Sex differences in blood pro-oxidant status and platelet activation in children admitted with respiratory syncytial virus bronchiolitis: a pilot study

Abstract

Background: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in the pediatric population worldwide and an important cause of death in developing countries. It has been demonstrated that the balance between oxidant and antioxidant systems is disrupted in children with bronchiolitis and that oxidative stress contributes to the pathogenesis of this disease. Platelets play an important role in antimicrobial host defenses and contribute to pulmonary vascular repair being either targets or source of reactive oxidizing species. The main purpose of this study was to assessing sex differences in clinical characteristics and platelets activation during RSV bronchiolitis in infancy. Methods: In this retrospective study a total of 203 patients (112 boys and 91 girls) with bronchiolitis, aged 12 months or less, admitted to the Bambino Gesù Pediatric Hospital of Rome (Italy) in the period from January to December 2017, were enrolled. Moreover, in a select group of patients (15 boys and 12 girls) with diagnosis of moderate bronchiolitis from RSV, a pilot study on oxidative stress and platelet characteristics was carried out by electron paramagnetic resonance and flow cytometry respectively. Age-matched healthy control subjects (10 boys and 10 girls) were chosen as controls. Data were analyzed using Student' T test, Chi Squared test and one-way ANOVA test. Results: This study highlights the influence of sex in the clinical course of bronchiolitis. In particular we found: i) a higher incidence of bronchiolitis in boys than in girls (55% vs 45%); ii) higher C reactive protein values in girls than boys (1.11 mg/dL vs 0.92 mg/dL respectively; p < 0.05); iii) a different degree of thrombocytosis during hospitalization (mild in the girls and severe in the boys). Moreover, in selected patients we found that compared to girls with bronchiolitis, boys showed: i) higher percentage of activated platelets (8% vs 2% respectively; p < 0.05) and iii) higher number of platelets forming homotypic aggregates (2.36% vs 0.84% respectively, p < 0.05).

Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou

“…15 In an 11-year study in Spain, 62.7% of the patients (children ≤ 2 years of age with acute bronchiolitis) had RSV infections, which is a percentage slightly higher than that noted in our study. 16 In a similar retrospective Slovenian study of children under 2 years with bronchiolitis, RSV (57.5%), HRV (25.6%), and HBoV (18.4%) were identi ed as the most common pathogenic viruses; 17 their results were similar to ours in the case of RSV but higher in the case of HRV.…”

Host Sex Steroids Interact With Virus Infection: New Insights Into Sex Disparity in Infectious Diseases

“…The infection of RSV is also showed a male propensity in severe RSV bronchiolitis. Meta-analyses showed that the gender of male is a known risk factor for the disease ( Lanari et al, 2015 ; De Jacobis et al, 2020 ; Orimadegun et al, 2020 ). A recent study showed that upon androgen treatment, higher amounts of RSV were detected in body fluids in comparison to solvent ( Echchgadda et al, 2011 ).…”

Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou

“…A cohort analysis showed that pneumonia, bronchitis, asthma, bronchiolitis, and URTI were significantly more common in males [ 14 ]; and males are approximately twice as likely to become hospitalized than females due to RSV infection [ 15 ]. A new retrospective study in Italy also shows that there is a higher incidence of bronchiolitis in boys than in girls [ 16 ]. Specific pathogenic mechanisms between RSV and gender need further exploration.…”