Seguimiento de lactantes hospitalizados por bronquiolitis por virus respiratorio sincicial. Evolución clínica, respuesta de atopia inflamatoria y marcadores. resultados preliminares

Abstract

Background: Respiratory syncytial virus infection (RSV) alone or associated to rhinovirus (RV) in the infant has been linked with more likelihood to develop asthma and atopy. Aim: Analyze clinical and immunological markers of patients with RSV or RV bronchiolitis that determine their evolution. Patients and Methods: We studied previously healthy infants hospitalized for bronchiolitis during the fall-winter period of 2009 and 2010. RSV and RV by qPCR, and proinflammatory interleukins (IL). IL-6, IL-8, TNF-α, IL-1β and IL-12, were determined in nasopharyngeal aspirate (NPA). A follow-up clinical, indoor pollution and immunological study was done at 4 or 5 years. Results are expressed in median and range. Mann-Whitney’s test was used in the nonparametric statistical analysis. Results: Eight out of 22 patients (36%) are currently with recurrent wheezing (RW) in treatment with budesonide 400 µg per day as a mean dose. In the IL assessment significant changes were detected only in IL-1β that was increased and in IL-12 that was decreased in the RW group versus the non RW (NRW) group. There were not significant differences in both groups in age at hospitalization, infection severity, presence of personal or family atopy, co-infection with RSV and RV, presence of older siblings or indoor air pollution. Conclusions: The determination of IL- and IL-12 in NPA for bronchiolitis could be an early marker of subsequent inflammation of the airway. Co-infection of RSV and RV does not get worse the clinical evolution. The group RW of preschool children had no further development of atopy than the NRW group. There could be other factors that contribute to the manifestation of bronchial inflammation in the RW group.