title: Severe respiratory syncytial virus infection in early life is associated with increased type 2 cytokine production in Gambian children.
abstract: BACKGROUND
  Severe respiratory syncytial virus (RSV) infection in early childhood has been associated with subsequent wheezing and atopy. The aim of this study was to test if severe RSV infection in early life was associated with an increase in type 2 cytokine production and atopy in Gambian children 5 years later.
  
  
  METHODS
  A cohort of children with severe RSV infection during the first year of life ('cases', n = 66) and without ('controls', n = 122) was followed-up at 5 years of age. Immediate hypersensitivity to common allergens, airway reactivity, serum IgE concentration and the production of IFN-gamma, IL-5 and IL-13 by lymphocytes activated in vitro with RSV F-G or control antigens was determined.
  
  
  RESULTS
  After adjustment for confounders, cases produced significantly higher concentrations of IL-13 in response to RSV F-G and of IL-5 and IL-13 in response to tuberculin. Cases were more likely to have presented with a wheezy lower respiratory tract infection in the first 3 years of life (adjusted odds ratio = 9.9; 95% CI 1.6-61.0), but not thereafter. Cases and controls had similar skin response to allergens, airway reactivity and serum IgE concentrations.
  
  
  CONCLUSIONS
  Severe RSV infection in early life is associated with a higher production of type 2 cytokines in Gambian children at 5 years of age. However this does not appear to result in increased risk of atopy or clinical allergy at that age.
authors.affiliation: Medical Research Council Laboratories, Fajara, The Gambia. mvsande@mrc.gm
authors.forename: M A B
authors.initials: MA
authors.lastname: van der Sande
authors.forename: I M
authors.initials: IM
authors.lastname: Kidd
authors.forename: T
authors.initials: T
authors.lastname: Goetghebuer
authors.forename: R A
authors.initials: RA
authors.lastname: Martynoga
authors.forename: A
authors.initials: A
authors.lastname: Magnusen
authors.forename: S
authors.initials: S
authors.lastname: Allen
authors.forename: M W
authors.initials: MW
authors.lastname: Weber
authors.forename: K L
authors.initials: KL
authors.lastname: Fielding
authors.forename: A
authors.initials: A
authors.lastname: Marchant
authors.forename: H C
authors.initials: HC
authors.lastname: Whittle
mesh_terms: D016535:Bronchial Hyperreactivity; D016022:Case-Control Studies; D002675:Child, Preschool; D016207:Cytokines / Q000276:immunology*; D005500:Follow-Up Studies; D005714:Gambia; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D007371:Interferon-gamma / Q000032:analysis; D018793:Interleukin-13 / Q000032:analysis; D015848:Interleukin-5 / Q000032:analysis; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000276:immunology; D015999:Multivariate Analysis; D018357:Respiratory Syncytial Virus Infections / Q000276:immunology*; D018113:Respiratory Syncytial Virus, Human / Q000276:immunology*; D014374:Tuberculin Test
chemical_list: D016207:Cytokines; D018793:Interleukin-13; D015848:Interleukin-5; D007073:Immunoglobulin E; D007371:Interferon-gamma