Serum levels of interleukin-18, interleukin-33 and fractional exhaled nitric oxide in children with acute respiratory syncytial virus bronchiolitis / 中国医师进修杂志

ABSTRACT

Objective To observe the changes of interleukin-18 (IL-18),interleukin-33 (IL-33) and fractional exhaled nitric oxide (FeNO) in children with acute respiratory syncytial virus (RSV) bronchiolitis,and explore the potential mechanism of the transformation from acute RSV bronchiolitis to recurrent wheezing.Methods Fifty-three children with RSV bronchiolitis (RSV bronchiolitis group),32 children with repeated wheeze (repeated wheeze group) and 30 children receiving regular physical examination (healthy control group) from January 2016 to January 2017 in Cangzhou People's Hospital of Hebei Province were selected.The serum IL-18 and IL-33 at the time of inclusion and 2,3 months after inclusion were detected by enzyme linked immunosorbent assay,the FeNO at the same time was detected by multiple breathing technique,and the indexes were compared.The correlation between FeNO and IL-33,IL-18 was analyzed by Spearman method.Results The IL-18 at the time of inclusion and 2,3 months after inclusion in RSV bronchiolitis group and repeated asthmatic group were significantly higher than those in healthy control group(10.89 ± 1.54) and (14.86 ± 5.54) ng/L vs.(7.26 ± 3.25) ng/L,(13.74 ± 4.16) and (15.45 ± 5.75) ng/L vs.(7.28 ± 3.56) ng/L,(11.38 ± 6.21) and (14.86 ± 5.28) ng/L vs.(7.18 ± 3.41) ng/L,those in repeated asthmatic group were significantly higher than those in RSV bronchiolitis group,and there were statistical differences (P＜0.05).The IL-33 levels at the time of inclusion and 2,3 months after inclusion in RSV bronchiolitis group and repeated asthmatic group were significantly higher than those in healthy control group(17.68 ± 5.25) and (13.14 ± 5.01) ng/L vs.(3.69 ± 1.61) ng/L,(15.68 ± 4.16) and (15.11 ± 5.24) ng/L vs.(3.28 ± 1.56) ng/L,(13.87 ± 6.21) and (14.11 ± 5.14) ng/L vs.(3.18 ± 1.41) ng/L,IL-33 levels at the time of inclusion in RSV bronchiolitis group were significantly higher than those in repeated asthmatic group,and there were statistical differences (P＜0.05).The FeNO levels at the time of inclusion and 2,3 months after inclusion in repeated asthmatic group were significantly higher than those in RSV bronchiolitis group and healthy control group(13.14 ± 4.47) ppb vs.(1.89 ± 1.54) and (7.26 ± 4.25) ppb,(14.75 ± 5.15) ppb vs.(7.74 ± 4.16) and (7.28 ± 4.12) ppb,(13.68 ± 5.62) ppb vs.(11.38 ± 6.21) and (7.18 ± 3.41) ppb;compared with that in healthy control group,FeNO at the time of inclusion in RSV bronchiolitis group was significantly decreased,and at 3 months was significantly increased,and there were statistical differences (P＜0.05).Correlation analysis result showed that FeNO at 2 and 3 months after inclusion in RSV bronchiolitis group had positive correlation with IL-18 level at the time of inclusion and 2,3 months after inclusion (P＜0.05),and negative correlation with IL-33 (P＜0.05);FeNO at 2 and 3 months after inclusion in repeated asthmatic group showed positive correlation with IL-18 at the same time (P＜0.05),and was negatively correlated with IL-33 level (P＜0.05);there was no correlation between FeNO and IL-18,IL-33 in healthy control group (P＞0.05).Conclusions IL-18 and IL-33 may be involved in the pathogenesis of acute RSV bronchiolitis and recurrent wheezing,and the concentration of IL-18 and IL-33 is correlated with the level of FeNO.Its potential mechanism needs further study.