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Skewing of the T-helper (Th1/Th2) cytokine balance in respiratory syncytial virus infection: impact on clinical severity

Acute RSV infection in infancy produces some asthma-like symptoms and may be followed by a recurrent wheeze later in the childhood. It has been proposed that RSV infection stimulates type 2 cytokine responses, akin to those found in atopy and asthma. We obtained peripheral blood cells from RSV-infected infants (n=30) and healthy controls (n=10). After restimulating them in vitro, intracellular IL-4 and IFN-g were measured by flow cytometry. Cells from RSV-infected infants produced more IL-4 and less IFN-g than healthy controls. Interleukin-4 production was more frequent in CD8 than CD4 cells, and the bias towards IL-4 production was the greatest in infants with mild infections. Suprisingly, B-lymphocytes in peripheral blood produced IL-4 as well. Our conclusions are that RSV infection is associated with IL-4 production in peripheral T cells, and that peripheral blood in infants with severe disease may be depleted of cytokine-producing cells.

T-helper (Th1/Th2); cytokine; respiratory syncytial virus-RSV; infection; : clinical syndrome

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