title: Rhinovirus-induced airway cytokines and respiratory morbidity in severely premature children.
abstract: BACKGROUND
  Rhinovirus (RV) has been linked to the pathogenesis of asthma. Prematurity is a risk factor for severe RV infection in early life, but is unknown if RV elicits enhanced pro-asthmatic airway cytokine responses in premature infants. This study investigated whether young children born severely premature (<32 wks gestation) exhibit airway secretion of Th2 and Th17 cytokines during natural RV infections and whether RV-induced Th2-Th17 responses are linked to more respiratory morbidity in premature children during the first 2 yrs of life.
  
  
  METHODS
  We measured Th2 and Th17 nasal airway cytokines in a retrospective cohort of young children aged 0-2 yrs with PCR-confirmed RV infection or non-detectable virus. Protein levels of IL-4, IL-13, TSLP, and IL-17 were determined with multiplex immunoassays. Demographic and clinical variables were obtained by electronic medical record (EMR) review.
  
  
  RESULTS
  The study comprised 214 children born full term (n = 108), preterm (n = 44) or severely premature (n = 62). Natural RV infection in severely premature children was associated with elevated airway secretion of Th2 (IL-4 and IL-13) and Th17 (IL-17) cytokines, particularly in subjects with history of bronchopulmonary dysplasia. Severely premature children with high RV-induced airway IL-4 had recurrent respiratory hospitalizations (median 3.65 hosp/yr; IQR 2.8-4.8) and were more likely to have at least one pediatric intensive care unit admission during the first 2 yrs of life (OR 8.72; 95% CI 1.3-58.7; p = 0.02).
  
  
  CONCLUSIONS
  Severely premature children have increased airway secretion of Th2 and Th17 cytokines during RV infections, which is associated with more respiratory morbidity in the first 2 yrs of life.
authors: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Integrative Systems Biology, George Washington University, Washington, DC, USA; Center for Genetic Research Medicine, Children's National Medical Center, Washington, DC, USA.
authors: Geovanny F
authors: GF
authors: Perez
authors: Krishna
authors: K
authors: Pancham
authors: Shehlanoor
authors: S
authors: Huseni
authors: Amisha
authors: A
authors: Jain
authors: Carlos E
authors: CE
authors: Rodriguez-Martinez
authors: Diego
authors: D
authors: Preciado
authors: Mary C
authors: MC
authors: Rose
authors: Gustavo
authors: G
authors: Nino
mesh_terms: D001249:Asthma / Q000276:immunology / Q000821:virology; D001997:Bronchopulmonary Dysplasia / Q000276:immunology / Q000821:virology; D015331:Cohort Studies; D003139:Common Cold / Q000150:complications / Q000276:immunology*; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature / Q000276:immunology*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D060885:Multiplex Polymerase Chain Reaction; D012137:Respiratory System / Q000276:immunology* / Q000821:virology*; D012189:Retrospective Studies; D012229:Rhinovirus
chemical_list: D016207:Cytokines
keywords: Th17; Th2; asthma; bronchopulmonary dysplasia; prematurity; rhinovirus
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