Plasma levels of soluble CD14 and endothelin-1 in infants with respiratory syncytial virus-induced bronchiolitis as predictors of subsequent recurrent wheezing in a two years follow-up study

ABSTRACT

Respiratory syncytial virus [RSV] infections have been demonstrated to be associated with subsequent recurrent wheezing episodes and the development of childhood asthma. The CD14 receptor responds to the microbial burden in the environment and modulates the development of the allergic phenotype. Endothelin-1 is a potent bronchoconstrictor involved in many diseases including respiratory tract infections. Plasma levels of soluble CD14 [SCD14] and endothelin-1 [ET-1] were measured by a commercially available enzyme-linked immunosorbent assay [ELISA] in 32 infants who were hospitalized with RSV bronchiolitis to investigate their relation to the subsequent development of recurrent wheezing during a two years follow-up period. Thirty healthy infants were served as a control group. The results proved that the mean level of plasma sCD14 was significantly lower in infants with acute RSV bronchiolitis compared to control group [22.01 +/- 6.27 vs 817.50 +/- 247.52 ng/ml, p<0.001]. The mean sCD14 plasma level of 18.52 +/- 5.24 ng/ml in the group of 19 children who exhibited recurrent wheezing was significantly lower than the level of 27.11 +/- 3.57ng/ml in the group of 13 children who did not exhibit recurrent wheezing [P<0.001]. the mean plasma level of ET-1 was significantly increased in infants with RSV bronchiolitis compared to the controls [3.86 +/- 1.44 vs 0.71 +/- 0.18 pg/ml, p<0.001] and the mean plasma ET-1 level of 4.60 +/- 1.17 pg/ml in the group of children who exhibited recurrent wheezing was significantly higher than level of 2.78 +/- 1.11 pg/ml in the group of children who did not exhibit recurrent wheezing [P<0.001]. the risk for subsequent development of recurrent wheezing was not influenced by age at hospitalization, sex, breast-feeding, positive family history of atopy, or passive smoking. The results of this study showed that plasma level of sCD14 was decreased and plasma endothelin-1 was increased in infants during acute RSV bronchiolitis and their levels were significantly different in infants who had experienced subsequent wheezing than in infants who not and that reduced plasma sCD14 and increased ET-1 levels in infants with RSV bronchiolitis are useful in predicting the risk to develop subsequent recurrent wheezing. From the results of this study, it can be recommended that CD14 may be a potential target for preventive measures against atopic diseases. This study also encourage further studies on the value of ET-1 antagonism among alternative therapeutic modalities of childhood asthma