We describe the characteristic clinical and pathologic findings of three cases of constrictive bronchiolitis. All three patients were middle-aged women with chronic respiratory illness characterized by chronic cough, dyspnea, mild to severe obstructive pulmonary dysfunction, relatively normal chest radiographs with occasional peribronchial infiltration, and lack of response to bronchodilators or prednisolone. The patients also had medical diseases such as non-Hodgkin's lymphoma and hyperprolactinemia in case 1 and 3, respectively. None of the patients smoked cigarettes and had clinical evidence of recent viral lower respiratory tract infection. Histologic study by open lung biopsy revealed a spectrum of changes ranging from active cellular bronchiolitis to obliterative peribronchiolar fibrosis. The intervening interstitial and alveolar areas showed no remarkable lesion. Immunohistochemically, the bronchiolar or peribronchiolar inflammatory infiltrates mainly comprised of mixed T- and B-lymphocytes. It may be possible that the active form of constrictive bronchiolitis is initiated by attendant lymphocytic inflammation of the airways, which is followed by fibrous obliteration of bronchioles.
Adult ; Biopsy ; Bronchiolitis/immunology/*pathology ; Bronchoconstriction/*immunology ; Female ; Human ; Middle Age ; Pulmonary Fibrosis/immunology/pathology ; T-Lymphocytes/immunology

OBJECTIVETo investigate the changes and clinical significance of lymphocyte subsets in infants with bronchitis, bronchopneumonia, and bronchiolitis.

METHODSA total of 111 children with bronchitis, 418 children with bronchopneumonia, and 83 children with bronchiolitis were enrolled as disease groups, and 235 healthy children were enrolled as control group. Flow cytometry was applied to measure lymphocyte subsets.

RESULTSThe bronchitis group had significantly lower numbers of T cells and CD3+CD8+ T cells than the control group (P<0.05). The bronchopneumonia group had significantly lower numbers of T cells and CD3+CD8+ T cells, a significantly higher number of T helper (Th) cells, and a significantly higher CD4/CD8 ratio than the control group, as well as a significantly higher number of Th cells than the bronchitis group. Compared with the children with mild bronchopneumonia, those with severe bronchopneumonia showed a reduction in T cells and an increase in B cells (P<0.05). The bronchiolitis group had a significantly higher number of Th cells, a significantly higher CD4/CD8 ratio, and a significantly lower number of CD3+CD8+ T cells than the control group (P<0.01). The disease groups showed a significantly higher number of B cells and a significantly lower number of natural killer cells than the control group (P<0.05).

CONCLUSIONSA low, disturbed cellular immune function and a high humoral immune function are involved in the development and progression of lower respiratory tract infectious diseases. The changes in immune function are related to the type and severity of diseases.

Bronchiolitis ; immunology ; Bronchitis ; immunology ; Bronchopneumonia ; immunology ; CD4-CD8 Ratio ; Child, Preschool ; Female ; Humans ; Infant ; Killer Cells, Natural ; immunology ; Lymphocyte Subsets ; immunology ; Male ; Respiratory Tract Infections ; immunology

OBJECTIVETo study the changes of red cell immune function and T-lymphocyte subsets in children with bronchiolitis and their possible roles in the pathogenesis of bronchiolitis.

METHODSForty-five children with bronchiolitis and 30 healthy controls were enrolled. Red cell immune complex rosette (RBC-ICR) and red cell C3b receptor rosette (RBC-C3bRR) were detected. The percentages of CD3+, CD4+ and CD8+ cells were assayed by flow cytometry.

RESULTSRBC-C3bRR［(13.6 ± 6.2)% vs (18.0 ± 7.4)%] and the percentage of CD8+ cells [(21.6 ± 4.4)% vs (25.6 ± 5.2) %］ in the bronchiolitis group were lower than those in the control group (P<0.01). The percentage of CD3+ cells ［(59.9 ± 6.7)% vs (52.1 ± 8.3)%］ and CD4+ cells [(53.5 ± 6.2)% vs (46.8 ± 4.9)%] and RBC-ICR [(8.3 ± 3.5)% vs (6.1 ± 2.5)%] in the bronchiolitis group were higher than those in the control group (P<0.01). The percentage of CD4+ cells was positively correlated with RBC-ICR (r=0.63,P<0.05) and negatively correlated with RBC-C3bRR (r=-0.82,P<0.01).

