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Erdede Ö, Sarı E, Külcü NU, Yamanel RGS. Neutrophil-to-Lymphocyte Ratio and the Systemic Immune-Inflammation Index: Biomarkers in Infants with Bronchiolitis: a Cross-Sectional Study. Jpn J Infect Dis 2023; 76:351-357. [PMID: 37518068 DOI: 10.7883/yoken.jjid.2023.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
The use of a novel inflammatory indicator, the systemic immune-inflammatory index (SII), in pediatric patients with bronchiolitis remains unreported. Therefore, this study investigated the relationship between the SII and the neutrophil-to-lymphocyte ratio (NLR) in patients with respiratory syncytial virus (RSV) and non-RSV bronchiolitis and clinical severity prediction. This study analyzed the data of 155 patients aged <2 years who were hospitalized for viral bronchiolitis caused by RSV and/or other viral pathogens. The SII (platelet count × [neutrophil/lymphocyte]) was calculated and compared among patients with RSV mono-infections, other viral mono-infections, and RSV co-infections. Severity was defined by the number of days of supplemental oxygen treatment. The NLR and SII were significantly higher in the non-RSV mono-infection group than in the RSV mono-infection group, and the number of days of supplemental oxygen therapy was significantly higher in the RSV mono-infection group. No significant differences in the NLR, SII, or days of supplemental oxygen therapy were found between the RSV mono-infection and RSV co-infection groups. Although patients with RSV mono-infection showed more severe clinical findings than those without non-RSV mono-infection, the NLR and SII values were significantly higher in the non-RSV mono-infection group. Therefore, the NLR and SII do not appear to be very useful measurements for determining the severity of acute bronchiolitis attacks; however, lower NLR and SII values in the RSV group compared to the non-RSV group may be potential biomarkers for RSV infection. Therefore, further studies are warranted.
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Affiliation(s)
- Özlem Erdede
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
| | - Erdal Sarı
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
| | - Nihan Uygur Külcü
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
| | - Rabia Gönül Sezer Yamanel
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
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2
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Rua IB, Diogo J, Januário G, Moinho R, Carvalho L, Mação P. Severe Influenza Virus and Respiratory Syncytial Virus Infections in Intensive Care Over the Last 15 Years. Cureus 2023; 15:e46966. [PMID: 38022179 PMCID: PMC10640910 DOI: 10.7759/cureus.46966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Influenza virus is a common agent of pediatric infections. Most cases are mild, but severe illness and death can occur. We aimed to analyze severe cases associated the influenza virus and compare it with respiratory syncytial virus (RSV). METHODS This is a retrospective study of 0-17-year-old patients admitted to the intensive care unit (ICU) of Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra (Pediatric Hospital, Coimbra Hospital and University Center), a tertiary pediatric hospital in Coimbra, Portugal, over the last 15 years (2008-2022) due to influenza virus infection. Clinical presentation, severity, and evolution were analyzed. A comparison of children with RSV infection admitted in the same period was performed. RESULTS We identified 47 cases of influenza virus infection (34% coinfection with other viruses), median age of 2.3 years (interquartile range (IQR) 6.1), and 38% had comorbidities. The median admissions were three/year (maximum 11 in 2019). Influenza A was identified in 96%. Ninety-six percent had respiratory symptoms, 38% had neurologic symptoms, and 28% had sepsis. The main reason for admission was respiratory failure (68%). The mean pediatric index of mortality 2 (PIM2) at admission was 9±15.9%. Ventilatory support was necessary in 66%, vasoactive support in 19%, and blood products in 17%. The median length of stay was four days (IQR 5). There were four (8.5%) deaths. During the same study period, there were 171 RSV-related admissions. When comparing influenza (group A, without RSV coinfection) and RSV (group B), the first had a higher PIM2 on admission, greater need of ventilatory support, more complications, and higher mortality (p=0.001). CONCLUSIONS The number of influenza virus infections admitted to ICU was much lower than RSV. However, influenza was more severe and associated with all deaths registered.
