The Role of CC10 Combined With CysLTs in Predicting Subsequent Wheezing in RSV-Infected Bronchiolitis

To clarify the predictive role of club cell 10-kDa protein (CC10) and cysteinyl leukotrienes (CysLTs) for subsequent wheezing after RSV infection.

From October 1, 2022, to October 31, 2023, children diagnosed with RSV-induced bronchiolitis hospitalized in the pediatric ward were included. Nasopharyngeal aspirates (NPAs) were obtained on the day of admission. NPAs from hospitalized children without respiratory infections served as the control group. We analyzed the correlation between CC10 and CysLTs levels in NPAs and disease severity. Follow-up assessments were conducted to observe the subsequent wheezing.

There were 169 hospitalized infants diagnosed with RSV-bronchiolitis, and 22 healthy controls matched for age were selected. The levels of CC10 in the NPAs were significantly lower in the RSV group (219.4 ± 83.1 pg/mL) than those in the control group (284.1 ± 68.1 pg/mL; p < 0.001). Levels of CysLTs were significantly greater in the RSV group (346.3 ± 98.1 pg/mL) than in the control group (288.3 ± 82.5 pg/mL; p < 0.05). Pearson correlation analysis showed that CC10 protein level was negatively correlated with severity (r² = 0.34, p < 0.001). Conversely, the level of CysLTs was positively correlated with severity (r² = 0.09, p < 0.001). 142 cases were completed with follow-up within a year after discharge. 47 cases (33.1%) had experienced subsequent wheezing, and 95 cases (66.9%) did not have subsequent wheezing. The multivariate logistic regression analysis indicates a higher likelihood of subsequent wheezing in children with CysLTs levels over 335.3 pg/mL (OR = 5.496), allergy history (OR = 3.466), and longer ventilation duration (OR = 1.364).

While CC10 and CysLTs levels correlated with the severity of RSV-bronchiolitis, only CysLTs, along with allergy history and duration of ventilation, showed a suggestive link to subsequent wheezing, but further validation is needed.