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- Title
Robust Cytokine and Chemokine Response in Nasopharyngeal Secretions: Association With Decreased Severity in Children With Physician Diagnosed Bronchiolitis.
- Authors
Nicholson, Erin G.; Schlegel, Chelsea; Garofalo, Roberto P.; Mehta, Reena; Scheffler, Margaret; Minghua Mei; Piedra, Pedro A.; Mei, Minghua
- Abstract
<bold>Background: </bold>Bronchiolitis causes substantial disease in young children. Previous findings had indicated that a robust innate immune response was not associated with a poor clinical outcome in bronchiolitis. This study tested the hypothesis that increased concentrations of cytokines and chemokines in nasal wash specimens were associated with decreased severity in bronchiolitis.<bold>Methods: </bold>Children <24 months old who presented to the emergency department with signs and symptoms of bronchiolitis were eligible for enrollment. Nasal wash specimens were analyzed for viral pathogens and cytokine/chemokine concentrations. These results were evaluated with regard to disposition.<bold>Results: </bold>One hundred eleven children with bronchiolitis were enrolled. A viral pathogen was identified in 91.9% of patients (respiratory syncytial virus in 51.4%, human rhinovirus in 11.7%). Higher levels of cytokines and chemokines (interferon [IFN] γ; interleukin [IL] 4, 15, and 17; CXCL10; and eotaxin) were significantly associated with a decreased risk of hospitalization. IL-17, IL-4, IFN-γ, and IFN-γ-inducible protein 10 (CXCL10 or IP-10) remained statistically significant in the multivariate analyses.<bold>Conclusions: </bold>The cytokines and chemokines significantly associated with decreased bronchiolitis severity are classified in a wide range of functional groups (T-helper 1 and 2, regulatory, and chemoattractant). The involvement of these functional groups suggest that a broadly overlapping cytokine/chemokine response is required for control of virus-mediated respiratory disease in young children.
- Subjects
CYTOKINES; CHEMOKINES; BRONCHIOLITIS; IMMUNE response; RHINOVIRUSES
- Publication
Journal of Infectious Diseases, 2016, Vol 214, Issue 4, p649
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiw191