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Blood eosinophils, specific immunoglobulin E, and bronchiolitis severity.

Elie J Mitri1, David X Zheng1, Vebhav Garg1

  • 1Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Pediatric Pulmonology
|June 22, 2021
PubMed
Summary

Serum specific IgE (sIgE) levels, not blood eosinophilia, are linked to increased bronchiolitis severity in infants. This finding highlights sIgE as a potential biomarker for severe cases of this common respiratory illness.

Keywords:
bronchiolitiseffect modificationeosinophilimmunoglobulin Eseverity

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Area of Science:

  • Pediatric respiratory illnesses
  • Immunology
  • Biomarker research

Background:

  • Bronchiolitis is a primary cause of infant hospitalization in the U.S.
  • Previous research suggests links between blood eosinophils, serum specific IgE (sIgE), and bronchiolitis severity, but their combined effect is understudied.

Purpose of the Study:

  • To investigate the association between blood eosinophilia and bronchiolitis severity.
  • To examine the relationship between sIgE sensitization and bronchiolitis severity.
  • To determine if these biomarkers interact to influence severity.

Main Methods:

  • A prospective cohort study of 1016 infants hospitalized for bronchiolitis across 17 U.S. hospitals.
  • Analysis of blood eosinophil counts (n=873) and sIgE levels (n=1016) at hospitalization.
  • Bronchiolitis severity was defined by the need for intensive care therapy (ICU admission, intubation, or CPAP).

Main Results:

  • 18% of infants had blood eosinophilia (≥3%), and 20% were sIgE positive; 15% required intensive care.
  • Blood eosinophilia was not associated with increased severity, while sIgE was significantly associated with higher risk (OR=1.60, p=0.03) in multivariable models.
  • No significant interaction was found between sIgE and eosinophil levels in predicting intensive care therapy (p=0.14).

Conclusions:

  • Blood eosinophil levels ≥3% are not associated with increased severity in hospitalized infants with bronchiolitis.
  • Serum specific IgE sensitization is independently associated with greater bronchiolitis severity.
  • sIgE does not modify the relationship between eosinophil levels and bronchiolitis severity.