Differential Effects of Corticosteroids on Serum Eosinophil Cationic Protein and Cytokine Production in Rhinovirus- and Respiratory Syncytial Virus-Induced Acute Exacerbation of Childhood Asthma

Abstract

Background: Little information is available on eosinophil activation and the cytokine profile in virus-induced acute exacerbation of bronchial asthma; therefore, we examined the effects of treatments that included systemic corticosteroids on serum eosinophil cationic protein (ECP) and 17 cytokines/chemokines in rhinovirus- and respiratory syncytial (RS) virus-induced acute exacerbation of childhood asthma. Methods: We measured the peripheral eosinophil count, as well as the serum levels of ECP and 17 types of cytokines/chemokines (IL-1β, 2, 4, 5, 6, 7, 8, 10, 12, 13, and 17 and IFN-γ, TNF-α, GM-CSF, G-CSF, MCP-1, and MIP-1β), using a multiplex bead-based assay in 21 cases of rhinovirus- and 12 cases of RS virus-induced acute exacerbation of childhood asthma and 13 controls. We also compared the clinical data and the effects of systemic corticosteroids on these responses between rhinovirus and RS virus groups. Results: The serum levels of ECP, IL-5, and IL-6 were significantly elevated in patients with rhinovirus-induced acute exacerbation of asthma compared with controls, while serum IL-1β and IFN-γ were significantly lower in patients with rhinovirus-induced acute exacerbation of asthma than in controls. On the other hand, in RS virus-induced acute exacerbation of asthma, only the peripheral eosinophil count was significantly decreased compared with that in rhinovirus-induced acute exacerbation of asthma and controls. Furthermore, the serum levels of ECP, IL-5, and IL-6 in rhinovirus-induced acute exacerbation of asthma and levels of G-CSF in RS virus-induced acute exacerbation of asthma were significantly reduced after treatments that included systemic corticosteroids, respectively. Conclusion: These results suggest that the effects of systemic corticosteroids on serum ECP and the cytokine profile are different between rhinovirus- and RS virus-induced acute exacerbation of childhood asthma.

Respiratory Viruses and Treatment Failure in Children With Asthma Exacerbation

“…This observation is in line with a small study in which researchers documented a lower response to steroids in children with asthma who were infected with RSV compared to those who were not infected. 25 It is also congruent with substantive literature on the lack of response to corticosteroids and bronchodilators in children with RSV bronchiolitis, 26,27 which raises the possibility that RSV per se confers treatment resistance irrespective of disease and not only in infants aged <1 year with wheezing. 28 The third most frequent organism, hMPV, was associated with a risk of treatment failure similar to that of RSV, but its RD did not reach statistical significance.…”

Serum Interleukin-5 Changes in Partly Controlled Atopic Asthmatic Children

“…In the present study serum IL-5 level was significantly elevated in asthmatic children compared to control group. This finding was also reported in other studies [17][18][19].…”

Eosinophilic airway inflammation is common in subacute cough following acute upper respiratory tract infection

“…Our patients had a history of common cold or influenza in initial stage, and because respiratory viral infection can activate eosinophil in asthmatics, viral infections may have been a trigger of airway eosinophilic inflammation. However, although it is well known that respiratory syncytial virus (RSV) infection, which often occurs in infants, children and the elderly, can induce airway eosinophilic inflammation, our patients were adults; therefore, this cannot fully explain the airway eosinophilic inflammation observed here.…”