms or medication use, was higher in hospitalized patients (adjusted OR 3.1 (95% CI 1.3–7.5). Compared to non-hospitalized children, RSV bronchiolitis hospitalization was associated with lower lung function (mean difference FEV1% predicted −6.8 l (95% CI (−10.2 to −3.4). Conclusions and Clinical Relevance This is the first study showing that hospitalization for RSV bronchiolitis during infancy is associated with increased risk of wheezing, current asthma, and impaired lung function as compared to an unselected birth cohort at age 6.
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Affiliation(s)
- Kim Zomer-Kooijker
- Department of Paediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cornelis K. van der Ent
- Department of Paediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marieke J. J. Ermers
- Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cuno S. P. M. Uiterwaal
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Maroeska M. Rovers
- Department of Epidemiology, Biostatistics & HTA and operating rooms, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Louis J. Bont
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
- * E-mail:
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Abstract
Respiratory syncytial virus (RSV) is amongst the most important pathogenic infections of childhood and is associated with significant morbidity and mortality. Although there have been extensive studies of epidemiology, clinical manifestations, diagnostic techniques, animal models and the immunobiology of infection, there is not yet a convincing and safe vaccine available. The major histopathologic characteristics of RSV infection are acute bronchiolitis, mucosal and submucosal edema, and luminal occlusion by cellular debris of sloughed epithelial cells mixed with macrophages, strands of fibrin, and some mucin. There is a single RSV serotype with two major antigenic subgroups, A and B. Strains of both subtypes often co-circulate, but usually one subtype predominates. In temperate climates, RSV infections reflect a distinct seasonality with onset in late fall or early winter. It is believed that most children will experience at least one RSV infection by the age of 2 years. There are several key animal models of RSV. These include a model in mice and, more importantly, a bovine model; the latter reflects distinct similarity to the human disease. Importantly, the prevalence of asthma is significantly higher amongst children who are hospitalized with RSV in infancy or early childhood. However, there have been only limited investigations of candidate genes that have the potential to explain this increase in susceptibility. An atopic predisposition appears to predispose to subsequent development of asthma and it is likely that subsequent development of asthma is secondary to the pathogenic inflammatory response involving cytokines, chemokines and their cognate receptors. Numerous approaches to the development of RSV vaccines are being evaluated, as are the use of newer antiviral agents to mitigate disease. There is also significant attention being placed on the potential impact of co-infection and defining the natural history of RSV. Clearly, more research is required to define the relationships between RSV bronchiolitis, other viral induced inflammatory responses, and asthma.
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Affiliation(s)
- Andrea T. Borchers
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - M. Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - Laurel J. Gershwin
- Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA USA
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Sun L, Cornell TT, LeVine A, Berlin AA, Hinkovska-Galcheva V, Fleszar AJ, Lukacs NW, Shanley TP. Dual role of interleukin-10 in the regulation of respiratory syncitial virus (RSV)-induced lung inflammation. Clin Exp Immunol 2013; 172:263-79. [PMID: 23574323 DOI: 10.1111/cei.12059] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 12/23/2022] Open
Abstract
RSV lower respiratory tract infections (LRTI) are among the most common diseases necessitating hospital admission in children. In addition to causing acute respiratory failure, RSV infections are associated with sequelae such as secondary bacterial infections and reactive airway disease. One characteristic host response observed in severe RSV-induced LRTI and/or subsequent development of asthma is increased expression of interleukin (IL)-10. However, contradictory results have been reported regarding whether IL-10 inhibits asthmatic responses or intensifies the disease. We aimed to reconcile these discordant observations by elucidating the role of IL-10 in regulating the host response to RSV LRTI. In this study, we used a lung-specific, inducible IL-10 over-expression (OE) transgenic mouse model to address this question. Our results showed that the presence of IL-10 at the time of RSV infection not only attenuated acute inflammatory process (i.e. 24 h post-infection), but also late inflammatory changes [characterized by T helper type 2 (Th2) cytokine and chemokine expression]. While this result appears contradictory to some clinical observations where elevated IL-10 levels are observed in asthmatic patients, we also found that delaying IL-10 OE until the late immune response to RSV infection, additive effects rather than inhibitory effects were observed. Importantly, in non-infected, IL-10 OE mice, IL-10 OE alone induced up-regulation of Th2 cytokine (IL-13 and IL-5) and Th2-related chemokine [monocyte chemoattractant protein 1 (MCP-1), chemokine (C-C motif) ligand 3 (CCL3) and regulated upon activation normal T cell expressed and secreted (RANTES)] expression. We identified a subset of CD11b(+)CD11c(+)CD49b(+)F4/80(-)Gr-1(-) myeloid cells as a prinicipal source of IL-10-induced IL-13 production. Therefore, the augmented pathological responses observed in our 'delayed' IL-10 over-expression model could be attributed to IL-10 OE alone. Taken together, our study indicated dual roles of IL-10 on RSV-induced lung inflammation which appear to depend upon the timing of when elevated IL-10 is expressed in the lung.
