Respiratory Virus Bronchiolitis Research Articles

Relationship between early life respiratory infections and childhood asthma

Viral infections in early life, especially respiratory syncytial virus and human rhinovirus, are closely related to childhood asthma.An initial wheezing of the lower respiratory tract infection of human rhinovirus can serve as a marker of asthma predisposition, whereas respiratory syncytial virus bronchiolitis (particularly severe infection) in early life can have a causative role in asthma attacks.The interaction of viral infections with the bacterial microbiological environment of respiratory tract is an important determinant of childhood asthma. Key words: Viral infection; Microbial environment; Asthma; Early life; Children

Clinical characteristics of children with respiratory syncytial virus bronchiolitis versus non-respiratory syncytial virus bronchiolitis

Objective To study the difference in clinical characteristics between respiratory syncytial virus (RSV) bronchiolitis and non-RSV bronchiolitis. Methods A retrospective review of the medical records of 541 children with bronchiolitis in Children′s Hospital of Soochow University between January 2012 and December 2013 was conducted.The secretions of the lower respiratory tract were collected to detect RSV and other pathogens, the clinical characteristics between the 2 teams were analyzed by using PASW 21.0 software. Results (1)There were 194 patients (36%) hospitalized for bronchiolitis, who were assigned as RSV group, and 347 patients (64%) were assigned as non-RSV group.(2) Bronchiolitis due to RSV was more common from December to February, and bronchiolitis due to non-RSV was more common from May to October.(3) Compared with non-RSV group, RSV bronchiolitis started from a younger age(Z=5.62, P<0.001), pron to cyanosis(χ2=9.02, P=0.003), longer hospital stays, more expensive cost, more oxygen use, longer days of oxygen, ICU and mechanical ventilation, higher risk of ICU admission, higher the percentage of lymphocyte and platelet, the differences between 2 types were statistically significant(all P<0.05). White blood cell(WBC) count, neutrophils proportion and C-reactive protein(CRP) was higher in non-RSV than RSV bronchiolitis, the levels of lymphocyte, blood platelet and alanine aminotransferase (ALT) were higher in RSV than non-RSV bronchiolitis, the differences were statistically significant(all P<0.05). Conclusions Compared with non-RSV group, so RSV bronchiolitis is much more severe, and the patients need longer hospital stays and more expensive cost.Clinicians should pay close attention to RSV bronchiolitis. Key words: Respiratory syncytial virus; Non-respiratory syncytial virus; Bronchiolitis

Changes of microRNA-206 in peripheral blood mononuclear cells from children with respiratory syncytial virus bronchiolitis

Objective To explore the role of microRNA-206(miR-206) in peripheral blood mononuclear cells(PBMCs) in infantile bronchiolitis caused by respiratory syncytial virus(RSV). Methods Thirty-five cases of infantile bronchiolitis and 25 cases of healthy controls were enrolled into the current study.PBMCs were isolated from the peripheral blood of both healthy subjects and those with infantile bronchiolitis in the acute and the convalescent stages.Total RNAs were extracted from PBMCs which were stimulated by phorbol-12-myristate-13-acetate(PMA) and Ionomycin, and then the RNA was transcribed reversely into cDNA.The expressions of miR-206 and Kruppel-like transcription factor 4(KLF4) were detected by real-time quantitative polymerase chain reaction(qRT-PCR) method.Plasma interleukin-17(IL-17) was determined by enzyme linked immunosorbent assay(ELISA). Results There was a significant difference in miR-206 levels of children with RSV bronchiolitis in the acute stage(0.055±0.018) and the convalescent stage(0.187±0.069) as well as the healthy controls(0.204±0.075). Through pairwise comparison, the miR-206 levels in the children in the acute stage were significantly lower than those in the convalescent stage and healthy control group(P 0.05). The levels of KLF4 mRNA of children in the acute stage, convalescent stage as well as the healthy subjects were 0.588±0.161, 0.086±0.024, 0.075±0.019, respectively, which was significantly difference(P 0.05). Furthermore, the result of this study showed a negative correlation between the expression of miR-206 and KLF4(r=-0.624, P<0.01)and IL-17(r=-0.609, P<0.01) in children in the acute stage and a positive correlation between KLF4 mRNA and IL-17 in children in the acute stage(r=0.662, P<0.01). Conclusion The levels of miR-206 may play a role in the onset of RSV associated post-bronchiolitis(PB) and the low expression of miR-206 in children infected with RSV may increase the susceptibility to PB. Key words: Capillary bronchitis; Respiratory syncytial virus; MicroRNA-206; Kruppel-like transcription factor 4; Interleukin-17; Infant; Child

The curative effect of inhaled ribavirin in children with respiratory syncytial virus bronchiolitis

