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Bronchoalveolar lavage fluid cellularity and soluble intercellular adhesion molecule-1 in children with colds
J Grigg1, J Riedler, C F Robertson
1Department of Thoracic Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia. jg33@le.ac.uk
Insights
Children with active colds show lower airway inflammation and viral infection. Inflammation persists even after symptoms resolve, indicating a prolonged response to viral infections.
Area of Science:
- Pediatric Respiratory Medicine
- Immunology
- Virology
Background:
- Viral colds are common in children, causing respiratory symptoms.
- Adult studies link lower respiratory tract inflammation to viral colds.
- Data on lower airway inflammation and viral infection in children with colds is lacking.
Purpose of the Study:
- To investigate lower airway inflammation and viral infection in children with active colds.
- To assess inflammation in children during the convalescent period after a cold.
- To compare these findings with healthy, non-infected children.
Main Methods:
- Bronchoalveolar lavage fluid (BALF) analysis in three groups: active colds, convalescent colds, and healthy controls.
- Differential cell counts (lymphocytes, neutrophils, macrophages) in BALF.
- Measurement of BALF concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), total protein, and albumin.
Main Results:
- Children with active colds (Group I) showed increased BALF lymphocytes, neutrophils, sICAM-1, protein, and albumin compared to controls.
- A depressed alveolar macrophage count was observed in Group I.
- Similar inflammatory changes, including increased neutrophils, lymphocytes, sICAM-1, protein, and albumin, were found in children in the convalescent period (Group II).
Conclusions:
- Lower airway inflammation and viral infection are present during active viral colds in children.
- Inflammation in the lower airway persists into the convalescent period after a cold.
- These findings highlight the significant impact of viral infections on pediatric respiratory health.
Abstract:
Viral colds are an important cause of respiratory symptoms in normal children. Studies in adults suggest that inflammation in the lower respiratory tract is associated with viral colds, but there are no data regarding inflammation and viral infection in the lower airway of normal children with colds. We, therefore, studied the lower airway of two groups of children: Group I, those with active coryzal symptoms and a respiratory virus isolated from bronchoalveolar lavage fluid (BALF); and Group II: asymptomatic children who had had a clinical cold within the previous 2 weeks and no respiratory virus in BALF. Both groups were compared to age- and weight-matched normal noninfected controls, who had had no coryzal symptoms for at least 8 weeks. Viruses isolated from BALF of Group I (n = 7) were: respiratory syncytial virus (n = 2), rhinovirus (n = 3), parainfluenza I (n = 1), and echovirus 11 (n = 1). Compared to normal controls, Group I had an increased BALF lymphocyte and neutrophil differential count (P < 0.05), a concomitant depressed alveolar macrophage differential count (P < 0.05), and increased BALF concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) (P < 0.05, n = 6), total protein (P < 0.05, n = 6) and albumin (P < 0.05, n = 7). Similar changes were seen in Group II (n = 22), with an increased BALF neutrophil (P < 0.05) and lymphocyte (P < 0.01) differential count, and increased concentrations of sICAM-1 (P < 0.01, n = 15), total protein (P < 0.0001, n = 9) and albumin (P = 0.05, n = 17). Our results suggest that inflammation and viral infection in the lower airway are present during active colds, and that inflammation is also present during the convalescent period.