The Appearance of Cell-Bound IgE in Respiratory-Tract Epithelium after Respiratory-Syncytial-Virus Infection

Welliver, Robert C.; Kaul, Tej N.; Ogra, Pearay L.

doi:10.1056/nejm198011203032103

Cited by 176 publications

(44 citation statements)

References 17 publications

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“…This procedure was well tolerated and can be routinely carried out by a paediatric chest physiotherapist. In infants, the noninvasive collection of respiratory tract secretions usually involves a simple nasopharyngeal aspiration [5,6,21]. However, these studies do not sample the secretions from the bronchial tree.…”

Section: Discussionmentioning

confidence: 99%

Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Counil

Lebel²,

Segondy³

et al. 1997

Eur Respir J

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An acute wheezing episode is the most common feature of severe lower respiratory tract infection during infancy. Respiratory syncytial virus (RSV) is the major causative agent.In order to study inflammation during acute wheezing episodes in infants, we wanted to assess the feasibility and contribution of induction of pharyngeal secretions.We therefore compared inflammatory markers in the pharyngeal secretions of 27 infants suffering from acute wheezing episodes with an RSV infection (RSV+) and 18 infants suffering with acute wheezing episodes without RSV infection (RSV-). Pharyngeal secretions were recovered by physiotherapy using isotonic saline. The safety of the procedure was carefully checked. Pharyngeal secretions were homogenized with dithiothreitol. Total cells and eosinophils were counted and levels of eosinophil cationic protein (ECP) and histamine were measured.Induction of pharyngeal secretion was always well tolerated. Eosinophils were present in five RSV+ and seven RSV-patients. ECP levels were not significantly different between the groups. Histamine levels after protein adjustment were significantly increased in RSV+ patients (p<0.01) in comparison to RSV-patients.In this study, we have shown, that pharyngeal secretion can be safely recovered from infants suffering from acute wheezing episodes, and that it can be analysed for enumeration of inflammatory cells and measurement of inflammatory mediators. Eur Respir J 1997; 10: 2591-2595 An acute wheezing episode is the most common severe lower respiratory tract infection in infancy. During epidemics, over 80% of cases may be caused by a respiratory syncytial viral (RSV) infection [1]. Although symptoms may become severe, most infections are selflimited, and improvement usually occurs within several days [2,3]. Approximately 2% of infants under 2 yrs of age require hospitalization [4]. In severe acute wheezing episodes, necrosis of the respiratory epithelium, excessive production of mucus, and lymphocytic infiltration result in oedema, dense plugs of debris and subsequent bronchiolar obstruction. The role of eosinophil activation in RSV infection needs to be clarified. It has been observed that nasal or pharyngeal secretions recovered from infants suffering from RSV infection have increased eosinophil cationic protein (ECP) levels. A correlation between ECP levels and severity was noted in one study [5], but ECP levels were found to be similar to those of healthy infants in two other studies [6,7]. However, no study has yet examined inflammatory markers in the pharyngeal secretions of infants.A study was carried out during a viral infection episode in 45 infants suffering from acute wheezing episodes requiring hospitalization, and pharyngeal secretions were recovered by physiotherapy. The safety of the procedure was carefully monitored. Inflammatory cells were counted and inflammatory markers were measured in order to differentiate inflammation in infants suffering from acute wheezing episodes with RSV infection (RSV+) or without RSV infecti...

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Section: Discussionmentioning

confidence: 99%

Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Counil

Lebel²,

Segondy³

et al. 1997

Eur Respir J

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“…It has previously been shown that IgE antibodies are not only directed towards inhalant and food allergens, but also towards microbes. WELLIVER et al [17] reported IgE responses to RSV in children with bronchiolitis. Furthermore, these authors showed that this IgE response to RSV early in life was related to recurring wheezing, but not to lung function and allergic sensitisation at age 7-8 yrs [18].…”

mentioning

confidence: 99%

Do bacteria have a role in asthma development?