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Affiliation(s)
- Inês B Rua
- Pediatric Intensive Care Service, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, PRT
| | - João Diogo
- Department of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, PRT
| | - Gustavo Januário
- Pediatric Ambulatory Service, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, PRT
- Department of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, PRT
| | - Rita Moinho
- Pediatric Intensive Care Service, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, PRT
| | - Leonor Carvalho
- Pediatric Intensive Care Service, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, PRT
| | - Patrícia Mação
- Pediatric Emergency Service, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, PRT
- Department of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, PRT
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3
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Bergeron HC, Murray J, Juarez MG, Nangle SJ, DuBois RM, Tripp RA. Immunogenicity and protective efficacy of an RSV G S177Q central conserved domain nanoparticle vaccine. Front Immunol 2023; 14:1215323. [PMID: 37457705 PMCID: PMC10338877 DOI: 10.3389/fimmu.2023.1215323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Respiratory syncytial virus (RSV) can cause lower respiratory tract disease in infants and elderly populations. Despite decades of research, there remains no safe and approved RSV vaccine. Previously, we showed that an RSV G glycoprotein subunit vaccine candidate with a single point mutation within the central conserved domain (CCD), i.e. S177Q, considerably improved immunogenicity. Methods Here, we examine the development of nanoparticle (NP) vaccines having either an RSV G protein CCD with wild-type sequence (NPWT) or an S177Q mutation (NP-S177Q). The NP vaccine immunogens were adjuvanted with monophosphoryl lipid A (MPLA), a TLR4 agonist to improve Th1- type responses. BALB/c mice were primed with 10 μg of NP-WT vaccine, NPS177Q, or vehicle, rested, and then boosted with a high (25 μg) or low (10 μg) dose of the NP-WT or NP-S177Q homologous candidate and subsequently challenged with RSV A2. Results The results showed that mice boosted with NP-S177Q developed superior immunogenicity and neutralizing antibodies compared to NP-WT boosting. IgG from either NP-S177Q or NP-WT vaccinated mice did not interfere with fractalkine (CX3CL1) binding to CX3CR1 and effectively blocked G protein CX3C-CX3CR1 binding. Both NP-WT and NP-S177Q vaccination induced similar neutralizing antibodies to RSV in challenged mice compared to vehicle control. NP-S177Q boosting improved correlates of protection including reduced BAL cell infiltration following RSV challenge. However, the NP vaccine platform will require improvement due to the poor solubility and the unexpectedly weaker Th1-type IgG2a response. Discussion The results from this study support further NP-S177Q vaccine candidate development.
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Affiliation(s)
- Harrison C. Bergeron
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Jackelyn Murray
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Maria G. Juarez
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, United States
| | - Samuel J. Nangle
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, United States
| | - Rebecca M. DuBois
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, United States
| | - Ralph A. Tripp
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Piccirilli G, Rocca A, Borgatti EC, Gabrielli L, Zama D, Pierantoni L, Leone M, Totaro C, Pavoni M, Lazzarotto T, Lanari M. Respiratory Syncytial Virus-Load Kinetics and Clinical Course of Acute Bronchiolitis in Hospitalized Infants: Interim Results and Review of the Literature. Pathogens 2023; 12:pathogens12050645. [PMID: 37242316 DOI: 10.3390/pathogens12050645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Respiratory Syncytial Virus (RSV) bronchiolitis is the leading cause of hospitalization in infants. The role of RSV load in disease severity is still debated. We present the interim results of a prospective monocentric study enrolling previously healthy infants hospitalized for RSV bronchiolitis, collecting nasopharyngeal aspirates every 48 h from admission to discharge, and evaluating RSV load dynamics in relation to clinical outcome measures of bronchiolitis severity, including: need, type and duration of oxygen therapy, length of hospitalization, and the bronchiolitis clinical score calculated at admission. The results showed that the highest viral replication occurs within the first 48 hours after admission, with a significant decrease at subsequent time points (p < 0.0001). Moreover, higher RSV-RNA values were associated with the need for oxygen therapy (p = 0.03), particularly high-flow nasal cannula type (p = 0.04), and longer duration of respiratory support (p = 0.04). Finally, higher RSV load values were correlated with lower white blood cells, especially lymphocyte counts and C-reactive protein levels (p = 0.03, p = 0.04, and p = 0.01, respectively), as well as with patients of a younger age (p = 0.02). These data suggest that RSV may actively contribute to the clinical severity of bronchiolitis, together with other potential non-viral factors.