CONCLUSIONSThere are dysfunctions of red cell immune and T-lymphocyte subsets in children with brochiolitis, which may play a role in the pathogenesis of brochiolitis.

Bronchiolitis ; etiology ; immunology ; Erythrocytes ; immunology ; Female ; Humans ; Infant ; Male ; Receptors, Complement 3b ; physiology ; Rosette Formation ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo study the roles of chemokine receptor 3 (CXCR3) on lymphocytes and interferon-γ-inducible protein-10 (IP-10) of peripheral blood in childhood bronchiolitis.

METHODSFifty-five children with bronchiolitis were classified into Group I (with allergic factors) and Group II (without allergic factors). Twenty-eight children with noninfectious diseases were enrolled randomly as the control group. The expression of CXCR3 (CD183 as its molecular marker) on lymphocytes of peripheral blood was detected by flow cytometry. Serum IP-10 level was measured using ELISA.

RESULTSThe expression of CD183(+) cells on CD4(+) and CD8(+) lymphocytes in peripheral blood in children with bronchiolitis from both Group I and Group II was significantly higher than that in the control group (P<0.05), and Group I had higher expression of CD183(+) cells on CD4(+) and CD8(+) lymphocytes than Group II (P<0.05).Serum IP-10 levels in Group I and Group II were significantly higher than those in the control group (P<0.05). However, there was no significant difference in serum IP-10 levels between Group I and Group II.

CONCLUSIONSCXCR3 and IP-10 are involved in the pathogenesis of bronchiolitis, and CXCR3 is associated with allergic factors.

Bronchiolitis ; etiology ; immunology ; Chemokine CXCL10 ; blood ; physiology ; Child, Preschool ; Female ; Humans ; Infant ; Lymphocytes ; immunology ; Male ; Receptors, CXCR3 ; blood ; physiology

Bronchiolitis is a risk factor for the development of childhood asthma. Eosinophilic inflammation in airways plays an important role in the pathophysiology of both bronchiolitis and asthma. To investigate this inflammation, we measured the eosinophil cationic protein (ECP), regulated on activation normal T-cell expressed and secreted (RANTES) and eotaxin levels in nasopharyngeal secretions (NPS). Twenty-eight patients with RSV bronchiolitis (RSV group), 11 patients with non-RSV bronchiolitis (non-RSV group) and 7 controls were enrolled in this study. ECP, RANTES, and eotaxin levels were measured by enzyme immunoassays. The ECP level in the NPS of the RSV group was significantly higher than that in the NPS of the non-RSV group and controls. RANTES and eotaxin levels in infants with bronchiolitis were significantly higher than those in the controls, but there was no significant difference between the RSV and non-RSV groups. In conclusion, with regard to eosinophilic airway inflammation, as compared with non-RSV bronchiolitis, RSV bronchiolitis may be more similar to childhood asthma.
Respiratory Syncytial Virus Infections/*immunology ; RANTES/analysis ; Nasopharynx/*immunology/secretion ; Male ; Infant ; Humans ; Female ; Eosinophil Cationic Protein/*analysis ; Chemokines, CC/analysis ; Chemokines/*analysis ; Bronchiolitis/*immunology

OBJECTIVEA deficient interferon-gamma (IFN-gamma) response has been involved in the pathogenesis of severe respiratory syncytial virus (RSV) infection. Gene polymorphisms in IFN-gamma/A+874T have been associated with the susceptibility to asthma and might be related to disease severity of RSV infection. This study investigated the single nucleotide polymorphisms (SNPs) of IFN-gamma/A+874T in Han children in Wenzhou area and to explore the correlation between gene polymorphisms of IFN-gamma/A+874T and the susceptibility and disease severity of RSV bronchiolitis, as well as the effect of SNPs upon nasopharyngeal secretions (NPS) IFN-gamma and total serum IgE levels.

