Martinez F D, Stern D A, Wright A L, Taussig L M, Halonen M
Respiratory Sciences Center, University of Arizona Health Sciences Center, Tucson, AZ, USA.
J Allergy Clin Immunol. 1998 Dec;102(6 Pt 1):915-20. doi: 10.1016/s0091-6749(98)70328-8.
Recent epidemiologic evidence suggests that 2 wheezing syndromes coexist in early life: transient wheezing, limited to early childhood, and persistent wheezing, which starts in early childhood and persists beyond that age.
Whether the nature of the immune response occurring during acute lower respiratory illnesses (LRIs) in infancy differs between these 2 groups of wheezers has yet to be determined.
We compared total serum IgE levels and peripheral blood eosinophil counts obtained during the acute phase of the first LRI with those obtained during the convalescent phase or with well-baby samples in persistent (n = 49) and transient early wheezers (n = 88), as well as in children who had only nonwheezing LRIs (n = 43) during the first 3 years of life.
Total serum IgE levels were significantly higher (P =.008) during the acute phase compared with the convalescent phase of the LRI in persistent wheezers, a response not observed in transient early wheezers (P =.7). Peripheral blood eosinophil counts were significantly reduced during the acute phase of the LRI (P =.009) in transient early wheezers, a response not observed among persistent wheezers (P =.7). Acute responses in children who had nonwheezing LRIs only were similar to those seen in transient early wheezers.
Alterations in acute immune response to viral infection may be detected at the time of the first wheezing episode in subjects who will go on to have persistent wheezing symptoms.
近期流行病学证据表明，两种喘息综合征在生命早期并存：短暂性喘息，仅限于幼儿期；持续性喘息，始于幼儿期并持续至该年龄之后。
这两组喘息患儿在婴儿期急性下呼吸道感染（LRI）期间发生的免疫反应性质是否不同，尚待确定。
我们比较了持续性喘息患儿（n = 49）和短暂性早期喘息患儿（n = 88）在首次LRI急性期获得的血清总IgE水平和外周血嗜酸性粒细胞计数，以及在生命最初3年中仅患非喘息性LRI的儿童（n = 43）在恢复期或健康婴儿样本中的相应数据。
持续性喘息患儿LRI急性期的血清总IgE水平与恢复期相比显著更高（P = 0.008），而短暂性早期喘息患儿未观察到这种反应（P = 0.7）。短暂性早期喘息患儿LRI急性期外周血嗜酸性粒细胞计数显著降低（P = 0.009），持续性喘息患儿未观察到这种反应（P = 0.7）。仅患非喘息性LRI的儿童的急性反应与短暂性早期喘息患儿相似。
在后续将出现持续性喘息症状的受试者首次喘息发作时，可能检测到对病毒感染的急性免疫反应改变。
