ABSTRACT
BACKGROUND: Viruses are important triggers of asthma exacerbations. They are also detected outside of exacerbation. Alteration of anti-viral response in asthmatic patients has been shown although the mechanisms responsible for this defect remain unclear. The objective of this study was to compare in virus-infected and not-infected allergic asthmatic children, aged 6 to 16 years, admitted to hospital for a severe exacerbation, the innate immune response and especially the expression of pattern recognition receptor (PRR) and their function. METHODS: Virus identification was performed both during the exacerbation and at steady state (eight weeks later). Data assessed at both periods included clinical features, anti-viral response and inflammation (in sputum and plasma), and PRR expression/function in blood mononuclear cells. RESULTS: Viruses were identified in 46 out of 72 children (median age 8.9 years) during exacerbation, and among them, in 17 at steady state. IFN-ß, IFN-γ and IL-29 levels in sputum and plasma were similar between infected and not infected patients at both times, as well as the expression of TLR3, RIG-I and MDA5 in blood monocytes and dendritic cells. Airway inflammation in infected patients was characterized by significantly higher IL-5 concentration and eosinophil count. Compared to patients only infected at exacerbation, the re-infected children significantly exhibited lower levels of IFN-γ in plasma and sputum at exacerbation associated with modifications in PRR expression and function in blood mononuclear cells. These re-infected patients also presented an airway neutrophilic inflammation at steady state. CONCLUSION: Our results reports in asthmatic children that impaired anti-viral response during virus-induced exacerbation is more pronounced in a subgroup of patients prone to re-infection by virus. This subgroup is characterized by altered PRR function and a different pattern of airway inflammation. TRIAL REGISTRATION: This multicenter prospective study was approved by the regional investigational review board (ref: 08/07).
Subject(s)
Asthma/virology , Disease Progression , Hypersensitivity/virology , Inflammation Mediators , Neutrophils/virology , Adolescent , Asthma/immunology , Asthma/metabolism , Child , Female , Humans , Hypersensitivity/immunology , Hypersensitivity/metabolism , Inflammation/immunology , Inflammation/metabolism , Inflammation/virology , Inflammation Mediators/immunology , Inflammation Mediators/metabolism , Male , Neutrophils/immunology , Neutrophils/metabolism , Prospective StudiesABSTRACT
Los autores presentan el caso de un paciente de 2 años con historia de ser portador de retinoblastoma bilateral diagnosticado en octubre del 2001. Recibió Nº 6 ciclos de quimioterapia y no hubo respuesta adecuada. Fue tratado con cirugía láser en Colombia y luego recibió Nº2 ciclos más de quimioterapia. Actualmente consulta por tumoración en ojo izquierdo. Se le realiza TAC de órbita que muestra masa de tejidos blandos que proyecta el globo ocular hacia adelante y persistencia de calcificaciones previas.
