Department of Infectious Diseases.
Division of Pediatric Critical Care Medicine and.
Am J Respir Cell Mol Biol. 2020 Sep;63(3):349-361. doi: 10.1165/rcmb.2020-0014OC.
Allogeneic hematopoietic cell-transplant (alloHCT) recipients are at increased risk of complications from viral respiratory-tract infections (vRTIs). We measured cytokine concentrations in nasal washes (NWs) from pediatric alloHCT recipients to better understand their local response to vRTI. Forty-one immunologic analytes were measured in 70 NWs, collected during and after vRTI, from 15 alloHCT recipients (median age, 11 yr) with 19 episodes of vRTI. These were compared with NW cytokine concentrations from an independent group of otherwise healthy patients. AlloHCT recipients are able to produce a local response to vRTI and produce IFN-α2 and IL-12p40 in significant quantities above an uninfected baseline early in infection. Compared with otherwise healthy comparator-group patients, alloHCT recipients have higher NW concentrations of IL-4 when challenged with vRTI. Further study of these immunologic analytes as well as of type 1 versus type 2 balance in the respiratory mucosa in the context of vRTI during immune reconstitution may be of future research interest in this vulnerable patient population.
异基因造血细胞移植（alloHCT）受者发生病毒呼吸道感染（vRTI）相关并发症的风险增加。我们测量了儿科 alloHCT 受者鼻冲洗（NW）中的细胞因子浓度，以更好地了解他们对 vRTI 的局部反应。从 15 例 alloHCT 受者（中位年龄 11 岁）的 19 次 vRTI 中收集了 70 份 NW，并测量了 41 种免疫分析物，这些分析物在 vRTI 期间和之后进行了测量。将这些与另一组无病健康患者的 NW 细胞因子浓度进行了比较。alloHCT 受者能够对 vRTI 产生局部反应，并在感染早期产生大量 IFN-α2 和 IL-12p40，超过未感染的基线水平。与无病健康对照组患者相比，alloHCT 受者在受到 vRTI 挑战时，NW 中 IL-4 的浓度更高。在免疫重建期间 vRTI 背景下，进一步研究这些免疫分析物以及呼吸道黏膜中 1 型与 2 型平衡，可能是这一脆弱患者群体未来研究的兴趣所在。
