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a Respiratory Unit, Royal Liverpool Children's Hospital
and Department of Medical Microbiology, University of Liverpool, b Department of Medical
Microbiology, University of Liverpool
Correspondence to: Dr Rosalind Smyth, Respiratory Unit, Royal Liverpool Children's Hospital, Alder Hey, Liverpool L12 2AP.
Accepted 4 November 1996
OBJECTIVES
To determine whether there is evidence
of immunological responses in infants with respiratory syncytial virus
(RSV) bronchiolitis by measuring inflammatory mediators in peripheral
blood and, if found, whether these related to the severity of illness.
PATIENTS AND METHODSBlood was taken from 94 children with RSV infection during the acute episode and 10 or more
days later when the child was well. Control serum samples were obtained
from well children of similar ages. Serum samples were assayed for
mediators of lymphocyte activity (interleukin-4 (IL-4), soluble
interleukin-2 receptor (sCD25), soluble intercellular adhesion
molecule-1 (sICAM-1), eosinophil activity (eosinophil cationic protein)
and neutrophil activity (myeloperoxidase). Symptoms were assessed as
very mild (coryza only), mild (symptoms of lower respiratory tract
infection), moderate (requiring nasogastric or intravenous fluids), and
severe (requiring oxygen or ventilation).
RESULTSIL-4 concentrations were at the lower
limits of detection of the assay. The concentrations of sCD-25 were
greater in samples from patients with acute illness than from
convalescent patients and both were greater than in control samples.
sICAM-1 concentrations were similar in samples from patients with acute
illness and convalescent patients, but both were greater than in
samples from controls. Eosinophil cationic protein concentrations were
lower in samples from patients with acute illness than in those from
convalescent patients; there was no difference between samples from
convalescent and control patients. Myeloperoxidase concentrations were
similar in all samples. There was no correlation between the severity of infection and the concentrations of any inflammatory mediators.
CONCLUSIONSThere is evidence of an inflammatory
response in the peripheral blood of infants with acute bronchiolitis
which may affect lymphocytes and eosinophils, but an association
between this response and the severity of illness was not shown here.
This article has been cited by other articles:
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  P. S McNamara and R. L Smyth The pathogenesis of respiratory syncytial virus disease in childhood Br. Med. Bull., March 1, 2002; 61(1): 13 - 28. [Abstract] [Full Text] [PDF]
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 S. D. Hurst, B. W. P. Seymour, T. Muchamuel, V. P. Kurup, and R. L. Coffman Modulation of Inhaled Antigen-Induced IgE Tolerance by Ongoing Th2 Responses in the Lung J. Immunol., April 15, 2001; 166(8): 4922 - 4930. [Abstract] [Full Text] [PDF]
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 J. N Fletcher, R. L Smyth, H. M Thomas, D Ashby, and C A. Hart Respiratory syncytial virus genotypes and disease severity among children in hospital Arch. Dis. Child., December 1, 1997; 77(6): 508 - 511. [Abstract] [Full Text]
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