Immunologic Responses in Infants with Asthma and Bronchiolitis / 소아알레르기및호흡기학회지

ABSTRACT

PURPOSE: Respiratory syncytial virus (RSV) is the most common etiologic agent of acute bronchiolitis in infancy, and has been regarded as a possible cause of hyperreactive airway disease later in childhood. This study was performed to compare the immunologic responses between infantile asthma and bronchiolitis and to evaluate whether these immunologic responses can be useful markers to predict the development of subsequent wheezing. METHODS: We analyzed the serum concentrations of interleukin-4 (IL-4) and soluble intercellular adhesion molecule-1 (sICAM-1) from 29 infantile asthmatics, 13 infants with bronchiolitis, and 19 non-atopic controls. RSV infection was confirmed with indirect immunofluorescent staining and viral culture. RESULTS: Serum concentrations of IL-4 and sICAM-1 were significantly higher in infants with asthma compared with infants with those of controls. Peripheral blood eosinophils were significantly decreased in RSV positive bronchiolitis, but there were no differences in the serum concentrations of IL-4 and sICAM-1 between the infants with and without RSV infection. Serum concentrations of IL-4 and sICAM-1 in the first wheezing episode were higher in infants with persistent wheezing than those without. CONCLUSION: There are significant differences in immunologic responses between infantile asthma and bronchiolitis, and the serum IL-4 and sICAM-1 levels in the first wheezing episode may be used as a marker to predict the development of subsequent wheezing.