The Changes Of Interleukin-10, Interferon-? In Serum And Eosinophils In Nasapharyngeal Levels In Infants With Bronchiolitis

Objective:Bronchiolitis is one of the common diseases in infants and young children,about 30%-48% of children with bronchiolitis develop into asthma.Studies have shown that bronchiolitis and asthma share some similar abnormalities in cellular and humoral immune functions,that is,imbalance between Th1 /Th2 functions.The Th1/Th2 imbalance is featured with decreased Th1 cytokines such as IFN-?,IL-2,and increased Th2 cytokines such as IL-10,IL-4,resulting in respiratory inflammatory reaction and hyper-reactivity.Induced sputum analysis is a relatively noninvasive and safe,therefore,is widely used to study the airway inflammation in asthma.However,due to the difficulty in sampling sputum in infants and young children,eosinophil analyses in nasopharyngeal secretions from this population have been rarely reported.The objective of the study is to understand the immune status of children with bronchiolitis and association between bronchiolitis and asthma by analyzing changes in levels of IL-10 and IFN-? in serum and eosinophil level in nasopharyngeal secretions in infants and young children with bronchiolitis.Observations from this study may provide scientific evidences to understand the pathogenesis of asthma,and to develop new methods for early prevention of asthma and treatment of recurrent wheezing after bronchiolitis.Method:A total of 32 infants and young children with bronchiolitis(11 atopic and 21 non atopic cases;12 RSV bronchiolitis and 20 non-RSV bronchiolitis)admitted to our hospital for bronchiolitis between January 2015 and January 2016,whose diagnoses complied with the criteria proposed in “Zhu Futang Practical Paediatrics” were included in the treatment group.All patients were at their first occurrence of bronchiolitis.Patients with congenital immune-deficient,congenital heart disease,congenital pulmonary dysplasia,bronchial foreign body,allergic rhinitis,parasitic diseases were excluded.Meanwhile,18 age-matched normal infants or young children during the same period were included as the control group.Gender and age of the two groups were not statistically different.IL-10 and IFN-? levels in serum were determined by ELISA in 4 settings: control group,the treatment group upon admission(acute stage),treatment group at recovery(convalescence stage)and 2 months after discharge(follow up stage).In the meantime,nasopharyngeal secretions of the treatment group were sampled at acute stage,convalescence stage and follow up stage as described above to calculate total positive rate.Criteria of counting: 300 white blood cells were counted in each smear and percentage of eosinophil was calculated.Changes in IL-10,IFN-? and eosinophil counts in nasopharyngeal secretions of the control group and the treatment group at acute,convalescence and follow up stages were analyzed and compared.Data Statistics: All data is analyzed by the software of Spss 16.0 and EXCEL2003.The results are presented as X ±S.the number of multiple groups were compared using ANOVA,and total positive rate of the Independent-Sample using T Test.The correlation analysis of asopharyngeal secretions eosinophil count,the levels of serum IL-10 and IFN-? were compared using Pearson correlation analysis.P<0.05 for the difference was statistically significant.Results:1 The gestational age and gender between two groupsGender and age between the treatment group and the healthy control group had no statistical difference(P>0.05).2 The results of ELISA analysesThe levels of IL-10 in the acute group was higher than that in the convalescence group(P = 0.000),and in convalescence group was higher than that in the follow-up group(P = 0.027).The healthy control group was lower than that in follow-up group(P = 0.047),and lower than that in the acute stage group(P = 0.000).It can be observed directly from the bar chart,serum IL-10 levels decreased gradually.The level of IFN-? in acute stage group was lower than that of the convalescence group(P = 0.012),and in healthy control group was higher than that in the convalescence group(P = 0.001).The level of IFN-?in the healthy control group was higher than that in the follow up group(P = 0.000),and higher than that in the acute stage group(P = 0.000).It can be directly observed from the bar chart,with the recovery of the disease,serum IFN-?levels show a trend of gradually increase.Regarding the asopharyngeal secretions eosinophil count,no difference between acute stage group and the convalescence group(P=0.557).The eosinophils in the convalescence group was higher than that in the follow-up group(P = 0.003),and in the acute stage group was higher than that in follow-up group(P = 0.001).It can be observed directly from the bar chart,with the recovery of the disease,the level of nasopharyngeal secretions eosinophil was decreased gradually.Comparing with RSV negative group(non-RSV),the levels of serum IL-10 in RSV acute bronchiolitis cases were higher(P = 0.001);the levels of serum IFN-?in RSV bronchiolitis cases was lower than that in non-RSV bronchiolitis cases(P = 0.004);asopharyngeal secretions eosinophil count in RSV bronchiolitis cases was higher than that in non-RSV bronchiolitis cases(P = 0.028).Comparing with non-atopic group,the levels of serum IL-10 at acute stage in atopic group was higher(P = 0.025).The levels of serum IFN-?in non-atopic group was significantly higher than that in atpoic group(P = 0.004).The levels of asopharyngeal secretions eosinophil count in atopic group was significantly higher than that in non-atpic group(P = 0.015).The accumulation of asopharyngeal secretions eosinophil count in acute bronchiolitis group was positively cottelated with the accumulation of IL-10(r=0.400,P=0.023,<0.05),but negatively correlated with the accumulation of IFN-?(r=-0.628,P=0.000,<0.01).Conclusions:1 The study showed Th1/Th2 imbalance during not only acute stage but also convalescence stage of bronchiolitis.IFN-?,excreted by Th1 cytokines,is decreased,but IL-10,excreted by Th2 cytokinese,is increased.2 The level of asopharyngeal secretions eosinophil in acute group was higher than that in follow-up group.Compare with convalescence group,The result of asopharyngeal secretions eosinophil in acute group is increased,but there was no statistical significance.3 With the recovery of bronchiolitis,the level of cytokine IFN-?,IL-10 and nasopharyngeal secretions eosinophil recovered gradually,but they recovered more slowly than the clinical.4 Comparing with non-atopic group and non-RSV bronchiolitis group,the levels of IFN-?,IL-10 and asopharyngeal secretions eosinophil were different in RSV bronchiolitis group and atopic group.5 The accumulation of asopharyngeal secretions eosinophil count in acute bronchiolitis group was positively cottelated with the accumulation of IL-10,but negatively correlated with the accumulation of IFN-?.