Immunopathogenesis of respiratory syncytial virus bronchiolitis.

Abstract

BACKGROUND:

The objective of this study was to elucidate the relation between respiratory syncytial virus (RSV) infection and cytokine/chemokine concentrations, as well as the impact that these factors have on the severity of bronchiolitis.

METHODS:

Children <24 months old who presented to the emergency department with clinical symptoms of bronchiolitis were prospectively enrolled in the study. Nasal-wash samples were analyzed to identify viral pathogens and to quantify RSV and cytokine/chemokine concentrations. Severe cases of disease were defined as those requiring hospitalization, and severity was further determined on the basis of the duration of supplemental-oxygen and/or intravenous-fluid therapy.

RESULTS:

A total of 101 children were enrolled, 63 of whom were infected with RSV and 13 of whom were infected with other respiratory viruses; in 22 children, no virus was detected. RSV bronchiolitis was associated with a greater inflammatory response than was non-RSV bronchiolitis, although RSV infection was not associated with more-severe disease. Levels of interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-gamma, and macrophage inflammatory protein (MIP)-1beta were significantly inversely correlated with the duration of supplemental-oxygen therapy.

CONCLUSION:

The robust inflammatory response associated with RSV infection does not contribute to the severity of RSV bronchiolitis any more than it contributes to the severity of non-RSV bronchiolitis. Elevated levels of proinflammatory mediators IL-6, IL-8, IFN-gamma, and MIP-1beta, as well as of the regulatory cytokine IL-10, may be protective against hypoxia in bronchiolitis.

• Authors: Berkeley L Bennett, Roberto P Garofalo, Stanley G Cron, Yashoda M Hosakote, Robert L Atmar, Charles G Macias, Pedro A Piedra
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 195 Issue 10 Pg. 1532-40 (May 15 2007) ISSN: 0022-1899 [Print] United States
• PMID: 17436234 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Chemokines
• Cytokines

Topics

• Bronchiolitis (immunology, pathology, virology)
• Chemokines (analysis)
• Cytokines (analysis)
• Female
• Genetic Predisposition to Disease
• Heart Defects, Congenital (complications)
• Humans
• Infant
• Infant, Newborn
• Infant, Premature
• Male
• Nasal Mucosa (physiopathology)
• Prospective Studies
• Respiratory Syncytial Virus Infections (immunology, pathology)
• Respiratory Syncytial Viruses (genetics, immunology, isolation & purification)
• Respiratory Tract Infections (virology)