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Affiliation(s)
- L Sun
- Division of Critical Care Medicine, C.S Mott Children's Hospital and Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI 48109, USA
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Yeh CF, Chang JS, Wang KC, Shieh DE, Chiang LC. Water extract of Cinnamomum cassia Blume inhibited human respiratory syncytial virus by preventing viral attachment, internalization, and syncytium formation. JOURNAL OF ETHNOPHARMACOLOGY 2013; 147:321-326. [PMID: 23518419 DOI: 10.1016/j.jep.2013.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 03/04/2013] [Accepted: 03/06/2013] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cinnamomum cassia Blume is a popular traditional Chinese herbal medicine that has been used to manage respiratory tract disease, including common cold and chronic bronchitis for thousand years. Human respiratory syncytial virus (HRSV) is one of the leading causes of severe lower respiratory tract illness worldwide. No effective therapeutic modality against HRSV infection has been proved. It is unknown whether Cinnamomum cassia is effective against HRSV. AIM OF THE STUDY This study tested the hypothesis that Cinnamomum cassia can effectively decrease HRSV-induced plaque formation and syncytium formation in respiratory mucosal cell lines. MATERIALS AND METHODS Antiviral activity of the hot water extract of Cinnamomum cassia against HRSV was tested by plaque reduction assay in both human upper (HEp-2) and low (A549) respiratory tract cell lines. Its ability to inhibit the synthesis of viral fusion (F) protein was examined by Western blot assay. RESULTS Cinnamomum cassia dose-dependently inhibited HRSV-induced plaque formation in both HEp-2 and A549 cell lines (p<0.0001). Cinnamomum cassia was more effective when given before viral infection (p<0.0001) mainly by inhibition of viral attachment (p<0.0001) and internalization (p<0.0001). Cinnamomum cassia could inhibit F protein production and syncytium formation to interfere with HRSV spreading. CONCLUSIONS Cinnamomum cassia prevented airway epithelia from HRSV infection through inhibiting viral attachment, internalization and syncytium formation. Cinnamomum cassia could be a candidate to develop therapeutic modalities to manage HRSV infection in the future.
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Affiliation(s)
- Chia Feng Yeh
- Department of Renal Care, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
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Blanken MO, Rovers MM, Molenaar JM, Winkler-Seinstra PL, Meijer A, Kimpen JLL, Bont L. Respiratory syncytial virus and recurrent wheeze in healthy preterm infants. N Engl J Med 2013; 368:1791-9. [PMID: 23656644 DOI: 10.1056/nejmoa1211917] [Citation(s) in RCA: 468] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infection is associated with subsequent recurrent wheeze. Observational studies cannot determine whether RSV infection is the cause of recurrent wheeze or the first indication of preexistent pulmonary vulnerability in preterm infants. The monoclonal antibody palivizumab has shown efficacy in preventing severe RSV infection in high-risk infants. METHODS In the double-blind, placebo-controlled MAKI trial, we randomly assigned 429 otherwise healthy preterm infants born at a gestational age of 33 to 35 weeks to receive either monthly palivizumab injections (214 infants) or placebo (215 infants) during the RSV season. The prespecified primary outcome was the total number of parent-reported wheezing days in the first year of life. Nasopharyngeal swabs were taken during respiratory episodes for viral analysis. RESULTS Palivizumab treatment resulted in a relative reduction of 61% (95% confidence interval, 56 to 65) in the total number of wheezing days during the first year of life (930 of 53,075 days in the RSV-prevention group [1.8%] vs. 2309 of 51,726 days [4.5%] in the placebo group). During this time, the proportion of infants with recurrent wheeze was 10 percentage points lower in patients treated with palivizumab (11% vs. 21%, P=0.01). CONCLUSIONS In otherwise healthy preterm infants, palivizumab treatment resulted in a significant reduction in wheezing days during the first year of life, even after the end of treatment. These findings implicate RSV infection as an important mechanism of recurrent wheeze during the first year of life in such infants. (Funded by Abbott Laboratories and by the Netherlands Organization for Health Research and Development; MAKI Controlled Clinical Trials number, ISRCTN73641710.).
