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Updated: Jun 15, 2026

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Local production of inflammatory mediators during childhood parainfluenza virus infection
Rana E El Feghaly1, Lindsay McGann, Cynthia A Bonville
1Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Objective:
To describe the clinical manifestations of parainfluenza virus (PIV) infection and to characterize biochemical markers of PIV disease severity.
Patients And Methods:
We reviewed the medical records of 165 children who had a nasal wash culture positive for PIV at our institution between 1998 and 2008. Nasal wash samples were assayed for 26 inflammatory mediators using Luminex bead proteomics.
Results:
A total of 153 patients, ages 2 weeks to 12 years, with single virus infection were included in our final analysis. Fifty-two patients were infected with PIV1, 19 with PIV2, 74 with PIV3, and 8 with PIV4. Lower respiratory tract infection (LRTI) was diagnosed in 67 (44%) patients, 21 (14%) had laryngotracheobronchitis, and 49 (32%) had an upper respiratory infection other than laryngotracheobronchitis. LRTI was diagnosed in 54% of patients infected with PIV3, 35% of those infected with PIV1, 26% of those with PIV2, and 50% of those with PIV4. Compared with uninfected control patients, PIV-infected patients had higher nasal wash concentrations of interleukin-6, CX-chemokine ligand 8 (CXCL8 or interleukin-8), CCL3 (macrophage inflammatory protein-1alpha), CCL4 (macrophage inflammatory protein-1beta), CXCL9 (monokine induced by interferon gamma), and CCL5 (regulated upon activation, normal T cell expressed and secreted (RANTES). Patients with LRTI, moderate or severe illness, and PIV 1 or 3 (respirovirus) infection had higher nasal wash concentrations of CXCL8 when compared with patients with upper respiratory infection, mild illness, or PIV 2 and 4 (rubulavirus) infection (P < 0.05).
Conclusions:
PIV infection causes a spectrum of illnesses associated with the expression and release of several proinflammatory mediators. Of note, elevated concentrations of CXCL8 in nasal wash samples are associated with more severe forms of PIV disease.
Insights
Parainfluenza virus (PIV) infection presents a range of illnesses. Elevated levels of chemokine ligand 8 (CXCL8) in nasal washes indicate more severe PIV disease, particularly with respirovirus infections.
Area of Science:
- Pediatric infectious diseases
- Virology
- Immunology
Background:
- Parainfluenza virus (PIV) is a common cause of respiratory illness in children.
- Understanding the clinical spectrum and biochemical markers of PIV disease severity is crucial for effective management.
Purpose of the Study:
- To delineate the clinical manifestations of PIV infections.
- To identify biochemical markers associated with PIV disease severity.
Main Methods:
- Retrospective review of medical records for 165 children with PIV-positive nasal wash cultures (1998-2008).
- Analysis of 26 inflammatory mediators in nasal wash samples using Luminex bead proteomics.
Main Results:
- Lower respiratory tract infection (LRTI) occurred in 44% of patients, with higher incidence in PIV3 and PIV4 infections.
- PIV-infected patients exhibited elevated nasal concentrations of several inflammatory mediators, including interleukin-6 and CXCL8.
- Higher CXCL8 levels were associated with LRTI, severe illness, and respirovirus (PIV1/3) infections compared to rubulavirus (PIV2/4) infections.
Conclusions:
- PIV infection leads to a spectrum of respiratory illnesses.
- Elevated CXCL8 in nasal washes is a marker for more severe PIV disease, especially with respirovirus types.
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