RESUMEN
Background: In children with asthma, the viral infection of airways is usually a main cause of acute asthma exacerbation and hospitalization. However, few studies on clinical and biomolecular characteristics of asthmatic children in this field have been done, especially in emergent countries. Objective: This study described the clinical and biological characteristics of asthmatic children who had acute asthma exacerbation and rhinovirus (RV) infection. Methods: Children under 15 years of age hospitalized for acute asthma exacerbation were included. They underwent clinical examination and peripheral blood analyses for the cytokine profile. The severity of acute asthma exacerbation was evaluated by Pediatric Asthma Score (PAS). Healthy children under 15 years of age were also invited in this study. Results: One hundred fifteen asthmatic children were included in this study. There were 18.2% of mild PAS, 37.4% of moderate PAS, and 44.4% of severe PSA. Among them, 63/115 (54.8%) asthmatic children had positive RV infection (RV+). The percentages of asthmatic children with RV+ had increased polymorphonuclear leucocytes were significantly higher than asthmatic children with RV-. There were no significant differences of the concentrations of non-Th2-related cytokines in asthmatic children with RV- and RV+. The concentration of Th2-related cytokines (IL-5 and IL-13) in asthmatic children with RV+ was significantly higher than those with RV-. However, there was no significant difference for the cytokine profile between mild, moderate, and severe asthma. Conclusion: RV infection is a main cause of acute asthma exacerbation in children with asthma. The increase of Th2-related cytokines, especially IL-5 and IL-13, is a relevant biomarker for RV infection in asthmatic children with severe exacerbation.
Asunto(s)
Asma/inmunología , Interleucina-13/inmunología , Interleucina-5/inmunología , Infecciones por Picornaviridae/inmunología , Infecciones del Sistema Respiratorio/inmunología , Rhinovirus , Adolescente , Asma/complicaciones , Estudios de Casos y Controles , Niño , Preescolar , Citocinas/inmunología , Progresión de la Enfermedad , Femenino , Factor Estimulante de Colonias de Granulocitos y Macrófagos/inmunología , Hospitales Pediátricos , Humanos , Lactante , Interferón gamma/inmunología , Interleucina-10/inmunología , Interleucina-2/inmunología , Interleucina-4/inmunología , Interleucina-8/inmunología , Masculino , Neutrófilos , Infecciones por Picornaviridae/complicaciones , Infecciones del Sistema Respiratorio/complicaciones , Células TH1/inmunología , Células Th2/inmunología , Factor de Necrosis Tumoral alfa/inmunologíaRESUMEN
Objective To assess clinical characteristics and cytokine levels in children with severe pneumonia who required ventilatory support. Methods In this prospective, descriptive, cross-sectional study, blood and endotracheal fluid samples were obtained from patients with severe pneumonia, aged <5 years, within 24 h following intubation. Blood samples were also obtained from age-matched healthy controls. Cytokine levels were investigated using flow cytometry-assisted immunoassay. Results Forty-five patients with severe pneumonia requiring mechanical ventilation (aged 10 ± 5 months) and 35 healthy age-matched controls were included. Patients with severe pneumonia had significantly increased serum interleukin (IL)-6, IL-8, and granulocyte/macrophage colony-stimulating factor concentrations compared with controls (80.84 pg/ml versus 2.06 pg/ml, 90.03 pg/ml versus 6.62 pg/ml, and 115.58 pg/ml versus 11.47 pg/ml, respectively). In the severe pneumonia group, serum IL-10 levels were significantly higher in patients aged <6 months versus those aged 6-12 months. Age-group differences in serum cytokine levels did not correspond to age-group differences in endotracheal-fluid cytokine levels. Serum IL-6 levels were significantly higher in patients who subsequently died versus those who survived (267.12 pg/ml versus 20.75 pg/ml, respectively). Conclusion High IL-6 concentrations were associated with mortality in patients <5 years of age with severe pneumonia requiring mechanical ventilation.