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Affiliation(s)
- Maarten O Blanken
- Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
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Lotz MT, Peebles RS. Mechanisms of respiratory syncytial virus modulation of airway immune responses. Curr Allergy Asthma Rep 2013; 12:380-7. [PMID: 22692775 PMCID: PMC3432290 DOI: 10.1007/s11882-012-0278-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Respiratory syncytial virus (RSV) most often causes severe respiratory disease in the very young and the elderly. Acute disease can also cause exacerbations of asthma in any age group. Recent findings provide insight into how the innate and adaptive immune systems respond to RSV infection and provide preliminary evidence that these effects vary significantly by RSV strain and host. Components of cell signaling pathways that induce inflammatory cytokine expression during the innate immune response and alter epithelial cell polarity through activating transcription factors, namely NF-κB, are now more clearly understood. New studies also reveal how RSV infection skews T helper (Th) cell differentiation away from the cell-mediated Th1 subset and towards the Th2 subset. There are also new data supporting preferential Th17 differentiation during RSV infection. In addition, effective immune system regulation of IL-10 expression and T regulatory cell (Treg) airway accumulation are essential for effective RSV clearance.
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Affiliation(s)
- Matthew T Lotz
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA
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Derscheid RJ, Ackermann MR. The Innate Immune System of the Perinatal Lung and Responses to Respiratory Syncytial Virus Infection. Vet Pathol 2013; 50:827-41. [DOI: 10.1177/0300985813480216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The response of the preterm and newborn lung to airborne pathogens, particles, and other insults is initially dependent on innate immune responses since adaptive responses may not fully mature and require weeks for sufficient responses to antigenic stimuli. Foreign material and microbial agents trigger soluble, cell surface, and cytoplasmic receptors that activate signaling cascades that invoke release of surfactant proteins, defensins, interferons, lactoferrin, oxidative products, and other innate immune substances that have antimicrobial activity, which can also influence adaptive responses. For viral infections such as respiratory syncytial virus (RSV), the pulmonary innate immune responses has an essential role in defense as there are no fully effective vaccines or therapies for RSV infections of humans and reinfections are common. Understanding the innate immune response by the preterm and newborn lung may lead to preventive strategies and more effective therapeutic regimens.
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Affiliation(s)
- R. J. Derscheid
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - M. R. Ackermann
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
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Drysdale SB, Milner AD, Greenough A. Respiratory syncytial virus infection and chronic respiratory morbidity - is there a functional or genetic predisposition? Acta Paediatr 2012; 101:1114-20. [PMID: 22963586 DOI: 10.1111/j.1651-2227.2012.02825.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED A systematic literature review has been undertaken. Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in infancy is associated with chronic respiratory morbidity. Premorbid abnormal lung function may predispose to RVS LRTI in prematurely born infants. CONCLUSION Single-nucleotide polymorphisms in genes coding for IL-8, IL-19, IL-20, IL-13 mannose-binding lectin, IFNG and a RANTES polymorphism have been associated with subsequent wheeze following RSV LRTI in term-born infants.