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Affiliation(s)
- Giulia Piccirilli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Alessandro Rocca
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Eva Caterina Borgatti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Liliana Gabrielli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Marta Leone
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Camilla Totaro
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Matteo Pavoni
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Tiziana Lazzarotto
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
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5
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Juliana A, Plötz FB, Achten N, Bultman A, Jongman RM, van Meurs M, Wilschut JC, Zonneveld R. Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation. Pediatr Pulmonol 2021; 56:3908-3915. [PMID: 34491635 DOI: 10.1002/ppul.25663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/03/2021] [Accepted: 08/19/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evidence shows that activation of pulmonary vascular endothelium and neutrophils are involved in the pathophysiology of acute bronchiolitis. We hypothesized that levels of markers of endothelial activation and leukocyte counts are associated with requirement and duration of respiratory support. METHODS Thirty-four infants with bronchiolitis and eight controls were included. Nasopharyngeal swabs and blood samples were taken at admission. Serum levels of Angiopoietin (Ang)-1, Ang-2, sP-selectin, sE-selectin, vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), and leukocyte counts were measured. For univariate analysis, bronchiolitis cases were grouped into two groups, namely those not requiring and those requiring any form of respiratory support. To control for known risk factors for poor outcome (i.e., age, prematurity, and congenital heart disease), and for days post symptom onset, linear regression analysis was performed with duration of any type of respiratory support in days. RESULTS Ang-2 levels, Ang-2/Ang-1 ratios, sE-selectin levels, immature neutrophil count, and neutrophil/lymphocyte ratio (NLR) were higher in acute bronchiolitis versus controls. Ang-2, and NLR levels were significantly higher, and lymphocyte counts significantly lower, in infants that required respiratory support versus those that did not. Ang-2 levels (β: .32, 95% confidence interval [CI]: 0.19-1.19) and NLR (β: .68, 95% CI: 0.17-1.19) were positive predictors for the duration of respiratory support. CONCLUSIONS Markers of endothelial and neutrophil activation are associated with respiratory support for acute bronchiolitis. Admission Ang-2 levels and NLR may be promising markers to determine requirement of respiratory support and deserve further study.
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Affiliation(s)
- Amadu Juliana
- Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Frans B Plötz
- Department of Pediatrics, Tergooi Hospitals, Hilversum, The Netherlands.,Emma Children's Hospital, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Niek Achten
- Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Anita Bultman
- Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Rianne M Jongman
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Matijs van Meurs
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan C Wilschut
- Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rens Zonneveld
- Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
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6
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Tan J, Wu J, Jiang W, Huang L, Ji W, Yan Y, Wang M, Shao X. Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou. BMC Infect Dis 2021; 21:135. [PMID: 33522910 PMCID: PMC7851904 DOI: 10.1186/s12879-021-05772-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 01/06/2021] [Indexed: 01/21/2023] Open
Abstract
Background Bronchiolitis is a clinical syndrome commonly encountered in practice, particularly among infants and young children. To investigate the prevalence of pathogens in hospitalized children with bronchiolitis and study the clinical characteristics of bronchiolitis with or without coinfections. Methods We investigated the respiratory specimens and clinical data of 1012 children with bronchiolitis who were treated at the Children’s Hospital of Soochow University between November 2011 and December 2018. The nasopharyngeal aspirates were examined to detect viruses by direct immunofluorescence assay or polymerase chain reaction (PCR). Mycoplasma pneumoniae (MP) was tested by PCR and enzyme-linked immunosorbent assay. Results Of the 1134 children less than 2 years with bronchiolitis, 122 were excluded by exclusion criteria. Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). Coinfection was identified in 13.5% (137 of 1012) of the patients. Coinfection included mixed virus infection and virus infection with MP infection. Children with single virus infection had a higher rate of oxygen therapy compared with single MP infection. Conclusions The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia.
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Affiliation(s)
- Jiahong Tan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Jinfeng Wu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China. .,Children's Hospital of Wujiang District, Suzhou, China.
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
| | - Wei Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Xuejun Shao
- Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, China
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7
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Batista JDL, Ferreira MAP, Xavier CDS, Souza ITAD, Cruz LN, Polanczyk CA. A post-incorporation study on the use of palivizumab in the Brazilian public health system. Rev Inst Med Trop Sao Paulo 2021; 63:e5. [PMID: 33533808 PMCID: PMC7845933 DOI: 10.1590/s1678-9946202163005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/26/2020] [Indexed: 12/02/2022] Open
Abstract
Respiratory syncytial virus (RSV) is the main cause of lower respiratory disease in infants and children under five years of age. As there is no specific treatment for RSV infections, prophylaxis with the specific monoclonal antibody palivizumab (PVZ) has been widely recommended for high-risk cases during the RSV season. The present study aimed to evaluate the effectiveness of a public prophylaxis program with palivizumab on the incidence of hospitalizations for lower respiratory tract infections and RSV in children at high risk for severe RSV infections. A retrospective cohort study was carried out with preterm children or children under two years of age with chronic lung disease or hemodynamically significant congenital heart disease; the children were selected on the basis of their exposure status, which was defined as the prophylactic use of palivizumab during the RSV season. Children were enrolled retrospectively in two hospitals located in Southern Brazil, from May 2009 to August 2016. In a sample of 129 children, 69 (53.5%) received palivizumab and adherence to three or more doses was observed in 78%; 60 (46.5%) children did not receive palivizumab. PVZ prophylaxis was independently associated with a 66% reduction in hospitalizations for any cause (26/69 - 37.7%) in the PVZ group and 34/60 (56.7%) in the control group). A 52% reduction in hospitalizations due to lower respiratory tract infection was observed in the PVZ group (15/69 -21.7%) and 25/60 (41.7%) in the control group. These findings suggest that, for the group of studied patients, the adoption of an RSV prophylaxis scheme reached the same effectiveness as those described in previous clinical trials.