METHODSOne hundred and fourteen hospitalized children with RSV bronchiolitis and 90 healthy controls were recruited. Sequence analysis was used for detecting the SNPs of IFN-gamma/A+874T. NPS IFN-gamma levels were measured using ELISA. Total serum IgE levels were assayed using the chemiluminescence method.

RESULTSIFN-gamma/A+874T gene polymorphisms were present in both the patient and the control groups. AA and AT genotypes were found in both groups, with a AA frequency of 82.5% vs 77.8% and a AT frequency of 17.5% vs 21.1% (p>0.05). The frequency of allele was 90.4% (A) and 9.6% (T) in the patient group, and 88.3% (A) and 11.7% (T) in the control group, respectively. There were no significant differences in the allele frequency between the two groups. Moreover, no difference was found both in NPS IFN-gamma and total serum IgE levels between AA and AT genotypes in the patient group. There were no significant differences in the variation of IFN-gamma/+874 between mild and moderate to severe cases.

CONCLUSIONSIFN-gamma/A+874T gene polymorphisms were present in Han children in Wenzhou area. Gene variations were not associated with the susceptibility and disease severity of RSV bronchiolitis as well as IFN-gamma and total serum IgE levels.

Bronchiolitis ; genetics ; immunology ; Female ; Genetic Predisposition to Disease ; Humans ; Immunoglobulin E ; blood ; Infant ; Interferon-gamma ; genetics ; Male ; Nasopharynx ; immunology ; Polymorphism, Single Nucleotide ; Respiratory Syncytial Virus Infections ; genetics ; immunology

Asthma ; immunology ; virology ; Bronchiolitis, Viral ; complications ; immunology ; virology ; Child ; Humans ; Respiratory Syncytial Virus Infections ; complications ; genetics ; immunology ; Risk Factors ; Severity of Illness Index

OBJECTIVETo study changes to CD4(+)CD25(high+)CD127(low) regulatory T cells (Treg) in peripheral blood from children with bronchiolitis, and to explore its clinical significance.

METHODSThirty-one children with bronchiolitis and aged under two years were randomly enrolled as the bronchiolitis group, and 25 under two-year-olds with bronchopneumonia were randomly enrolled as the bronchopneumonia group. A further twenty-five children with non-infectious diseases such as hernia and renal calculus served as the control group. The level of CD4(+)CD25(high+)CD127(low) Treg in peripheral blood was measured by multi-color detection and multi-parameter flow cytometry.

RESULTSThe proportion of CD4(+)CD25(high+)CD127(low) Treg in peripheral blood in the bronchiolitis group (8.0%±2.1%) was significantly lower than in the bronchopneumonia (9.6%±2.6%; P<0.05) and control groups (11.3%±2.9%; P<0.05).

CONCLUSIONSCD4(+)CD25(high+)CD127(low) Treg level in peripheral blood may be an index of immunological function in infants. A decreased level of CD4(+)CD25(high+)CD127(low) Treg in peripheral blood suggests that Treg cells may be involved in the pathogenesis and development of bronchiolitis.

Bronchiolitis ; immunology ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Infant ; Interleukin-2 Receptor alpha Subunit ; blood ; Interleukin-7 Receptor alpha Subunit ; blood ; Male ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo study the roles of CD4(+)CD25(+) regulatory T cells and Foxp3 mRNA in peripheral blood as well as serum total immunoglobulin E (IgE) in the pathogenesis of bronchiolitis caused by respiratory syncytial virus (RSV).

METHODSThe proportion of CD4(+)CD25(+) regulatory T cells and expression of Foxp3 mRNA in peripheral blood, and total serum IgE level were tested by flow cytometry, RT-PCR and ELISA respectively in 57 children with RSV bronchiolitis (26 atopic patients and 31 nonatopic patients). Twenty five healthy children were used as the control group.

