Clinical and Laboratory Observation
Airway eicosanoids in acute severe respiratory syncytial virus bronchiolitis

https://doi.org/10.1016/j.jpeds.2004.03.049Get rights and content

Abstract

We prospectively studied the levels of eicosanoids in intubated patients with severe bronchiolitis and compared them to electively intubated non-infected infants. LeukotrieneE4 (LTE4), leukotrieneB4 (LTB4), and prostaglandinE2 (PGE2) levels were significantly increased (P <.01) from endotracheal (ET) aspirates of infants with bronchiolitis compared with controls, as were urinary LTE4 levels (P <.001). We conclude that eicosanoids are increased in the tracheal aspirates and urine of children with bronchiolitis.

Section snippets

Population characteristics

This prospective study was conducted between December 1, 1999, and April 30, 2000, in the PICU at Sainte-Justine Hospital. All infants younger than aged 2 years who required intubation for bronchiolitis were considered eligible. The control group was composed of healthy infants with no respiratory symptoms who were intubated for elective surgery. This study was approved by the Scientific and the Ethics Committee at Sainte-Justine Hospital.

Inclusion criteria for bronchiolitis population

Inclusion criteria were: (1) first episode of

Results

Fourteen children with RSV bronchiolitis and 14 controls constituted the two groups. There were no differences for sex, weight, age, and history of atopy or prematurity (Table). To confirm the severity of the disease, pediatric clinical scores (Pediatric Risk of Mortality Scale II [PRISM] scores [9] and Respiratory Distress Assessment Instrument [RDAI] scores [5]) were calculated.

The study population had severe bronchiolitis, were all intubated (for a mean of 6.3 days), and had an increased

Discussion

A variety of eicosanoids representing distinct pathways were measured in ET secretions collected from infants intubated for RSV bronchiolitis and were compared with those of children intubated for elective surgery. Cysteinyl LT and LTB4 from the 5-lipoxygenase pathway and PGE2 from the cyclooxygenase pathway were increased in infants with bronchiolitis. In contrast, 15 HETE from the 15-lipoxygenase pathway, the major eicosanoid found in normal lung fluids, was not elevated in children with RSV.

Acknowledgements

We thank Dr Francois Proulx and Dr Barbara Mazer for their help with the statistical analysis.

References (14)

There are more references available in the full text version of this article.

Cited by (36)

  • The effect of Ma-Xin-Gan-Shi decoction on asthma exacerbated by respiratory syncytial virus through regulating TRPV1 channel

    2022, Journal of Ethnopharmacology
    Citation Excerpt :

    TRPV1 activation can promote the level of inflammatory factor PGE2 (Gouin et al., 2017). Infants with RSV infection also showed elevated levels of PGE2 in plasma or intratracheal aspiration (Sznajer et al., 2004). The experimental results of Richardson et al. indicated the production of PGE2 in RSV-infected alveolar epithelial cells and the lungs of RSV-infected animals (Richardson et al., 2005).

  • Tuft cells in the pathogenesis of chronic rhinosinusitis with nasal polyps and asthma

    2021, Annals of Allergy, Asthma and Immunology
    Citation Excerpt :

    Cysteinyl leukotrienes are a subclass of eicosanoids that act as inflammatory mediators. Eicosanoids, including CysLT E4 (LTE4), are stable metabolites that have long been known to be increased in tracheal aspirates76,77 and urine78 of patients with asthma exacerbations. LTE4 has been found to cause airway constriction, plasma leakage, and eosinophil accumulation in the bronchial mucosa in humans.77

  • Oxidative stress pathway gene transcription after bovine respiratory syncytial virus infection in vitro and ex vivo

    2020, Veterinary Immunology and Immunopathology
    Citation Excerpt :

    Studies in human airway epithelial cells in vitro, and lamb and cotton rat lung cells ex vivo, reported increased PTGS2 gene transcription or COX-2 protein expression after RSV infection (Haeberle et al., 2008; Liu et al., 2005; Radi et al., 2010; Richardson et al., 2005). Increased COX-2 was also suggested indirectly by increased PGE2 in ex vivo samples after RSV/BRSV infection (Gershwin et al., 1989; Sznajer et al., 2004). PTGS2 is induced by oxidative stress (reviewed in Korbecki et al., 2013) and COX-2 contributes to oxidative stress (Kukreja et al., 1986).

  • Biomarkers of respiratory syncytial virus (RSV) infection: Specific neutrophil and cytokine levels provide increased accuracy in predicting disease severity

    2015, Paediatric Respiratory Reviews
    Citation Excerpt :

    Indeed, LTC4 is elevated in the nasopharyngeal secretions of children during acute RSV infection and correlates with clinical severity, with more appreciable LTC4 elevation in children displaying higher degrees of lower respiratory tract involvement [137,138]. Accordingly, the terminal urine metabolite of cysteinyl leukotrienes (LTE4) is elevated in the urine of young infants with RSV bronchiolitis as compared to controls without respiratory infection [139], and a study in intubated patients with severe RSV bronchiolitis found that increased LTE4 in endotracheal aspirates correlates well with urinary LTE4 levels [140]. An important practical implication of these findings is that the increased excretion of LTE4 during acute bronchiolitis could not only be used to assess severity, but also to assist in the decision of starting therapy with leukotriene modifiers that have been shown to have therapeutic value in this setting, and maybe monitor evolution of the disease and response to therapy (Table 4).

View all citing articles on Scopus

Yves Sznajer is supported by a Grant from the Scientific Foundation A. Loicq.

Bruce Mazer, Marisa Tucci and Baruch Toledano are supported by the Fonds de la Recherche en Santé du Québec

View full text