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Pro- and anti-inflammatory responses in respiratory syncytial virus bronchiolitis

P S McNamara1, B F Flanagan, A M Selby

  • 1Dept of Child Health, University of Liverpool, Institute of Child Health, Alder Hey Children's Hospital, Liverpool, UK. mcnamp@liv.ac.uk

The European Respiratory Journal
|January 24, 2004
PubMed

Insights

Respiratory syncytial virus (RSV) bronchiolitis involves significant pulmonary inflammation. Tumor necrosis factor-alpha and interleukin-6 levels are elevated in infants with RSV bronchiolitis, decreasing in preterm infants over illness duration.

Area of Science:

  • Pediatric Respiratory Medicine
  • Immunology
  • Virology

Background:

  • Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of severe infant respiratory illness.
  • Understanding the pulmonary inflammatory response is crucial for managing RSV bronchiolitis.

Purpose of the Study:

  • To characterize changes in pulmonary pro- and anti-inflammatory responses during RSV bronchiolitis in infants.
  • To compare inflammatory markers between term and preterm infants with RSV bronchiolitis.

Main Methods:

  • Non-bronchoscopic bronchoalveolar lavage was performed on infants with RSV bronchiolitis and controls.
  • Measurements included tumor necrosis factor-alpha (TNF-alpha), soluble TNF receptor (sTNFR), and interleukin-6 (IL-6) mRNA and protein.
  • Samples were collected on day of intubation (Day 1) and day of extubation (Day X).

Main Results:

  • Infants with RSV bronchiolitis showed higher TNF-alpha and IL-6 mRNA and protein than controls on Day 1.
  • In preterm infants, TNF-alpha and IL-6 proteins decreased from Day 1 to Day X.
  • sTNFR concentrations differed between groups on Day 1 but did not change over time.

Conclusions:

  • Elevated TNF-alpha and IL-6 in RSV-infected lungs suggest a role in disease pathogenesis.
  • The decrease in TNF-alpha and IL-6 in preterm infants may correlate with their prolonged illness course.
  • These findings highlight the inflammatory dynamics in infant RSV bronchiolitis.

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