Robust cytokine and chemokine response in nasopharyngeal secretions: Association with decreased severity in children with physician diagnosed bronchiolitis

Erin G. Nicholson, Chelsea Schlegel, Roberto Garofalo, Reena Mehta, Margaret Scheffler, Minghua Mei, Pedro A. Piedra

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background. Bronchiolitis causes substantial disease in young children. Previous findings had indicated that a robust innate immune response was not associated with a poor clinical outcome in bronchiolitis. This study tested the hypothesis that increased concentrations of cytokines and chemokines in nasal wash specimens were associated with decreased severity in bronchiolitis. Methods. Children <24 months old who presented to the emergency department with signs and symptoms of bronchiolitis were eligible for enrollment. Nasal wash specimens were analyzed for viral pathogens and cytokine/chemokine concentrations. These results were evaluated with regard to disposition. Results. One hundred eleven children with bronchiolitis were enrolled. A viral pathogen was identified in 91.9% of patients (respiratory syncytial virus in 51.4%, human rhinovirus in 11.7%). Higher levels of cytokines and chemokines (interferon [IFN] ?; interleukin [IL] 4, 15, and 17; CXCL10; and eotaxin) were significantly associated with a decreased risk of hospitalization. IL-17, IL-4, IFN-?, and IFN-?-inducible protein 10 (CXCL10 or IP-10) remained statistically significant in the multivariate analyses. Conclusions. The cytokines and chemokines significantly associated with decreased bronchiolitis severity are classified in a wide range of functional groups (T-helper 1 and 2, regulatory, and chemoattractant). The involvement of these functional groups suggest that a broadly overlapping cytokine/chemokine response is required for control of virus-mediated respiratory disease in young children.

Original languageEnglish (US)
Pages (from-to)649-655
Number of pages7
JournalJournal of Infectious Diseases
Volume214
Issue number4
DOIs
StatePublished - Aug 15 2016

Keywords

  • Bronchiolitis
  • Chemokine
  • Cytokine
  • Infants and children
  • Innate antiviral immune response

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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