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Affiliation(s)
- Joanna d'Arc Lyra Batista
- Universidade Federal da Fronteira Sul, Chapecó, Santa Catarina, Brazil.,Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Angélica Pires Ferreira
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Rio Grande do Sul, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Luciane Nascimento Cruz
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Rio Grande do Sul, Brazil.,Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carisi Anne Polanczyk
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Rio Grande do Sul, Brazil.,Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
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8
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Kenmoe S, Kengne-Nde C, Ebogo-Belobo JT, Mbaga DS, Fatawou Modiyinji A, Njouom R. Systematic review and meta-analysis of the prevalence of common respiratory viruses in children < 2 years with bronchiolitis in the pre-COVID-19 pandemic era. PLoS One 2020; 15:e0242302. [PMID: 33180855 PMCID: PMC7660462 DOI: 10.1371/journal.pone.0242302] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/01/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction The advent of genome amplification assays has allowed description of new respiratory viruses and to reconsider the role played by certain respiratory viruses in bronchiolitis. This systematic review and meta-analysis was initiated to clarify the prevalence of respiratory viruses in children with bronchiolitis in the pre-COVID-19 pandemic era. Methods We performed an electronic search through Pubmed and Global Index Medicus databases. We included observational studies reporting the detection rate of common respiratory viruses in children with bronchiolitis using molecular assays. Data was extracted and the quality of the included articles was assessed. We conducted sensitivity, subgroups, publication bias, and heterogeneity analyses using a random effect model. Results The final meta-analysis included 51 studies. Human respiratory syncytial virus (HRSV) was largely the most commonly detected virus 59.2%; 95% CI [54.7; 63.6]). The second predominant virus was Rhinovirus (RV) 19.3%; 95% CI [16.7; 22.0]) followed by Human bocavirus (HBoV) 8.2%; 95% CI [5.7; 11.2]). Other reported viruses included Human Adenovirus (HAdV) 6.1%; 95% CI [4.4; 8.0]), Human Metapneumovirus (HMPV) 5.4%; 95% CI [4.4; 6.4]), Human Parainfluenzavirus (HPIV) 5.4%; 95% CI [3.8; 7.3]), Influenza 3.2%; 95% CI [2.2; 4.3], Human Coronavirus (HCoV) 2.9%; 95% CI [2.0; 4.0]), and Enterovirus (EV) 2.9%; 95% CI [1.6; 4.5]). HRSV was the predominant virus involved in multiple detection and most codetections were HRSV + RV 7.1%, 95% CI [4.6; 9.9]) and HRSV + HBoV 4.5%, 95% CI [2.4; 7.3]). Conclusions The present study has shown that HRSV is the main cause of bronchiolitis in children, we also have Rhinovirus, and Bocavirus which also play a significant role. Data on the role played by SARS-CoV-2 in children with acute bronchiolitis is needed. Review registration PROSPERO, CRD42018116067.
