Severity of respiratory syncytial virus disease related to type and genotype of virus and to cytokine values in nasopharyngeal secretions
Severity of respiratory syncytial virus disease related to type and genotype of virus and to cytokine values in nasopharyngeal secretions
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DOI：
10.1097/00006454-199812000-00003
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发表时间：
1998-12-01
影响因子：
3.6
通讯作者：
Larsen, LB
中科院分区：
文献类型：
--
作者：
Hornsleth, A;Klug, B;Larsen, LB
背景呼吸道合胞病毒（RSV）疾病的严重程度与（1）PCR和限制性内切酶分析分别确定的RSV类型和基因型以及（2）鼻咽分泌物样本中的白细胞介素6（IL-6）和特纳坏死因子α（TNF-α）值相关的研究以前尚未被证实。我们前瞻性地研究了1993、1994和1995年三个冬季哥本哈根儿科收治的105例下呼吸道RSV感染的婴幼儿，通过PCR和核酸限制性分析分别对RSV株进行分型和基因分型，并与疾病的严重程度相关。肿瘤坏死因子-α，从IL-6-和肿瘤坏死因子-α值的样本中确定，与疾病的严重程度。在发病后5周内采集的血清样本中测定IL-6和TNF-α的浓度。根据住院时间、呼吸支持的使用和胸片上是否存在浸润来评估，B型感染比A型感染产生更严重的疾病，这种差异与年龄相关。在0至5个月大的婴儿中观察到，但在较大年龄组中未观察到。B型基因型B1122比A型基因型A2311在0 ~ 11月龄婴儿中产生更严重的疾病。在发病后1 ~ 2天采集的样本中检测到IL-6和TNF-α的血清浓度升高。而TNF-α血清浓度仍然很高，IL-6血清浓度下降，在随后的3至4 wk。IL-6：TNF-α的比例在样本中的疾病的严重程度有关。高比率与低严重程度相关。患有急性RSV感染的患者的疾病严重程度可以与通过PCR确定的RSV类型、通过核酸限制性分析确定的RSV基因型以及IL-6：TNF-α的比值相关。
Background Investigations concerning the severity of respiratory syncytial virus (RSV) disease as related to (1) RSV type and genotype determined respectively by PCR and restriction enzyme analysis and (2) interleukin 6 (IL-6) and turner necrosis factor alpha (TNF-alpha) values in samples of nasopharyngeal secretion (NPS) have not been previously reported.Methods. We prospectively studied 105 RSV infections in the lower respiratory tract of infants and young children admitted to a pediatric department in Copenhagen during three winter seasons, 1993, 1994 and 1995, RSV strains were typed and genotyped, respectively, by PCR and nucleic acid restriction analysis and correlated to the severity of the disease.The ratio IL-6:TNF-alpha, determined from IL-6- and TNF-alpha values in samples of NPS, was related to the severity of the disease. Concentrations of IL-6 and of TNF-alpha were determined in serum samples taken during 5 weeks after the onset of illness.Results. Type B infections produced more severe disease than did type A infections, as assessed on the length of the hospital stay, use of respiratory support and the presence of an infiltrate on a chest radiograph, This difference was age-related. It was observed in infants 0 to 5 months old, but not in older age groups. Type B genotype B1122 produced more severe disease than type A genotype A2311 in infants 0 to 11 months old.Increased serum concentrations of IL-6 and TNF-alpha were detected in samples taken 1 to 2 days after the onset of illness. Whereas TNF-alpha serum concentrations remained high, IL-6 serum concentrations decreased during the following 3 to 4 weeks.The IL-6:TNF-alpha ratio in samples of NPS was related to the severity of the disease. A high ratio was related to a low severity.Conclusions. The severity of disease in patients admitted with acute RSV infections can be correlated to the RSV type as determined by PCR, to the RSV genotype as determined by nucleic acid restriction analysis and to the ratio IL-6:TNF-alpha in NPS.