Association of interleukin-1 and and respiratory syncytial virus infection: a possible role in the pathogenesis of bronchial asthma in children

Bronchial asthma is considered an ongoing inflammatory process. Respiratory syncytial virus infection early in life may be the cause of the airway hyperresponsiveness. Many factors take part in the pathogenesis. The proinflammatory Interleukin-[1] alpha [IL-[1]alpha] seems to have a critical initiating role. The aim of this study was to assess the IL-[1]alpha level and R. S. V. antigen in the nasopharyngeal secretion of respiratory tract infected [wheezing and non-wheezing] children and the possible associations among several factors leading to the development of bronchial asthma. The present work is a cross-sectional cohort study on one hundred children attending Allergy Outpatient Clinic of New Children Hospital, Cairo University. All children were subjected to full routine investigations as well as to some immunological parameters. They were divided into 3 groups. Group [I] was formed of 50 children who suffered from acute respiratory infections with wheezes [asthmatics], most probably due to respiratory syncytial virus, [R.S.V.]; group [II] comprised 30 children, they were chronic asthmatic who came for follow up and were apparently free from any infections or wheezes and finally group [III] was formed of 20 children, they were not asthmatic but were suffering from viral respiratory infection with no wheezes. The 3 groups were examined for antigen detection of R.S.V. and Interlukin-[1]alpha was assessed by solid phase enzyme immunoassay in nasopharyngeal secretions in a trial to find out any association [correlation] in order to evaluate the pathophysiological events occurring in the microenvironment of the infected airway epithelium. The results were as such: - In group [I]: R.S.V. was significantly positively correlated with Interleukin-[1]alpha level [[54.7 +/- 64.3] pg/ml], [r = 0.486]. Also it was significantly positively correlated with the presence of infection [clinically] [r = 0.611, P < 0.001]. The graded level of Interleukin-[1]alpha was positively correlated with clinically diagnosed infection and also with the presence of R.S.V. [r = 0.673, P < 0.001] In group [II]: There was no correlation between R.S.V. and the severity of asthma, IL-[1]alpha level [mean level of IL-[1]alpha = [3.9 +/- 4.4] pg/ml] or clinically diagnosed infection. There was no correlation between IL-[1]alpha and total leucocytic count [TLC], Ig[E] level, Ig[G] level and mean absolute eosinophilic count. In group [III]: There was no correlation between R. S. V. and the severity of asthma, Interleukin-[1]alpha level [[41.2 +/- 57.5]pg/ml], or clinically infection. Also there was no correlation between IL-[1]alpha level and mean T.L.C, mean absolute eosinophilic count, Ig[G] level and Ig[E] level

Microbial study of bronchial lavage versus sputum in asthmatic children

This study included 50 asthmatic children [30 males, and 20 females], aged 2-13 years, they were suffering from allergic infectious asthma. They were subjected to all routine investigations as well as some immunological parameters. Ninteen [19] children out of the 50 were selected and studied for their bacteriological pattern of the bronchial lavage versus their sputa, in between attacks using investigative bronchoscopy and nasotracheal aspiration by catheterization. Eight [8] cultures out of 19 obtained through bronchoscope gave growth as follows: Klebsiella; 2 [25%], Neisseria; 1 [12.5%], the rest 5 showed no growth [62.5%]. The bronchial lavage obtained by nasotreacheal aspiration showed growth for Candida; 2 [18.2%], Strept viridans; 4 [36.4%], Staph. aureus; 3 [27.3%], Diphtheroid; 2 [18.2%] and Neisseria in one case only [9.1%] out ofthe 11 case respectively. One patient only gave growth for anaerobic organism [streptococcal group]. Three patients [27.3%] gave no growth. On the otherhand their sputa gave growth for, Candida; 1 [5.3%] Strept viridans; 5 [26. 3%], Diphtheroid; 4 [21.1%], Neisseria; 7 [36.8%], Klebsiella; 2 [10.5%], respectively in between attacks. The sputa of the total 50 asthmatics during attack gave growth for Haemophilus group; 39 [78%], Klebsiella; 4 [8%], Neisseria; 7 [14%], respectively. We conclude that sputa may not be an accurate reflection of lower respiratory infections, as there is a possibility of contamination. Also no correlation was found between sputum culture results and bronchial lavage either between attacks or during attacks. No correlations was found between [+ve] cultures and severity of the disease. Role of bacteria in triggering attacks of bronchial asthma is still vague

Role of aspergillus species in the pathogenesis of bronchial asthma in paediatrics

As understanding of the inflammatory nature of asthma increases, so does our ability to treat asthma. The fine tuned management of asthma requires awareness and the ability to control these other factors. Allergic bronchopulmonary aspergillosis is not just an associated condition that may make asthma worse but it is also a complication of asthma and can be confused with asthma. This study included 25 asthmatic children who suffer sever interactable asthma, their ages ranged from 4-13 years [mean=8.0 +/- 3.5]. They were fourteen males [56%] and eleven females [44%]. All gave [+ve] skin test to aspergillus mix extract. Their total Ig[E] was very high with mean value [505.2] I. U. /ml] which ranged from [44 to 8950 I.U./ ml]; and absolute eosinophllic count mean value was [573 +/- 83/ml]. The atopic ones were 76% and 80% gave positive family history of allergy. Their X-Ray findings showed heavy infilterates and tendancy to central destruction in most of them. While their course of the disease was very progressive and interactable, they only improved on corticosteroid therapy. The specific Ig[E] against Aspergillus fumigatus gave [-ve] results. We found positive cultures for Fungi in Sputum of 25 asthmatics, they were Aspergillus niger [52%], Aspergillus flavus [12%], Aspergillus fumigtus [4%], Candida [36%] and Penicillium [24%] while 20% showed no growth. While the 10 normal controls showed Asp. niger [20%], Candida [40%], Penicillium [10%], and the rest [30%], showed no growth. We conclude that Aspergillosis could affect asthmatic children as well as adults and needs full accurate investigation as well as steroids therapy; when suspicious interactable course noticed in them