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Affiliation(s)
- Sebastien Kenmoe
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Cyprien Kengne-Nde
- National AIDS Control Committee, Epidemiological Surveillance, Evaluation and Research Unit, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Donatien Serge Mbaga
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Abdou Fatawou Modiyinji
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- Department of Animals Biology and Physiology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- * E-mail: ,
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9
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Vu LD, Siefker D, Jones TL, You D, Taylor R, DeVincenzo J, Cormier SA. Elevated Levels of Type 2 Respiratory Innate Lymphoid Cells in Human Infants with Severe Respiratory Syncytial Virus Bronchiolitis. Am J Respir Crit Care Med 2020; 200:1414-1423. [PMID: 31237777 DOI: 10.1164/rccm.201812-2366oc] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Rationale: Studies of the immune responses at the site of respiratory syncytial virus (RSV) infection are sparse despite nearly five decades of research into understanding RSV disease.Objectives: To investigate the role of mucosal innate immune responses to RSV and respiratory viral load in infants hospitalized with the natural disease.Methods: Cytokines, viral load, and type 2 innate lymphoid cell (ILC2) levels in nasal aspirates, collected within 24 hours of enrollment, from infants hospitalized with RSV infection were quantified.Measurements and Main Results: RSV severity in infants was categorized based on admission to the general ward (moderate) or the pediatric ICU (severe). Evaluable subjects included 30 patients with severe and 63 patients with moderate disease (median age, 74 d; range, 9-297 d). ILC2s were found in the nasal aspirates of patients with severe disease (0.051% of total respiratory CD45+ cells) to a significantly greater extent than in patients with moderate disease (0.018%, P = 0.004). Levels of IL-4, IL-13, IL-33, and IL-1β were significantly higher in nasal aspirates of patients with severe disease compared with those of patients with moderate disease. Factors associated with disease severity were gestational age (odds ratio, 0.49; 95% confidence interval, 0.29-0.82; P = 0.007) and IL-4 (odds ratio, 9.67; 95% confidence interval, 2.45-38.15; P = 0.001).Conclusions: This study shows, for the first time, that elevated levels of ILC2s is associated with infant RSV severity. The findings highlight the dominance of type-2 responses to RSV infection in infants and suggest an important role of ILC2 in shaping the immune response early during RSV infection.
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Affiliation(s)
- Luan D Vu
- Department of Biological Sciences, Louisiana State University, Baton Rouge, Louisiana.,Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana
| | - David Siefker
- Department of Biological Sciences, Louisiana State University, Baton Rouge, Louisiana.,Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana
| | - Tamekia L Jones
- Department of Pediatrics.,Department of Preventive Medicine, and.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee
| | | | | | - John DeVincenzo
- Department of Pediatrics.,Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee; and.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Stephania A Cormier
- Department of Biological Sciences, Louisiana State University, Baton Rouge, Louisiana.,Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana
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Comerlato Scotta M, Greff Machado D, Goecks Oliveira S, de Moura A, Rhoden Estorgato G, de Souza APD, Nery Porto B, de Araújo PD, Sarria EE, Pitrez PM, Jones MH, Araújo Pinto L, Tetelbom Stein R, Polack FP, Mattiello R. Evaluation of nasal levels of interferon and clinical severity of influenza in children. J Clin Virol 2019; 114:37-42. [PMID: 30913521 DOI: 10.1016/j.jcv.2019.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/04/2019] [Accepted: 02/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Experimental data show that type I interferon has a key role in innate immune response against influenza infection. OBJECTIVE We compared nasal levels of interferon-α2 and β among inpatients and outpatients with influenza. STUDY DESIGN Children younger than 5 years of age with influenza-like illness seeking care at the emergency department within the first 72 h of disease onset were prospectively included. Clinical and demographic data and secretions through nasal wash were obtained. Influenza infection was assessed through reverse-transcription polymerase chain reaction and nasal levels of interferon-α2 and β were measured by enzyme-linked immunosorbent assay. All patients followed until the end of the disease. RESULTS One hundred patients were included, of which 24 had confirmed influenza infection, and 5 of them were hospitalized. Subtypes A (H3N2) and B were confirmed in 10 and 14 patients, respectively. Seventy-six patients without influenza, including 48% of outpatients, were recruited as controls. All hospitalized patients were significantly younger regardless of influenza status (age <6 months in 59% vs. 23.2%, p < 0.001). All other data were similar among the groups. Comparing median levels of interferon-α2 among children with influenza, levels were significantly higher in outpatients than in hospitalized patients and were 263.2 pg/mL (25-75 interquartile range: 58.3-634) and detectable in only one patient (90 pg/mL), respectively. The levels of interferon-α2 in controls and those of interferon-β in all groups were not detected. CONCLUSIONS Higher levels of interferon-α2 in patients with less severe influenza reinforce experimental evidence about the protective role of interferon-α2 against influenza infection.
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Affiliation(s)
| | - Denise Greff Machado
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Centro Universitário Ritter dos Reis, Porto Alegre, Brazil
| | - Suelen Goecks Oliveira
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Angela de Moura
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Barbara Nery Porto
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Edgar Enrique Sarria
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Universidade de Santa Cruz do Sul (UNISC), School of Medicine, Department of Biology and Pharmacy, Brazil
| | - Paulo Marcio Pitrez
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Marcus Herbert Jones
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Araújo Pinto
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato Tetelbom Stein
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rita Mattiello
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
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