van Benten Inesz J, van Drunen Cornelis M, Koopman Laurens P, KleinJan Alex, van Middelkoop Barbara C, de Waal Leon, Osterhaus Albert D M E, Neijens Herman J, Fokkens Wytske J
Department of Otorhinolaryngology, Erasmus Medical Centre Rotterdam, The Netherlands.
J Med Virol. 2003 Oct;71(2):290-7. doi: 10.1002/jmv.10482.
The aim of this study was to investigate potential differences in the local nasal immune response between bronchiolitis and upper respiratory tract infection induced by respiratory syncytial virus (RSV). Nasal brush samples were obtained from 14 infants with RSV bronchiolitis and from 8 infants with RSV upper respiratory tract infection. The samples were taken during infection (acute phase) and 2-4 weeks later (convalescent phase). Cytospin preparations were stained immunohistochemically for T cells, macrophages, and eosinophils. Staining also took place for intercellular adhesion molecule-1 (ICAM-1), T-helper 1 (Th1)-like (interleukin-12 [IL-12], interferon-gamma [IFN-gamma]), Th2-like (IL-4, IL-10), and proinflammatory cytokines (IL-6, IL-8, IL-18). During both RSV-induced bronchiolitis and upper respiratory tract infection, cellular inflammation was observed. This was characterised by an increase in the numbers of nasal macrophages, which tended to be higher in bronchiolitis than in upper respiratory tract infection. Numbers of T lymphocytes and ICAM-1 positive cells increased during both bronchiolitis and upper respiratory tract infection. There were no differences between numbers in the groups. Interestingly, a distinct nasal proinflammatory cytokine response was observed in RSV-induced bronchiolitis. This is characterised by an increase in the number of IL-18 positive cells. This increase is specific for bronchiolitis, as a similar increase could not be detected in RSV-induced upper respiratory tract infection. Numbers of IL-6 and IL-12 positive cells were higher in both bronchiolitis and upper respiratory tract infection, and there were no differences between the groups. By contrast, the number of IL-8, IFN-gamma, IL-4, and IL-10-positive cells remained constant. In conclusion, clear differences were found in nasal immune responses of children with RSV-induced upper respiratory tract infection or bronchiolitis. The induction of a strong IL-18 response was typical for bronchiolitis, as this could not be observed in RSV-induced upper respiratory tract infection, and could explain the eosinophilia that is observed frequently during bronchiolitis.
本研究旨在调查呼吸道合胞病毒（RSV）诱发的细支气管炎和上呼吸道感染在局部鼻腔免疫反应方面的潜在差异。从14例RSV细支气管炎婴儿和8例RSV上呼吸道感染婴儿获取鼻刷样本。样本在感染期间（急性期）以及2至4周后（恢复期）采集。细胞涂片制剂进行免疫组织化学染色，检测T细胞、巨噬细胞和嗜酸性粒细胞。同时也对细胞间黏附分子-1（ICAM-1）、T辅助1（Th1）样（白细胞介素-12 [IL-12]、干扰素-γ [IFN-γ]）、Th2样（IL-4、IL-10）和促炎细胞因子（IL-6、IL-8、IL-18）进行染色。在RSV诱发的细支气管炎和上呼吸道感染期间，均观察到细胞炎症。其特征为鼻腔巨噬细胞数量增加，细支气管炎中的巨噬细胞数量往往高于上呼吸道感染。细支气管炎和上呼吸道感染期间，T淋巴细胞和ICAM-1阳性细胞数量均增加。两组数量无差异。有趣的是，在RSV诱发的细支气管炎中观察到明显的鼻腔促炎细胞因子反应。其特征为IL-18阳性细胞数量增加。这种增加是细支气管炎所特有的，因为在RSV诱发的上呼吸道感染中未检测到类似增加。细支气管炎和上呼吸道感染中IL-6和IL-12阳性细胞数量均较高，两组之间无差异。相比之下，IL-8、IFN-γ、IL-4和IL-10阳性细胞数量保持不变。总之，在RSV诱发的上呼吸道感染或细支气管炎患儿的鼻腔免疫反应中发现了明显差异。强烈的IL-18反应的诱导是细支气管炎的典型特征，因为在RSV诱发的上呼吸道感染中未观察到这种情况，这可以解释细支气管炎期间经常出现的嗜酸性粒细胞增多现象。