Objective To investigate the clinical effect of inhaled ribavirin on the therapeutic actions and the expression of interleukin 6(IL-6), interleukin 10(IL-10)and CysLTs in children with RSV bronchitis. Methods 81 cases of children with RSV bronchitis, were chosen and randomly divided into observing group and control group. Two groups of children were inhaled pulmicort respulas and accessed others support treatment, until the symptoms disappeared. But observing group were added with ribavirin atomization. Treatments time and symptoms disappearance time in the hospital were compared, and the serum IL-6,IL-10 and CysLTs level changes before and after treatment were observed. Results Treatments time and symptoms(wheezing, coughing, dry and wet rale)disappearance time in observation group were shorter than those of the control group with(6.58±1.36)d vs.(8.92±1.12)d,(1.21± 0.59)d vs. (2.68±1.22)d,(4.86±1.31)d vs.(7.34±1.39)d and(4.00±1.52)d vs.(6.37±1.58)d, which with significant differences(t＝-8.387,-7.012,-8.267,-6.887,all P＜0.01). Before the treatment, two groups had no significant difference(P＞0.05). After treatment, the levels of serum IL-6 and CysLTs were significantly lower in the observation group, and the levels of IL-10 were higher with(76.59±10.77)ng／L vs.(116.81±10.81)ng／L,(34.40±7.19)ng／mL vs.(48.26±8.36)ng／mL and,(43.25±3.97)ng／L vs.(31.39± 4.81)ng／L. The significant differences were observed in two groups(t＝-16.74,-8.024,12.315,all P＜0.05). Conclusion Compared with general therapy, the curative effect was significant. Combined inhaled ribavirin and pul-micort respulas in RSV bronchitis early, can reduce patients'clinical symptoms and the treatment time. Key words: Respiratory syncytial virus; Bronchiolitis; Ribavirin

Effects of virus coinfection on the severity of respiratory syncytial virus bronchiolitis

Objective To investigate the effects of virus coinfection on the severity of respiratory syncytial virus (RSV)bronchiolitis through the clinical analysis of 286 cases. Methods Various virus antibody were measured by using ELISA in 286 cases of RSV bronchiolitis.The frequency of respiratory virus coinfection on the severity of RSV bronchiolitis was observed. Results RSV bronchiolitis complicated with virus coinfection ratio reached 29.37%, especially with the double infection. Compared to patients with RSV infection, the severe cases increased significantly in patients with virus coinfection(χ2=128.7,P<0.01). Conclusion Other respiratory viruses coinfection are not uncommon in infants with RSV bronchiolitis and may increase the severity of RSV bronchiolitis. Key words: Respiratory syncytial virus; Children; Bronchiolitis; Viruses; Bacteria

Increased Nasal Interleukin-33 in the Infants with Acute Respiratory Syncytial Virus Bronchiolitis

목 적 : Interleukin (IL)-33은 IL-1 계열에 속하는 사이토카인으로 호흡기 점막의 선천 면역에 기여하며 Th2 면역반응을 유도하는 것으로 알려져 있다. 본 연구에서는 RSV감염에 의한 급성 세기관지염으로 입원하였던 소아들에서 IL-33이 기도 염증 반응의 기전에 관여하는지 알아보고자 하였다. 방 법: 출생 이후 처음으로 respiratory syncytial virus(RSV) 감염에 의한 급성 세기관지염으로 입원 치료하였던 38명의 24개월 미만 연령의 소아들을 대상으로 하였다. 아토피는 최소한 1개 이상의 혈청 내 알레르겐 특이 immunoglobulin E 항체를 가지고 있거나 알레르겐에 대한 피부 반응 검사에서 1 개 이상의 양성 반응을 보였던 경우로 정의하였고 입원 중 산소 포화도가 92% 이하인 상태가 있었거나 , 빈호흡이 있었거나, 천명의 지속 기간이 1주일 이상이었던 경우들 중 2가지 이상의 소견을 나타내었던 경우를 심한 호흡기 증상을 나타내었던 경우로 정의하였다. IL-33과 IL-33 수용체(sST2)는 입원 당시 채취한 비분비물에서 enzyme-linked immunosorbent assay 방법으로 측정하여 대조군과 비교하였으며 또한 소아들의 아토피 상태 및 증상의 심한 정도에 따른 차이가 있는지 조사하였다. 결 과 : 비분비물의 IL-33 측정치는 RSV 세기관지염 환자군에서 대조군에 비해 유의하게 증가되어 있었으나(P＜0.05), IL-33 수용체는 두 군간에 차이를 보이지 않았다. IL-33과 IL-33 수용체는 모두 소아들의 아토피나 증상의 심한 정도와는 관련성을 보이지 않았다. 결 론 : 본 연구의 결과는 RSV 감염에 의한 호흡기 염증반응의 기전에 IL-33이 중요하게 관여할 가능성을 시사하는 것으로 생각된다.