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MESH Headings
- Asthma/etiology
- Asthma/genetics
- Asthma/physiopathology
- Bronchiolitis, Viral/complications
- Chronic Disease
- Cough/etiology
- Cough/genetics
- Cough/physiopathology
- Disease Susceptibility/physiopathology
- Genetic Markers
- Genetic Predisposition to Disease
- Humans
- Infant
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/etiology
- Infant, Premature, Diseases/genetics
- Infant, Premature, Diseases/physiopathology
- Lung/physiopathology
- Polymorphism, Single Nucleotide
- Respiratory Function Tests
- Respiratory Sounds/etiology
- Respiratory Sounds/genetics
- Respiratory Sounds/physiopathology
- Respiratory Syncytial Virus Infections/complications
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Affiliation(s)
- Simon B Drysdale
- Division of Asthma, Allergy and Lung Biology, the MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK
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Faber TE, Groen H, Welfing M, Jansen KJG, Bont LJ. Specific increase in local IL-17 production during recovery from primary RSV bronchiolitis. J Med Virol 2012; 84:1084-8. [PMID: 22585726 DOI: 10.1002/jmv.23291] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Although Respiratory syncytial virus (RSV) bronchiolitis is the most important cause of hospital admission for infants during the winter season, the pathogenesis is largely unknown. Interleukin-17 (IL-17) concentrations were studied in nasopharyngeal aspirates from 21 non-ventilated and 17 ventilated infants admitted to hospital with RSV bronchiolitis at time of admission and discharge from the hospital. On admission, nasopharyngeal concentrations of most cytokines and chemokines were lower in non-ventilated infants than in ventilated infants, reaching statistical significance for Eotaxin, IL-1α, and IL-6. During course of disease, nasopharyngeal concentrations of most cytokines and chemokines decreased, reaching statistical significance for IL-6 and IP-10. However, nasopharyngeal IL-17 concentrations were higher at discharge than at admission in children with non-ventilated RSV disease (209-101 pg/ml, P = 0.008), a response pattern not observed in ventilated RSV patients nor for other cytokines or chemokines. It is speculated that local IL-17 production may be involved during convalescence from RSV bronchiolitis in non-ventilated patients by facilitating innate and adaptive antiviral immune responses. The role of IL-17 in the pathogenesis of RSV bronchiolitis is to be explored further.
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Affiliation(s)
- Tina E Faber
- Department of Pediatrics, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
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Guo J, He YH, Chen F, Jiang MH, Gao SP, Su YM, Shi GL, Deng XT, Zhu JH, Pan M. The A to G polymorphism at -1082 of the interleukin-10 gene is rare in the Han Chinese population. Mol Med Rep 2012; 6:894-6. [PMID: 22825546 DOI: 10.3892/mmr.2012.995] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 07/13/2012] [Indexed: 11/05/2022] Open
Abstract
Interleukin-10 (IL-10) is a multifunctional anti-inflammatory cytokine involved in various physiological and pathophysiological processes including cardiovascular disease. It has been reported that 50-75% of the variation in IL-10 production is genetically controlled. In the present study, the IL-10 -1082A/G (rs1800896) polymorphism was detected in 174 coronary artery disease (CAD) patients confirmed by selective coronary angiography and 176 age and gender-matched controls from the Jiangsu area (East China). The majority of the subjects (93.14%) carried the AA wild-type genotype, whereas only 0.29% carried the GG genotype. Our results suggest that IL-10 -1082A/G is rare and unlikely to be a significant contributory to disease susceptibility in the Han Chinese population.
