Matsuda Shinichi, Kato Masahiko, Koike Takashi, Kama Yuichi, Suzuki Kazuo, Enseki Mayumi, Tabata Hideyuki, Hirai Kota, Yamada Yoshiyuki, Mochizuki Hiroyuki
Department of Pediatrics, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan.
Tokai J Exp Clin Med. 2020 Apr 20;45(1):10-17.
To distinguish between first wheeze and asthma in early childhood, we investigated respiratory viruses and cytokine/chemokine profiles among patients with first wheeze and established asthma.
We enrolled children with acute exacerbations of wheezing (17 first wheeze and 32 asthma) and 11 controls (no wheezing) aged between 10 months and 6 years. Nasal aspirates were obtained, and virus detection was performed with antigenic assay kits and/or RT-PCR. Serum 27 cytokines/chemokines were assayed by a multi-cytokine detection system.
Rhinovirus and respiratory syncytial (RS) virus were dominant in acute exacerbations of asthma. However, many types of viruses were isolated in first wheeze. Serum IL-8 and IL-12 values were significantly higher in first wheeze than in acute asthma or the controls. IL-5 and IP-10 levels in acute asthma and first wheeze cases were higher than in the controls. Both of them were significantly higher in cases of acute asthma than in convalescence stage of asthma cases. Only IP-10 was significantly higher in first wheeze than in convalescence stage of first wheeze cases.
Different profiles in virus detection and production of IL-8 and IL-12 might distinguish between first wheeze and childhood asthma.
为了区分幼儿期首次喘息与哮喘,我们调查了首次喘息患者和已确诊哮喘患者的呼吸道病毒以及细胞因子/趋化因子谱。
我们纳入了年龄在10个月至6岁之间喘息急性加重的儿童(17例首次喘息和32例哮喘)以及11名对照(无喘息)。获取鼻吸出物,并用抗原检测试剂盒和/或逆转录-聚合酶链反应(RT-PCR)进行病毒检测。通过多细胞因子检测系统测定血清中的27种细胞因子/趋化因子。
鼻病毒和呼吸道合胞(RS)病毒在哮喘急性加重中占主导地位。然而,在首次喘息中分离出多种病毒。首次喘息患者血清白细胞介素-8(IL-8)和白细胞介素-12(IL-12)值显著高于急性哮喘患者或对照组。急性哮喘和首次喘息病例中的IL-5和干扰素诱导蛋白10(IP-10)水平高于对照组。两者在急性哮喘病例中均显著高于哮喘恢复期病例。只有IP-10在首次喘息中显著高于首次喘息恢复期病例。
病毒检测以及IL-8和IL-12产生的不同谱型可能有助于区分首次喘息和儿童哮喘。