RESULTSThe proportion of CD4(+)CD25(+) regulatory T cells in peripheral blood in children with bronchiolitis, either in the atopic (7.7+/- 1.6%)or the nonatopic group (8.8+/- 2.1%), was significantly lower than that in the control group (10.5+/- 1.6%) (P< 0.01). Foxp3 mRNA expression in peripheral blood was significantly lower in both atopic and nonatopic children with bronchiolitis than that in the control group (P< 0.01). Significantly increased total serum IgE level was noted in both atopic (241.2+/- 102.5 IU/mL) and nonatopic children (125.5+/- 63.2 IU/mL) with bronchiolitis compared with that in the control group (27.2+/- 10.5 IU/ml) (P< 0.01). There were significant differences in the proportion of CD4(+)CD25(+) regulatory T cells and Foxp3 mRNA expression in peripheral blood (P< 0.05) as well as total serum IgE level (P< 0.01) between the atopic and the nonatopic group. The proportion of CD4(+)CD25(+) regulatory T cells (r=-0.70, P< 0.01) and Foxp3 mRNA expression in peripheral blood (r=-0.79, P< 0.01) were closely negatively correlated to total serum IgE level.

CONCLUSIONSBoth the proportion of CD4(+)CD25(+) regulatory T cells and Foxp3 mRNA expression in peripheral blood were reduced, in contrast, the total serum IgE level increased in children with RSV bronchiolitis. This suggested that CD4(+)CD25(+) regulatory T cells and Foxp3 mRNA together with IgE participated in the pathogenesis of RSV bronchiolitis.

Bronchiolitis ; etiology ; immunology ; CD4-Positive T-Lymphocytes ; immunology ; Female ; Forkhead Transcription Factors ; genetics ; Humans ; Immunoglobulin E ; blood ; Infant ; Male ; RNA, Messenger ; blood ; Respiratory Syncytial Virus Infections ; etiology ; immunology ; T-Lymphocytes, Regulatory ; physiology

OBJECTIVEThe pathogenesis of bronchiolitis has not been fully identified. Immune function abnormality following virus infection may be associated with the pathogenesis. CD40 and CD40 ligand (CD40L) is a pair of co-stimulatory molecules in immunoreaction. They might play an important role in the development of bronchiolitis. This study aimed to investigate the expression of CD40 and CD40L in peripheral blood mononuclear cells (PBMCs) in children with bronchiolitis and explore their possible roles in the disease.

METHODSThirty children with bronchiolitis, 26 children with bronchopneumonia and 30 healthy children (control) were enrolled. Flow cytometry was used to detect CD40 and CD40L expression in PBMCs. Total serum IgE level was measured using ELISA.

RESULTSCompared with the control group, CD40L expression significantly increased in the bronchiolitis and bronchopneumonia groups (P< 0.05). The CD40L expression in the bronchiolitis group was significantly higher than that in the bronchopneumonia group (P< 0.05). A significantly increased CD40 expression was also found in the bronchiolitis group when compared with the bronchopneumonia and the control group (P< 0.01). Total serum IgE level in the bronchiolitis group was significantly higher than the bronchopneumonia and the control groups (P< 0.01). CD40 and CD40L expression was positively correlated with serum IgE level in the bronchiolitis group (r=0.607, r=0.819, respectively; P< 0.01).

CONCLUSIONSCD40 and CD40L expression in PBMCs and serum IgE level increased and there is a positive correlation between CD40 and CD40L expression and serum IgE level in children with bronchiolitis. Over-expression of CD40 and CD40L may play an important role in the development of bronchiolitis.

Bronchiolitis ; etiology ; immunology ; CD40 Antigens ; blood ; physiology ; CD40 Ligand ; blood ; physiology ; Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Leukocytes, Mononuclear ; chemistry ; Male