Armann¹

2010

European Respiratory Journal

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“…Ainda mais intrigante foi a demonstração por Welliver et al 26 de que as crianças que desenvolvem essas duas síndromes produzem resposta IgE específica aos vírus, enquanto aquelas que são infectadas e que apresentam somente sintomas de vias aéreas superiores não a produzem. Esses autores sugeriram que a tendência de pacientes mais jovens produzirem anticorpos IgE a esses vírus constituía determinante importante no desenvolvimento de doença do trato respiratório inferior, atuando como deflagrador para o desencadeamento das crises por alérgenos.…”

Section: Discussionunclassified

Risk factors and clinical evolution of asthma in children

Camelo-Nunes

Solé²,

Naspitz³

1997

J Pediatr (Rio J)

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ResumoObjetivo: O objetivo deste estudo foi obter dados sobre a evolução clínica e os fatores de risco relacionados às manifestações de asma em crianças acompanhadas em nossa Disciplina de Alergia.Métodos: O grupo asmático foi composto por 165 crianças (107 meninos e 58 meninas) com idades entre 3 e 14 anos. Todas as crianças eram atópicas e tinham "prick test" positivo para o D. pteronyssinus. O grupo controle foi composto por 40 crianças sadias (20 meninos e 20 meninas), de mesma faixa etária, sem história pessoal de asma ou outra doença atópica e com "prick test" negativo para o D. pteronyssinus. As mães foram entrevistadas para a obtenção de dados sobre: a) evolução clínica; b) história familiar de asma ou outra doença atópica; c) descrição do ambiente domiciliar.Resultados 1) Em aproximadamente metade dos casos, os sintomas iniciaram-se no primeiro ano de vida. As mães não foram informadas sobre o diagnóstico naquela ocasião; 2) as infecções das vias aéreas superiores e a bronquiolite foram responsáveis pelo desencadeamento da primeira crise na maioria dos casos, e permaneceram os principais fatores precipitantes de crise durante o primeiro ano da doença, enquanto alérgenos, irritantes, sinusite, esforço físico e fatores emocionais foram os principais fatores desencadeantes para crianças entre 5 e 13 anos de idade; 3) as mudanças nas condições climáticas desencadearam crises durante toda a evolução da doença; 4) a asma não foi manifestação alérgica isolada, sendo a rinite alérgica a condição mais freqüentemente associada; 5) história familiar de atopia (Risco Relativo (RR) = 2,40; intervalo de confiança de 95% (IC95%) = 1,60-3,50); asma na história materna (RR = 2,23; IC95% = 1,10-4,63) e presença de fumantes no domicílio (RR = 2,30; IC95% = 1,20-4,31) foram os principais fatores de risco para a manifestação de asma.Conclusões: a) não houve diferenças entre meninos e meninas quanto aos aspectos evolutivos; b) a asma foi subdiagnosticada; c) a história familiar de atopia, a asma na história materna e a presença de fumantes no domicílio foram fatores de risco para a manifestação de asma.J. pediatr. (Rio J.). 1997; 73(3): 151-160: asma, criança, fatores de risco, evolução, desencadeantes. AbstractObjetive: The purpose of this study was to obtain data on the clinical evolution and risk factors related to asthma in children followed as outpatients in our Division of Allergy.Methods: The asthmatic group consisted of 165 children (107 boys, 58 girls), between the ages of 3 and 14 years. All children were atopic and had a positive skin prick test to D. pteronyssinus. The control group consisted of 40 healthy children (20 boys, 20 girls), within the same age range, without personal history of asthma or other atopic disease and with negative skin prick test to D. pteronyssinus. The mothers were interviewed to obtain data on: a) clinical evolution, b) family history of asthma or any other atopic disease, c) description of the house environment.Results: 1) in approximately half of the cases symptoms started on the firs...

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The Appearance of Cell-Bound IgE in Respiratory-Tract Epithelium after Respiratory-Syncytial-Virus Infection

Cited by 176 publications

References 17 publications

Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Do bacteria have a role in asthma development?

Risk factors and clinical evolution of asthma in children

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