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Blood eosinophil counts during bronchiolitis are related to bronchial hyper-responsiveness and lung function in early
Ingvild Bruun Mikalsen1, Thomas Halvorsen, Knut Øymar
1Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
Insights
Infant blood eosinophil counts during bronchiolitis predict later asthma and reduced lung function. This suggests eosinophil inflammation in infancy may impact long-term respiratory health.
Area of Science:
- Pediatric pulmonology
- Immunology
- Respiratory medicine
Background:
- Bronchiolitis is a common viral respiratory infection in infants.
- Long-term respiratory sequelae, including asthma, are observed after severe bronchiolitis.
- The role of specific inflammatory markers during acute illness in predicting later outcomes is not fully understood.
Purpose of the Study:
- To investigate the association between inflammatory markers measured during acute infant bronchiolitis and the development of asthma, lung function, bronchial hyper-responsiveness (BHR), and atopy at age 11.
- To determine if specific urinary and blood inflammatory markers predict long-term respiratory outcomes.
Main Methods:
- A cohort of 105 infants hospitalized for bronchiolitis was recruited.
- Urinary eosinophil protein X, U-leukotriene E4, U-prostaglandin 9α, 11β-PGF2, and blood eosinophil counts were measured during acute illness.
- Ninety-five children (90%) were followed up at 11 years of age for assessment of asthma, lung function, BHR, and atopy.
Main Results:
- Higher blood eosinophil counts during bronchiolitis were significantly associated with the presence of asthma at age 11 (p=0.048).
- Blood eosinophil counts during acute bronchiolitis positively correlated with bronchial hyper-responsiveness (BHR) (p=0.006) and negatively with forced expiratory volume in the first second (FEV1) (p=0.025) at age 11.
- No significant associations were found between other measured inflammatory markers and long-term respiratory outcomes.
Conclusions:
- Eosinophil inflammation during acute infant bronchiolitis may have a lasting impact on lung function and airway responsiveness.
- These findings suggest that eosinophil-driven inflammation during early respiratory infections could contribute to the development of chronic respiratory conditions.
- The observed associations may be attributed to virus-host interactions or pre-existing host susceptibility.
Aim:
To assess whether inflammatory markers measured in urine and blood during acute bronchiolitis in infancy were associated with asthma, lung function, bronchial hyper-responsiveness (BHR) and atopy at 11 years of age.
Methods:
We included 105 children hospitalised for bronchiolitis during their first year of life. At hospitalisation, urinary (U-) eosinophil protein X, U-leukotriene E4 , U-prostaglandin 9α, 11β-PGF2 and blood eosinophil counts were measured. Ninety-five children (90%) were available for follow-up at 11 years of age.
Results:
At follow-up, higher blood eosinophil counts obtained during bronchiolitis were observed in the group with asthma than in the group without asthma (median 0.27 versus 0.09 × 10(9) /L, respectively, p = 0.048). By regression analyses, blood eosinophil counts during the acute bronchiolitis were positively associated with BHR (p = 0.006) and negatively associated with forced expiratory volume in first second (p = 0.025) at 11 years of age. None of the other inflammatory markers were associated with asthma, lung function, BHR or atopy at 11 years of age.
Conclusion:
Eosinophil inflammation during bronchiolitis may have a long-term impact on lung function and airway responsiveness. The associations could be related to virus-host interactions during bronchiolitis or to predisposed children.
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