Abstract

Background. A novel swine-origin influenza A H1N1 virus (S-OIV) caused human infection and acute respiratory illness in 2009, resulting in an influenza pandemic. Objectives. This study characterized the immune responses of S-OIV infection in pediatric patients at risk of pulmonary complications. Methods. All enrolled pediatric patients were confirmed virologically for S-OIV infection in 2009-2010, prospectively. Changes in cellular immunophenotypes were analyzed using flow cytometry. Plasma cytokine levels associated with S-OIV infection by pulmonary and without pulmonary complications were measured using cytokine cytometric bead assay kits. Results. A total of 85 patients with a mean age of 10.3 years were recruited. The level of C-reactive protein (CRP) was high in patients exhibiting pulmonary complications. The percentage of cellular immunophenotypes did not change between patients with and without pulmonary complications. The absolute numbers of peripheral blood mononuclear cells (PBMC), CD3, CD8, and CD16CD56 decreased with acute S-OIV pulmonary complications. Acute influenza infection with pulmonary complications was associated with high plasma concentrations of IL-1β, IL-6, IL-12, and IFN-γ. Conclusion. Immunophenotype studies have reported variability in immune response to the severity of S-OIV infections. Acute phase cytokine profiles of the 2009 S-OIV infection might have contributed to the pathogenesis of the pulmonary complications.

Highlights

  • Influenza pandemics have occurred at irregular intervals in the past, and supposing that another “new” influenza pandemic would occur in the future is justified

  • H1N1 swine-origin influenza A virus (S-OIV) is a pandemic acute respiratory illness caused by a novel influenza H1N1 strain that first emerged in humans in Mexico and the United States in March 2009 and early April 2009

  • An inflammatory response of the host to the influenza virus occurs in infection with the release of pro- and antiinflammatory cytokines

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Summary

Introduction

Influenza pandemics have occurred at irregular intervals in the past, and supposing that another “new” influenza pandemic would occur in the future is justified. Children have been disproportionately affected by pandemic influenza A H1N1, compared with older age groups This infection has caused severe disease and death in few children [1]. H1N1 swine-origin influenza A virus (S-OIV) is a pandemic acute respiratory illness caused by a novel influenza H1N1 strain that first emerged in humans in Mexico and the United States in March 2009 and early April 2009. A novel swine-origin influenza A H1N1 virus (S-OIV) caused human infection and acute respiratory illness in 2009, resulting in an influenza pandemic. This study characterized the immune responses of S-OIV infection in pediatric patients at risk of pulmonary complications. The percentage of cellular immunophenotypes did not change between patients with and without pulmonary complications. Acute influenza infection with pulmonary complications was associated with high plasma concentrations of IL-1β, IL-6, IL-12, and IFN-γ. Acute phase cytokine profiles of the 2009 S-OIV infection might have contributed to the pathogenesis of the pulmonary complications

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