Abstract
Background: Viral infections are the major cause of acute wheezing illnesses in childhood. Variations in immunologic responses at birth may be determinants of the risk of acquiring these illnesses. Objectives: To determine the immunologic risk factors for virus-induced wheezing in high-risk infants. Methods: The study involves 285 children with a parental history of asthma and/or respiratory allergies. Mononuclear cells obtained at birth (umbilical cord blood) and at 1 year of age were incubated with phytohemagglutinin, respiratory syncytial virus, or rhinovirus, and supernatants were analyzed for IL-5, IL-10, IL-13, and IFN-γ. Nasal secretions obtained at well child visits and during respiratory illnesses were analyzed for common respiratory viruses. Results: Respiratory syncytial virus-induced wheezing was associated with reduced phytohemagglutinin-induced IL-13 responses (medians, 213 vs 304 pg/mL; P = .026) from cord blood cells, and similar trends were found for wheezing in general. Furthermore, median IL-13 responses diminished by 28% in nonwheezing children by age 1 year, versus only 3% in wheezing children (P = .013). Children with ≥2 episodes of wheezing had lower phytohemagglutinin- induced IFN-γ responses and were less likely to have rhinovirus-induced IFN-γ responses at birth (P < .05). Finally, children with measurable cord blood IFN responses to respiratory syncytial virus were less likely to wheeze in their first year (odds ratio, 0.43 [0.23, 0.79]). Conclusion: In children with a family history of allergies and/or asthma, mononuclear cell phytohemagglutinin-induced IL-13 and virus-induced IFN-γ responses at birth are indicative of the risk for wheezing in the first year of life.
Original language | English (US) |
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Pages (from-to) | 72-78 |
Number of pages | 7 |
Journal | Journal of Allergy and Clinical Immunology |
Volume | 117 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2006 |
Externally published | Yes |
Bibliographical note
Funding Information:Supported by National Institutes of Health grants R01HL61879-01, P01HL70831-01, and 5M01 RR03186-18.
Keywords
- Atopy
- Birth cohort
- Bronchiolitis
- Cytokines
- IFN-γ
- IL-13
- Respiratory syncytial virus
- Rhinoviruses
- Viral infections
- Wheezing