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Published on: January 21, 2018
Disease Severity and Cytokine Expression in the Rhinovirus-Induced First Wheezing Episode
Pekka Hurme1, Miisa Kähkönen1, Beate Rückert2
1Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20520 Turku, Finland.
Insights
Rhinovirus (RV) infection in infants with severe wheezing is linked to asthma risk. Cytokine responses during the first wheezing episode differ between hospitalized and outpatient children, suggesting a role in illness severity.
Area of Science:
- Pediatric Allergy and Immunology
- Viral Respiratory Infections
- Immunology
Background:
- Rhinovirus (RV) infection in young children with wheezing increases the risk of recurrent wheezing and asthma development.
- The relationship between cytokine responses and the severity of acute illness during a child's first RV-induced wheezing episode remains unstudied.
- Understanding these immune responses is crucial for predicting long-term outcomes like asthma.
Purpose of the Study:
- To investigate the association between cytokine profiles and the severity of acute illness in infants experiencing their first rhinovirus (RV) wheezing episode.
- To compare cytokine responses in hospitalized versus outpatient children with severe RV-induced wheezing.
- To identify potential immune markers that correlate with disease severity.
Main Methods:
- Recruitment of 47 children (3-23 months) with severe first wheezing episodes caused solely by RV.
- Isolation and in vitro stimulation of peripheral blood mononuclear cells (PBMCs) with anti-CD3/anti-CD28.
- Quantitative analysis of 56 cytokines using multiplex ELISA.
Main Results:
- Significant differences in cytokine expression profiles were observed between inpatient and outpatient groups.
- Hospitalized children showed decreased expression of interferon gamma (IFN-γ), interleukin 10 (IL-10), macrophage inflammatory protein 1 alpha (MIP-1α), RANTES (CCL5), and tumor necrosis factor-alpha (TNF-α).
- In contrast, hospitalized children exhibited increased expression of ENA-78 (CXCL5) compared to outpatients.
Conclusions:
- The cytokine response profiles of PBMCs differ based on the severity of acute illness in RV-infected wheezing infants.
- A balanced interplay between pro-inflammatory and anti-inflammatory responses appears necessary to resolve acute viral infections and mitigate illness severity.
- These findings highlight the importance of the early immune response in determining the clinical course and potential long-term consequences of RV infections in infants.
Abstract:
Wheezing children infected with rhinovirus (RV) have a markedly increased risk of subsequently developing recurrencies and asthma. No previous studies have assessed the association between cytokine response and the severity of acute illness in the first wheezing episode in children infected with RV. Forty-seven children treated both as inpatients and as outpatients infected with RV only, aged 3-23 months, with severe first wheezing episodes were recruited. During acute illness, peripheral blood mononuclear cells (PBMCs) were isolated and stimulated with anti-CD3/anti-CD28 in vitro. A multiplex ELISA was used to quantitatively identify 56 different cytokines. The mean age of the children was 17 months, 74% were males, 79% were hospitalized, and 33% were sensitized. In adjusted analyses, the inpatient group was characterized by decreased expressions of interferon gamma (IFN-γ), interleukin 10 (IL-10), macrophage inflammatory protein 1 alpha (MIP-1α), RANTES (CCL5), and tumor necrosis factor-alpha (TNF-α) and an increased expression of ENA-78 (CXCL5) compared to the outpatient group. The cytokine response profiles from the PBMCs were different between the inpatient and outpatient groups. Our results support that firmly controlled interplay between pro-inflammatory and anti-inflammatory responses are required during acute viral infection to absolve the initial infection leading, to less severe illness.
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