Introduction: Variability in severity of Respiratory Syncytial Virus (RSV) infection is reportedly due to differences in inflammatory response. Objective: To characterize the cytokine response in RSV+ infants aged 0 - 36 months and to relate their responses to disease severity. Methods: Nasopharyngeal aspirations (NPAs) were analyzed for RSV and IL-1 β , IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-1RA, IL-4R, IFN- γ , sTNFR1, sTNFR2, and TNF- α . Clinical data were collected from the medical records. Results: We included 331 infants of whom 214 were RSV+. In comparison to RSV- infants, they had significantly higher levels of TNF- α , IL-6, IL-1 β , and IFN- γ (p < 0.05). This also applied to anti-inflammatory cytokine IL-10 levels, but these levels were remarkably lower than levels of TNF- α , IL-6, and IL-1 β . sTNFR1/2 were significantly increased in RSV+ infants. Hospitalized patients had significantly higher levels of TNF- α , sTNFR2, and IL-10 (p < 0.05) than non-hospitalized patients. The cytokine response could not be related to disease severity. We found no evidence of a skewed Th1/Th2 immune profile. Conclusion: In acute RSV disease, infected infants’ NPAs contain a significant amount of pro-inflammatory cytokines. Whether this response is beneficial or deleterious remains unanswered. Interpersonal variations in cytokine responses might be linked to an inherited tendency to variations in disease severity.
KeywordsRespiratory Syncytial VirusBronchiolitisInflammationCytokinesInfants Aged 0 - 3 Years
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