Mechanisms of asthma and allergic inflammation
Respiratory syncytial virus and other respiratory viruses during the first 3 months of life promote a local Th2-like response

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Background

Respiratory syncytial virus (RSV) infections during infancy are considered to be a risk factor for developing asthma and possibly allergic sensitization.

Objective

The aim of this study was to investigate the cytokines, chemokines, and eosinophil cationic protein in the nasopharyngeal secretions of infants ≤7 months of age with RSV infections or other respiratory viral infections and healthy infants as controls. Groups were also analyzed according to age, ≤3 months and >3 months, and the levels were compared within and between groups.

Results

Thirty-nine infants with RSV, 9 with influenza or parainfluenza virus infections and 50 controls with no history of infections, were enrolled in the study. The RSV-infected infants had significantly higher levels of IL-4; macrophage inflammatory protein 1β, a chemoattractant for T cells; and eosinophil cationic protein in nasopharyngeal secretions compared with the control group. The levels of the Th2 cytokine IL-4 were significantly higher in RSV-infected infants ≤3 months of age compared with RSV-infected infants >3 months of age. In infants ≤3 months of age, infections with influenza or parainfluenza virus caused Th2-like responses similar to those produced by RSV.

Conclusion

Infections with RSV as well as with influenza and parainfluenza virus during early infancy preferentially promote a Th2-like response in the nose with local production of IL-4, IL-5, and macrophage inflammatory protein 1β and infiltration and activation of eosinophils.

Section snippets

Infected infants

In the RSV seasons of January to April 2000 and December 2000 to May 2001, the first 48 eligible infants ≤7 months of age with respiratory tract infection with RSV, influenza, or parainfluenza virus admitted to the emergency department at the Landspitali-University Hospital in Reykjavik were enrolled in the study. The virus infection was diagnosed by direct immunofluorescent staining of nasopharyngeal aspirate. The same doctor and nurse attended all infants. The infants had no history of

Results

The study cohort consisted of 98 infants ≤7 months of age. RSV infection was confirmed in 39 infants with median age of 2.0 (0.5-6.5) months and other viral infections in 9 infants (influenza A, n = 3; influenza B, n = 4; and parainfluenza 3, n = 2) 1.8 (1.0-3.0) months old. Fifty healthy infants with no history of infection 4.2 (2.8-7.0) months old were enrolled in the study as controls. The demographic and clinical data for all infants are shown in Table I. RSV-infected infants ≤3 months old

Discussion

In the current study, the cytokine and chemokine profiles and ECP in nasopharyngeal secretions were compared between infants with RSV infections, infants with other respiratory viral infections, and uninfected infants. Importantly, when the RSV-positive infants were analyzed according to age, ≤3 months and >3 months, the results revealed that infants infected with RSV during the first 3 months of life had elevated local production of the Th2-type cytokine IL-4. Interestingly, a similar Th2

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    Supported by the Science Fund of the Icelandic Research Council, the Research Fund of Landspitali-University Hospital, the Faculty of Medicine, Göteborg University, the Swedish Asthma and Allergy Association, and the Swedish Foundation for Health Care Sciences and Allergy Research.

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    These authors contributed equally to this work.

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