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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
CD4+ T-cell counts and interleukin-8 and CCL-5 plasma concentrations discriminate disease severity in children with
Hanne K Brand1, Gerben Ferwerda, Frank Preijers
1Department of Pediatrics, Radboud University Medical Center, Nijmegen, The Netherlands.
Insights
Predicting respiratory syncytial virus (RSV) severity in children can be improved using immunological markers. A combination of CD4+ T-cell counts and specific inflammatory markers like IL-8 and CCL-5 effectively differentiates severe from mild RSV infections.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Clinical Diagnostics
Background:
- Predictive tools for respiratory syncytial virus (RSV) severity may benefit from incorporating immunological parameters.
- Hypothesized that a combination of inflammatory markers could distinguish severe from mild RSV disease in children.
Purpose of the Study:
- To investigate the utility of immunological markers in predicting RSV infection severity.
- To identify specific inflammatory markers and cell counts that correlate with disease severity in pediatric RSV cases.
Main Methods:
- Collected blood and nasopharyngeal samples from 52 RSV-infected children during acute infection and recovery.
- Categorized patients into mild, moderate, and severe disease groups based on clinical criteria.
- Compared clinical data, leukocyte subsets, and cytokine concentrations between severity groups.
Main Results:
- Severe RSV infection associated with younger age, lymphocytopenia, elevated IL-8, G-CSF, IL-6, and decreased CCL-5.
- A combination of plasma IL-8, CCL-5, and CD4+ T-cell counts accurately discriminated severe from mild RSV infection (82% sensitivity, 96% specificity).
Conclusions:
- CD4+ T-cell counts and plasma IL-8 and CCL-5 concentrations correlate with RSV disease severity in children.
- These immunological markers, alongside clinical features, can aid in assessing RSV severity and guiding patient management.
Background:
Current tools to predict the severity of respiratory syncytial virus (RSV) infection might be improved by including immunological parameters. We hypothesized that a combination of inflammatory markers would differentiate between severe and mild disease in RSV-infected children.
Methods:
Blood and nasopharyngeal samples from 52 RSV-infected children were collected during acute infection and after recovery. Retrospectively, patients were categorized into three groups based on disease severity: mild (no supportive treatment), moderate (supplemental oxygen and/or nasogastric feeding), and severe (mechanical ventilation). Clinical data, number of flow-defined leukocyte subsets, and cytokine concentrations were compared.
Results:
Children with severe RSV infection were characterized by young age; lymphocytopenia; increased interleukin (IL)-8, granulocyte colony-stimulating factor (G-CSF), and IL-6 concentrations; and decreased chemokine (C-C motif) ligand (CCL-5) concentrations in plasma. The combination of plasma levels of IL-8 and CCL-5, and CD4+ T-cell counts, with cutoff values of 67 pg/ml, 13 ng/ml, and 2.3 × 10(6)/ml, respectively, discriminated severe from mild RSV infection with 82% sensitivity and 96% specificity.
Conclusion:
This study demonstrates that the combination of CD4+ T-cell counts and IL-8 and CCL-5 plasma concentrations correlates with disease severity in RSV-infected children. In addition to clinical features, these immunological markers may be used to assess severity of RSV infection and guide clinical management.
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