1.Granulocyte-Macrophage colony stimulating factor in asthmatic patients infected with respiratory syncytial virus
The Medical Journal of Malaysia 2021;76(2):177-182
Introduction: It is estimated that at least 30 to 40% of asthma
attacks in adults are related to respiratory infections with
viruses. The majority of asthma-related viruses include
respiratory syncytial virus (RSV), rhinovirus, and
parainfluenza. Inflammatory cytokines are supposed to play
a vital role in causing inflammation of the respiratory tract as
regulators of proliferation, chemotaxis, and activation of
inflammatory cells.
Objectives: The aim of this study is to assess the role of
Granulocyte Macrophage-Colony Stimulating Factor (GMCSF) in asthmatic airway hyper-responsiveness associated
with RSV infections.
Materials and Methods: Forty five asthmatic cases and 45
healthy individuals were studied in a cross-sectional design.
All asthmatics underwent symptom score assessment.GMCSF concentrations in sputum and RSV-IgM/IgG in serum
samples were measured for all participants by Enzyme
Linked Immuno-Sorbent Assay (ELISA).
Results: The GM-CSF concentration level was significantly
higher in asthmatics (270.27± 194.87pg/mL) especially
among moderate and severe disease with mean
concentration of 197.33±98.47 and 521.08± 310.04
respectively, compared to healthy controls (22.20±21.27 pg/
mL) (p=0.0001). The sputum level of GM-CSF in asthmatics
is highly significant associated with positive anti-RSV IgG
sera which represents 35/45(77.8%) with mean GM-CSF
concentration of (276.99± 86.42) compared with controls at
about 31/45 (68.9%) with GM-CSF mean concentration of
(22.84±23.47). On the other hand, positive anti-RSV IgM in
asthma cases was 8 out of 45(17.8 %) with GM-CSF mean
concentration of (307.25± 306.65). Furthermore, GM-CSF
sputum level was significantly correlated with eosinophil
count especially in moderate and severe asthma.
Conclusions: This study revealed that GM-CSF level is
associated with eosinophilia and indicates asthma severity
that might be evident during RSV infection .The distinctive
GM-CSF features observed in the sputum from asthmatics
with RSV may be useful as a diagnostic methods to help
match patients with antibody therapy.

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