Abstract
BackgroundRespiratory 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.MethodsIn 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.ResultsThis 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).ConclusionThe present study affirm that the bronchiolitis is an infection in which sex seems to act as a modulating factor only in the clinical course, influencing also the choice of the therapy should be made.
Highlights
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
Platelets play an important role in antimicrobial host defense, induction of inflammation and tissue repair, but the mechanism utilized by infection to induce thrombocytosis in these patients has not yet been understood
The most common virus detected in these patients was Respiratory syncytial virus B (RSVB), followed by Respiratory syncytial virus A (RSVA)
Summary
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. Platelets play an important role in antimicrobial host defenses and contribute to pulmonary vascular repair being either targets or source of reactive oxidizing species. Bronchiolitis is the result of common viral infection in young children, usually caused by respiratory syncytial virus (RSV) and rhinovirus. RSV frequently causes severe morbidity and mortality, especially in premature infants and children with other chronic diseases [1]. RSV infection in infants with bronchiolitis can be associated with a higher rate of thrombocytosis [2]. Platelets play an important role in antimicrobial host defense, induction of inflammation and tissue repair, but the mechanism utilized by infection to induce thrombocytosis in these patients has not yet been understood. Platelets regulate pulmonary vascular permeability and influence pulmonary vessel-reactivity, and lungs are sites of thrombopoiesis (process of platelet production) [3]
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