BACKGROUND: Most patients with respiratory syncytial virus (RSV) bronchiolitis requiring admission to the pediatric intensive care unit (PICU) have no risk factors for severe disease. We sought to investigate the relationship between serum cytokine concentrations, innate immune responsiveness, and RSV disease severity. METHODS: Previously healthy infants (median age, 2.6 months) with RSV bronchiolitis (PICU, n = 20; floor, n = 46) and healthy matched controls (n = 14) were enrolled, and blood samples were obtained within 24 hours of admission to measure plasma tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8), and interleukin 10 (IL-10) concentrations and, whole blood lipopolysaccharide-stimulated cytokine production capacity. RESULTS: Plasma IL-6, IL-8, and IL-10 concentrations were comparable between PICU and floor patients, but higher than in healthy controls (P < .05). In contrast, TNF-α, IL-6, and IL-8 production capacity was significantly decreased in PICU compared with both floor patients and healthy controls. In adjusted analyses, only impaired TNF-α and IL-8 production capacity were associated with longer length of stay (P = .035) and greater disease severity scores (P = .001). CONCLUSIONS: Infants with severe RSV bronchiolitis had increased plasma cytokine concentrations and yet impaired innate immunity cytokine production capacity, which predicted worse disease outcomes. Immune monitoring of otherwise healthy infants with RSV lower respiratory tract infection could help identify patients at risk for severe disease at the time of hospitalization.
BACKGROUND: Most patients with respiratory syncytial virus (RSV) bronchiolitis requiring admission to the pediatric intensive care unit (PICU) have no risk factors for severe disease. We sought to investigate the relationship between serum cytokine concentrations, innate immune responsiveness, and RSV disease severity. METHODS: Previously healthy infants (median age, 2.6 months) with RSV bronchiolitis (PICU, n = 20; floor, n = 46) and healthy matched controls (n = 14) were enrolled, and blood samples were obtained within 24 hours of admission to measure plasma tumornecrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8), and interleukin 10 (IL-10) concentrations and, whole blood lipopolysaccharide-stimulated cytokine production capacity. RESULTS: Plasma IL-6, IL-8, and IL-10 concentrations were comparable between PICU and floor patients, but higher than in healthy controls (P < .05). In contrast, TNF-α, IL-6, and IL-8 production capacity was significantly decreased in PICU compared with both floor patients and healthy controls. In adjusted analyses, only impaired TNF-α and IL-8 production capacity were associated with longer length of stay (P = .035) and greater disease severity scores (P = .001). CONCLUSIONS:Infants with severe RSV bronchiolitis had increased plasma cytokine concentrations and yet impaired innate immunity cytokine production capacity, which predicted worse disease outcomes. Immune monitoring of otherwise healthy infants with RSV lower respiratory tract infection could help identify patients at risk for severe disease at the time of hospitalization.
Authors: David J Marquardt; Nina L Knatz; Lawrence A Wetterau; Mark D Wewers; Mark W Hall Journal: Pediatr Crit Care Med Date: 2010-01 Impact factor: 3.624
Authors: Christian Meisel; Joerg C Schefold; Rene Pschowski; Tycho Baumann; Katrin Hetzger; Jan Gregor; Steffen Weber-Carstens; Dietrich Hasper; Didier Keh; Heidrun Zuckermann; Petra Reinke; Hans-Dieter Volk Journal: Am J Respir Crit Care Med Date: 2009-07-09 Impact factor: 21.405
Authors: Harish Nair; D James Nokes; Bradford D Gessner; Mukesh Dherani; Shabir A Madhi; Rosalyn J Singleton; Katherine L O'Brien; Anna Roca; Peter F Wright; Nigel Bruce; Aruna Chandran; Evropi Theodoratou; Agustinus Sutanto; Endang R Sedyaningsih; Mwanajuma Ngama; Patrick K Munywoki; Cissy Kartasasmita; Eric A F Simões; Igor Rudan; Martin W Weber; Harry Campbell Journal: Lancet Date: 2010-05-01 Impact factor: 79.321
Authors: Carmen L Larrañaga; Sandra L Ampuero; Vivian F Luchsinger; Flavio A Carrión; Nelson V Aguilar; Pamela R Morales; María Angélica M Palomino; Lorena F Tapia; Luis F Avendaño Journal: Pediatr Infect Dis J Date: 2009-10 Impact factor: 2.129
Authors: Federico R Laham; Amanda A Trott; Berkeley L Bennett; Claudia A Kozinetz; Alan M Jewell; Roberto P Garofalo; Pedro A Piedra Journal: Pediatrics Date: 2010-01-25 Impact factor: 7.124
Authors: M L Houben; F E J Coenjaerts; J W A Rossen; M E Belderbos; R W Hofland; J L L Kimpen; L Bont Journal: J Med Virol Date: 2010-07 Impact factor: 2.327
Authors: Kedir N Turi; Jyoti Shankar; Larry J Anderson; Devi Rajan; Kelsey Gaston; Tebeb Gebretsadik; Suman R Das; Cosby Stone; Emma K Larkin; Christian Rosas-Salazar; Steven M Brunwasser; Martin L Moore; R Stokes Peebles; Tina V Hartert Journal: Am J Respir Crit Care Med Date: 2018-10-15 Impact factor: 21.405
Authors: Martin Albert; David Williamson; John Muscedere; Francois Lauzier; Coleman Rotstein; Salmaan Kanji; Xuran Jiang; Mark Hall; Daren Heyland Journal: Intensive Care Med Date: 2014-07-01 Impact factor: 17.440
Authors: Mark W Hall; Kristin C Greathouse; Rajan K Thakkar; Eric A Sribnick; Jennifer A Muszynski Journal: Pediatr Clin North Am Date: 2017-08-18 Impact factor: 3.278
Authors: Wouter A A de Steenhuijsen Piters; Santtu Heinonen; Raiza Hasrat; Eleonora Bunsow; Bennett Smith; Maria-Carmen Suarez-Arrabal; Damien Chaussabel; Daniel M Cohen; Elisabeth A M Sanders; Octavio Ramilo; Debby Bogaert; Asuncion Mejias Journal: Am J Respir Crit Care Med Date: 2016-11-01 Impact factor: 21.405
Authors: Jonathan M Ciencewicki; Xuting Wang; Jacqui Marzec; M Elina Serra; Douglas A Bell; Fernando P Polack; Steven R Kleeberger Journal: FASEB J Date: 2014-01-13 Impact factor: 5.191
Authors: Philippa Hillyer; Rachel Shepard; Megan Uehling; Mina Krenz; Faruk Sheikh; Kalyn R Thayer; Lei Huang; Lihan Yan; Debasis Panda; Cindy Luongo; Ursula J Buchholz; Peter L Collins; Raymond P Donnelly; Ronald L Rabin Journal: J Virol Date: 2018-07-17 Impact factor: 5.103