Association of IL-10-592A/C polymorphism with respiratory syncytial virus bronchiolitis

Objective To explore the association of IL-10-592A/C polymorphism with the susceptibility to respiratory syncytial virus(RSV) bronchiolitis and disease severity,and to explore the impact of IL10-592A/C polymorphism upon total serum IL-10 levels in children with RSV bronchiolitis. Methods One hundred children (patients group) admitted to hospital with RSV bronchiolitis and 100 healthy children (control group) were recruited. PCR restriction length fragment polymorphism assay was used to detect the single nucleotide polymorphisms of IL-10-592A/C. Total serum IL-10 levels in patients group were assayed with ELISA. Results The genotype frequency of IL-10-592A/C were AA 44% ,AC 38% ,CC 18% in patients group ,and AA 41% ,AC 42% ,CC 17% in the control group,it showed no significant difference between two groups (χ2= 0. 33, P > 0. 05) . The frequency of each allele were A 63%, C 37 % in patient group, and A 64% ,C 36% in the control group,there was no significant difference in allele frequency between two groups (χ2=0. 43 ,P >0. 05) . There was no significant difference in total serum IL-10 levels between different genotype of IL-10-592A/C (F = 0. 87, P > 0. 05) . The differences in genotype frequency of IL-10-592A/C were not significant between mild and moderate to severe cases (χ2= 2. 67, P > 0. 05) . Conclusion IL-10-592A/C gene polymorphisms do not correlated with RSV bronchiolitis. Key words: Respiratory syncytial virus ; Bronchiolitis; Interleukin-10; Gene polymorphism

Association of RANTES gene promoter -28C/G polymorphism with respiratory syncytial virus bronchiolitis

Respiratory syncytial virus (RSV) infects nearly all children under two years of age. It is poorly understood why a few children who were infected with RSV develop bronchiolitis that require hospital admission while most have a relatively minor illness. Several recent studies have obtained some indications for the involvement of genetic heterogeneity in RSV bronchiolitis, implying that the clinical outcome of RSV infection perhaps is determined by genetic factors. Regulated on activation, normal T cell expressed and secreted RANTES plays a key role in the pathophysiology of RSV bronchiolitis. The purpose of this study was to explore the genetic association between the RANTES gene promoter -28C/G polymorphism and RSV bronchiolitis in Chinese Han ethnic group population. The study recruited 238 hospitalized patients (186 male and 52 female) under 12 months of age, with a clinical diagnosis of bronchiolitis due to RSV, the sex, age, hospital stay, SaO2 at the time of admission, personal and family history of atopy were recorded. The 288 healthy control subjects (206 male and 82 female), who had no evidence of personal or familial history of atopy and no history of wheezing, were chosen at the same time. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to identify the polymorphism at position -28C/G of the RANTES promoter. The total IgE concentrations in serum samples were measured by enzyme-linked immunosorbent assay (ELISA). The absolute peripheral blood eosinophil counts were measured by using an automated hematology analyzer. The distribution of RANTES -28C/G gene polymorphism was in accordance with Hardy-Weinberg equilibrium. Compared to control subjects, significant difference was demonstrated for genotypes and allele frequencies of the RANTES -28C/G polymorphism in patients with RSV bronchiolitis (G = 10.22, P < 0.01; chi2 = 9.708, P < 0.01). Compared with the wild type CC, the -28G allele carriers demonstrated a 2.09-fold increased risk of RSV bronchiolitis (OR = 2.09, 95% CI = 1.32 - 3.30, P < 0.01). Interestingly, both the percentage of personal history of atopy and the percentage of family history of atopy for the -28G allele carriers were significantly higher (P < 0.05) than that for those CC homozygotes carriers in RSV bronchiolitis. Compared with the wild type CC, the -28G allele carriers demonstrated a 1.85-fold increased risk of the personal history of atopy (OR = 1.85, 95% CI = 1.01 - 3.38, P = 0.045) and a 1.91-fold increased risk of the family history of atopy (OR = 1.91, 95% CI = 1.03 - 3.54, P = 0.037), and the absolute peripheral blood eosinophil counts for the -28G allele carriers were significantly higher (P < 0.05). The RANTES gene promoter -28C/G polymorphism is associated with the susceptibility to RSV bronchiolitis, and the -28G allele is an important predisposing factor for the personal history of atopy and the family history of atopy in RSV bronchiolitis.

Progress of Gene Polymorphism in Respiratory Syncytial Virus Bronchiolitis

呼吸道合胞病毒(RSV)是婴幼儿呼吸道感染最常见的病原.感染RSV以后多数患儿仅表现为上呼吸道感染,而少数则出现需住院治疗的严重毛细支气管炎(毛支)和肺炎.导致这种病情差异的原因尚不清楚,随着对其遗传学研究的不断深入,通过对RSV毛支患儿基因型的分析,发现白细胞介素-8,4,10和表面活性蛋白等均存在基因多态性,且与RSV毛支的疾病易感性、病情严重程度等相关。

Pathogenesis of respiratory syncytial virus infection in ferret and fetal human tracheas in organ culture.

The pathogenesis of human respiratory syncytial virus infection was studied in ferret and fetal human tracheas in organ culture. Although the patterns of virus growth were similar in these species, the sites and morphologic consequences of virus replication differed markedly. In human trachea, synthesis of respiratory syncytial virus occurred in a population of ciliated epithelial cells, whereas other cells in the epithelial layer were spared. Virus replication was associated with cell injury characterized by ballooning degeneration and syncytium formation. In ferret trachea, virus growth occurred in fibroblasts of the lamina propria and serosa. Ciliated epithelial cells did not contain viral antigen and remained histologically normal. These observations are relevant to understanding the pathogenesis of human disease and the evaluation of animal models of respiratory syncytial virus bronchiolitis.