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Affiliation(s)
- Jing Guo
- Department of Cardiology, Fourth People's Hospital of Wuxi and Affiliated Hospital of Jiangnan University, Wuxi 216042, PR China
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Faber TE, Schuurhof A, Vonk A, Koppelman GH, Hennus MP, Kimpen JLL, Janssen R, Bont LJ. IL1RL1 gene variants and nasopharyngeal IL1RL-a levels are associated with severe RSV bronchiolitis: a multicenter cohort study. PLoS One 2012; 7:e34364. [PMID: 22574108 PMCID: PMC3344820 DOI: 10.1371/journal.pone.0034364] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 02/27/2012] [Indexed: 02/02/2023] Open
Abstract
Background Targets for intervention are required for respiratory syncytial virus (RSV) bronchiolitis, a common disease during infancy for which no effective treatment exists. Clinical and genetic studies indicate that IL1RL1 plays an important role in the development and exacerbations of asthma. Human IL1RL1 encodes three isoforms, including soluble IL1RL1-a, that can influence IL33 signalling by modifying inflammatory responses to epithelial damage. We hypothesized that IL1RL1 gene variants and soluble IL1RL1-a are associated with severe RSV bronchiolitis. Methodology/Principal Findings We studied the association between RSV and 3 selected IL1RL1 single-nucleotide polymorphisms rs1921622, rs11685480 or rs1420101 in 81 ventilated and 384 non-ventilated children under 1 year of age hospitalized with primary RSV bronchiolitis in comparison to 930 healthy controls. Severe RSV infection was defined by need for mechanical ventilation. Furthermore, we examined soluble IL1RL1-a concentration in nasopharyngeal aspirates from children hospitalized with primary RSV bronchiolitis. An association between SNP rs1921622 and disease severity was found at the allele and genotype level (p = 0.011 and p = 0.040, respectively). In hospitalized non-ventilated patients, RSV bronchiolitis was not associated with IL1RL1 genotypes. Median concentrations of soluble IL1RL1-a in nasopharyngeal aspirates were >20-fold higher in ventilated infants when compared to non-ventilated infants with RSV (median [and quartiles] 9,357 [936–15,528] pg/ml vs. 405 [112–1,193] pg/ml respectively; p<0.001). Conclusions We found a genetic link between rs1921622 IL1RL1 polymorphism and disease severity in RSV bronchiolitis. The potential biological role of IL1RL1 in the pathogenesis of severe RSV bronchiolitis was further supported by high local concentrations of IL1RL1 in children with most severe disease. We speculate that IL1RL1a modifies epithelial damage mediated inflammatory responses during RSV bronchiolitis and thus may serve as a novel target for intervention to control disease severity.
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Affiliation(s)
- Tina E Faber
- Department of Pediatrics, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
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38
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Loebbermann J, Schnoeller C, Thornton H, Durant L, Sweeney NP, Schuijs M, O'Garra A, Johansson C, Openshaw PJ. IL-10 regulates viral lung immunopathology during acute respiratory syncytial virus infection in mice. PLoS One 2012; 7:e32371. [PMID: 22393401 PMCID: PMC3290561 DOI: 10.1371/journal.pone.0032371] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 01/26/2012] [Indexed: 11/18/2022] Open
Abstract
Interleukin (IL-) 10 is a pleiotropic cytokine with broad immunosuppressive functions, particularly at mucosal sites such as the intestine and lung. Here we demonstrate that infection of BALB/c mice with respiratory syncytial virus (RSV) induced IL-10 production by CD4+ and CD8+ T cells in the airways at later time points (e.g. day 8); a proportion of these cells also co-produced IFN-γ. Furthermore, RSV infection of IL-10−/− mice resulted in more severe disease with enhanced weight loss, delayed recovery and greater cell infiltration of the respiratory tract without affecting viral load. In addition, IL-10−/− mice had a pronounced airway neutrophilia and heightened levels of pro-inflammatory cytokines and chemokines in the bronchoalveolar lavage fluid. Notably, the proportion of lung T cells producing IFN-γ was enhanced, suggesting that IL-10 may act in an autocrine manner to dampen effector T cell responses. Similar findings were made in mice treated with anti-IL-10R antibody and infected with RSV. Therefore, IL-10 inhibits disease and inflammation in mice infected with RSV, especially during recovery from infection.
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Affiliation(s)
- Jens Loebbermann
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Corinna Schnoeller
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Hannah Thornton
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Lydia Durant
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Nathan P. Sweeney
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Martijn Schuijs
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Anne O'Garra
- Division of Immunoregulation, MRC National Institute for Medical Research, The Ridgeway, Mill Hill, London, United Kingdom
| | - Cecilia Johansson
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Peter J. Openshaw
- Centre for Respiratory Infection/MRC and Asthma UK Centre, Respiratory Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom
- * E-mail:
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