Epidemiological characteristics and immune status of children with Respiratory Syncytial Virus

Abstract

Respiratory Syncytial Virus (RSV) infections are the dominant cause of pneumonia in children. In order to determine the epidemiological characteristics and immune status of children with Respiratory Syncytial Virus, a prospective study was performed among patients with RSV infection. Comparisons between RSV pneumonia group and normal control group, RSV pneumonia group had lower IL-2 (median levels, pg/ml: 3.8 vs. 5.1, P < 0.01), and higher IL-4 (median levels, pg/ml: 3.2 vs. 2.4, P < 0.01), IL-10 (median levels, pg/ml: 12.2 vs. 2.3, P < 0.01), and IFN-γ (median levels, pg/ml: 13.4 vs. 4.6, P < 0.01). The level of IgE among pneumonia patients caused by RSV increased sharply (median levels, mg/L: 48.1 vs. 8.8, P < 0.01). Another amazing finding is that after birth, the degree of IgE of the children infected by RSV increases gradually with age. This effect is at its peak in 0.6 years old. The IgE and eosinophil levels were higher when patients suffered from RSV pneumonia with wheeze (IgE median levels, IU/ml: with wheeze: 72.74 vs. without wheeze: 11.5, P < 0.05; eosinophil median levels, ×10(9) /l: with wheeze: 0.21 vs. without wheeze: 0.05, P < 0.05). The main morbidity crowd is the children under the age of 1 year old. The downregulation of IL2 and the upregulation of IL-4, IL-10, IFN-γ, and IgE happen after RSV infection.

The Human Immune Response to Respiratory Syncytial Virus Infection

“…Nasopharyngeal RSV IgE, histamine, and leukotriene C4 levels are interrelated and associated with bronchiolitis (where peak levels correlate with hypoxia) compared to other manifestations of infection (URTI or pneumonia) (36,94). In children with RSV bronchiolitis or pneumonia, higher serum IgE at admission has been associated with prolonged fever and worse symptoms and IgE titers and eosinophil counts with the development of wheeze during RSV LRTI (95)(96)(97).…”

“…Systemic. Markers of the Th1 response (IFN-␥, soluble tumor necrosis factor receptor II, and soluble interleukin-2 receptor [sCD25]) are elevated in the circulation during RSV LRTI, and systemic IFN-␥ exerts a protective effect (97)(98)(99)(100). Children Յ6 months with RSV bronchiolitis have a reduced IFN-␥ response, possibly contributing to the increased incidence of RSV disease in the younger age group (101).…”

“…Systemic. Systemic IL-4, IL-6, IL-10, and IL-13 levels are elevated in children with RSV LRTI (37,97,101,(121)(122)(123). Systemic IL-6 and IL-10 levels correlate with disease severity in RSV LRTI, including the requirement for supplemental oxygen (99,122,124,125).…”

Interleukin-5, interleukin-6, interferon induced protein-10, procalcitonin and C-reactive protein among mechanically ventilated severe community-acquired viral and bacterial pneumonia patients

“…In influenza pneumonia, IL-6, IL-8, IL-17, and transforming growth factor (TGF)-β1 have been shown to be elevated in an acute phase of the disease [13,14]. Children with respiratory syncytial virus (RSV) pneumonia have presented high serum levels of IL-4, IL-10, and interferon gamma (IFN-γ) [14,15]. However, the precise role of cytokines and the relationship between serum cytokine levels and microbiological etiology among mechanically ventilated SCAP patients is unclear [10,11].…”

Relevant Cytokines in the Management of Community-Acquired Pneumonia

“…In fact, high levels of IFN-γ, IL-4, and IL-10 were found in these patients. This cytokine pattern is characteristic of the Th1/Th2/Treg response coexisting to control infection and/or avoid tissue injury [40].…”