MIP-1α level in nasopharyngeal aspirates at the first wheezing episode predicts recurrent wheezing.
BACKGROUND
Respiratory virus-induced wheezing, such as that induced by respiratory syncytial virus (RSV) and human rhinovirus, is an important risk factor for recurrent wheezing and childhood asthma. However, no biomarkers for predicting recurrent wheezing have been identified.


OBJECTIVE
We searched for predictors of recurrent wheezing using nasopharyngeal aspirates obtained from patients during the first wheezing episode who were hospitalized with an acute lower respiratory tract illness.


METHODS
We enrolled 82 infants during the first wheezing episode (median age, 5.0 months) who were hospitalized for acute lower respiratory tract illness between August 2009 and June 2012 and followed these patients for 2.5 years. Nasopharyngeal aspirates and blood samples were obtained on the first day of hospitalization. Viral genomes were identified by using RT-PCR and sequencing. Levels of 33 cytokines, tryptase, IgE, anti-RSV IgE, and anti-RSV IgG were measured by using ELISAs or the Bio-Plex multiplex assay. Predictors of recurrent wheezing were examined by using a stepwise logistic regression model with backward elimination.


RESULTS
Sixty percent of the patients experienced recurrent wheezing episodes. One or more viruses were detected in the nasopharynxes of 93% of the patients during the first wheezing episode. IFN-γ, IL-2, IL-9, MIP-1α, and MIP-1β levels were significantly higher among patients with recurrent wheezing than among those without recurrent wheezing (P < .05 or .01). The stepwise model demonstrated that the MIP-1α level (odds ratio, 7.72; 95% CI, 1.50-39.77; P = .015) was the strongest independent predictor of the occurrence of recurrent wheezing.


CONCLUSIONS
An increased MIP-1α level in nasopharyngeal aspirates from patients with acute respiratory symptoms during the first wheezing episode caused by viral infections might predict recurrent wheezing.
Department of Pediatrics, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan.
Kazuko
K
Sugai
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan.
Hirokazu
H
Kimura
Department of Pediatrics, National Hospital Organization Yokohama Medical Center, Yokohama, Japan.
Yumiko
Y
Miyaji
Department of Health Science, Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Japan.
Hiroyuki
H
Tsukagoshi
Department of Health Science, Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Japan.
Masakazu
M
Yoshizumi
Allergy and Immunology Group, Research Institute of Medical Science, Division of Medical Education Planning and Development, Nihon University School of Medicine, Tokyo, Japan.
Tomomi
T
Sasaki-Sakamoto
Department of Molecular Biodefence Research, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Satoko
S
Matsunaga
Yamada Gastroenterology Pediatric Clinic, Tochigi, Japan.
Yumi
Y
Yamada
Laboratory for Allergic Disease, RCAI, RIKEN Center for Integrative Medical Sciences (IMS-RCAI), Yokohama, Japan.
Jun-ichi
J
Kashiwakura
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan.
Masahiro
M
Noda
Department of Pediatrics, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan.
Masanori
M
Ikeda
Department of Health Science, Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Japan.
Kunihisa
K
Kozawa
Department of Molecular Biodefence Research, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Akihide
A
Ryo
Department of Pediatrics, Dokkyo Medical University, Mibu, Japan.
Shigemi
S
Yoshihara
Center for Information Research, National Institute of Public Health, Saitama, Tokyo, Japan.
Hiromitsu
H
Ogata
Allergy and Immunology Group, Research Institute of Medical Science, Division of Medical Education Planning and Development, Nihon University School of Medicine, Tokyo, Japan. Electronic address: okayama.yoshimichi@nihon-u.ac.jp.
Yoshimichi
Y
Okayama
D000914:Antibodies, Viral / Q000276:immunology; D015415:Biomarkers; D054405:Chemokine CCL3 / Q000378:metabolism*; D002675:Child, Preschool; D016207:Cytokines / Q000378:metabolism; D045604:Extracellular Fluid / Q000378:metabolism*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology / Q000378:metabolism; D007074:Immunoglobulin G; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000378:metabolism*; D011379:Prognosis; D012008:Recurrence; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000209:etiology; D012136:Respiratory Syncytial Viruses / Q000276:immunology; D053802:Tryptases
D000914:Antibodies, Viral; D015415:Biomarkers; D054405:Chemokine CCL3; D016207:Cytokines; D007074:Immunoglobulin G; D007073:Immunoglobulin E; D053802:Tryptases
Acute lower respiratory tract illness; IFN-γ; MIP-1α; MIP-1β; biomarkers; human rhinovirus; nasopharyngeal aspirates; recurrent wheezing; respiratory syncytial virus