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Pediatric bronchiolitis disease severity is associated with immune checkpoint dysregulation

Mehmet Akif Dundar1,2, Serife Erdem3,4,5, Benhur Cetin6

  • 1Department of Pediatric Intensive Care, Faculty of Medicine, Erciyes University, Kayseri, Turkey.

Pediatric Research
|March 14, 2026
PubMed

Insights

Pediatric bronchiolitis severity is linked to immune checkpoint molecule dysregulation. Increased CTLA-4 and TIM-3 expression in T cells suggests potential biomarkers for disease progression and targeted therapies.

Area of Science:

  • Immunology
  • Pediatric Medicine
  • Respiratory Diseases

Background:

  • Immune dysregulation is central to bronchiolitis pathogenesis.
  • Understanding immune responses is key to managing pediatric respiratory infections.

Purpose of the Study:

  • Investigate immune checkpoint molecules and regulatory cytokines in pediatric bronchiolitis.
  • Correlate immune markers with disease severity.

Main Methods:

  • Prospective cohort study of 151 pediatric patients (1 month-2 years).
  • Assessed immune checkpoint molecules (CTLA-4, TIM-3, TIGIT, GARP) and cytokines (IL-2Rα, 4-1BB, TGF-β1, LAG-3, galectin-9).
  • Utilized flow cytometry and ELISA on T cell subsets and plasma.

Main Results:

  • Decreased CD4+ T cell levels with increased severity.
  • Elevated Treg in mild cases, decreased in moderate/severe cases.
  • Increased CTLA-4 and TIM-3 expression in moderate/severe groups; elevated soluble PD-1, TIM-3, LAG-3, TGF-β1, 4-1BB in severe cases.

Conclusions:

  • Bronchiolitis severity correlates with immune checkpoint dysregulation and immunosuppression.
  • Altered T cell subsets and increased CTLA-4/TIM-3 indicate potential biomarkers.
  • Findings offer insights into immunopathogenesis and potential for risk stratification and targeted therapies.
Abstract

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