Department of Pediatrics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Pediatr Infect Dis J. 2012 Sep;31(9):931-4. doi: 10.1097/INF.0b013e31826366e3.
The burden of respiratory syncytial virus (RSV) bronchiolitis in individual children and their families, the medical system and society is considerable. Mechanisms underlying RSV bronchiolitis in healthy term infants are largely unknown. Sterile intraamniotic inflammation and chorioamnionitis have been associated with increased lung volume and compliance.
The aim of this study was to determine whether high amniotic fluid interleukin-8 (IL-8), and tumor necrosis factor-α protect against RSV bronchiolitis in healthy term infants.
We conducted a prospective birth cohort study of healthy term newborns, born after uncomplicated pregnancy. Amniotic fluid was collected during labor. In case of medical attention for respiratory symptoms during the first year of life, a nose-throat swab was taken to establish the presence of respiratory viruses by polymerase chain reaction.
Physician-attended RSV infection was observed in 27 (9.3%) of 292 children at median age 6 months. Amniotic fluid concentrations of IL-8 were higher in children without physician-attended RSV infection than in children with physician-attended RSV infection (11.1 versus 5.5 ng/mL; P = 0.002). Similarly, in children without physician-attended RSV, the proportion of detectable amniotic fluid tumor necrosis factor-α was higher (159/265 [60%] versus 8/27 [30%]; P = 0.002). Among children with physician-attended RSV infection, amniotic fluid IL-8 was inversely correlated to the number of wheezing days during the first year of life (ρ = -0.38; P = 0.048).
High concentrations of amniotic fluid IL-8 and tumor necrosis factor-α are associated with low risk of RSV bronchiolitis in healthy term infants. We hypothesize that direct exposure of fetal lungs to proinflammatory signals induces local protection against viral infection during infancy.
呼吸道合胞病毒（RSV）细支气管炎给个体儿童及其家庭、医疗系统和社会带来了相当大的负担。健康足月婴儿中 RSV 细支气管炎的发病机制尚不清楚。无菌性羊膜内炎症和绒毛膜羊膜炎与肺容积增加和顺应性增加有关。
本研究旨在确定羊水白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）浓度较高是否能预防健康足月婴儿发生 RSV 细支气管炎。
我们对健康足月新生儿进行了一项前瞻性出生队列研究，这些新生儿均在无并发症的妊娠后出生。在分娩期间采集羊水。如果在生命的第一年因呼吸道症状而需要医疗关注，则取鼻喉拭子，通过聚合酶链反应确定呼吸道病毒的存在。
在 292 名儿童中，有 27 名（9.3%）在中位年龄 6 个月时发生了经医生诊断的 RSV 感染。与经医生诊断的 RSV 感染儿童相比，未经医生诊断的 RSV 感染儿童的羊水 IL-8 浓度更高（11.1 比 5.5ng/ml；P=0.002）。同样，在未经医生诊断的 RSV 感染儿童中，可检测到的羊水 TNF-α比例更高（265 名儿童中有 159 名[60%]，27 名儿童中有 8 名[30%]；P=0.002）。在经医生诊断的 RSV 感染儿童中，羊水 IL-8 与生命第一年的喘息天数呈负相关（ρ=-0.38；P=0.048）。
羊水 IL-8 和 TNF-α浓度较高与健康足月婴儿 RSV 细支气管炎的低风险相关。我们假设胎儿肺部直接暴露于促炎信号会诱导其在婴儿期对病毒感染产生局部保护作用。
