Background: Respiratory syncytial virus (RSV) stimulates the production of specific immunoglobulin (Ig) E and IgG4 antibodies as a hallmark of the Th2 immune response. In this paper, we evaluated the occurrence of atopic diseases in 10-year-old children who were positive for RSV-specific IgG antibodies during infancy. Methods: The prospective follow-up of 72 children included a physical examination, an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the determination of RSV-specific antibodies and total and allergen-specific IgE. Results: Children with asthma had their first wheezing episode at a younger age (χ2 8.097, df = 1, p = 0.004). RSV-specific IgG4 levels at year one were positively correlated with atopic dermatitis (AD) (tau_b = 0.211, p = 0.049) and current AD (tau_b = 0.269, p = 0.012); and RSV-specific IgE levels were positively correlated with allergic rhinitis (AR) (tau_b = 0.290, p = 0.012) and current AR (tau_b = 0.260, p = 0.025). Positive RSV-specific IgE at the age of one increased the chances of asthma occurrence by 5.94 (OR = 5.94, 95% CI = 1.05–33.64; p = 0.044) and the chances of AR by more than 15 times (OR = 15.03, 95% CI = 2.08–108.72; p = 0.007). A positive family history of atopy increased the chances of asthma occurrence by 5.49 times (OR = 5.49, 95% CI = 1.01–30.07; p = 0.049), and a longer duration of exclusive breastfeeding lowered that chance (OR = 0.63, 95% CI = 0.45–0.89; p = 0.008). Prenatal smoking increased the chances of AR occurrence by 7.63 times (OR = 7.63, 95% CI = 1.59–36.53; p = 0.011). Conclusion: RSV-specific IgE and RSV-specific IgG4 antibodies could be risk markers for the development of atopic diseases in children.

Article: Respiratory syncytial virus specific immunoglobulin G4 antibodies and atopic diseases in children - Minerva Pediatrics 2022 Feb 15 - Minerva Medica - Journals

Periostin is a matricellular protein upregulated in response to IL-4 and IL-13, that have a role in development of allergic diseases. Previous studies reported that periostin can be a non-invasive biomarker of T2-driven inflammatory response in asthma in adults, with inconsistent results in children. None of the studies examined the association of serum periostin levels with asthma symptoms in children who have been infected with respiratory syncytial virus (RSV) in the first two years of life. The aim of this study was to determine the usefulness of serum periostin levels as a potential biomarker for asthma, especially recent asthma symptoms in children. This prospective study observed 72 children from birth. RSV infection was confirmed with positive serum specific RSV Immunoglobulin G (IgG) at one and/or two years of age. Asthma was diagnosed according to International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire at 10 years of age. Fractional exhaled nitric oxide (FeNO), lung function, skin prick test and blood samples for analysis of specific immunoglobulin E (sIgE) on standard pallet of inhalant allergens, total IgE (tIgE) and periostin were provided. At 10 years of age, asthma was diagnosed in 23 (31.9%) of the observed children. In 15 (20.8%) of them who reported asthma symptoms during the last 12 months, median serum periostin levels were 40.04 ng/ml. In 57 (79.2%) children who were free of asthma symptoms in the last 12 months, mean serum periostin levels were 30.57 ng/ml. Serum periostin levels correlated significantly with recent asthma symptoms (Kendall’s Tau-B = 0.236, p = 0.016). Serum periostin levels significantly correlated with asthma symptoms during the last 12 months in 10-year-old children who were infected with RSV during their first two years of life. Our preliminary results suggest that serum periostin level may be useful in diagnosing asthma in children, especially those with recent asthma symptoms and history of RSV infection in infancy.

Razumijevanje čimbenika rizika povezanih s ponavljajućim ili perzistentnim piskanjem, ali i s razvojem, 6progresijom i pogoršanjem astme važno je u ciljanoj strategiji prevencije astme te u svrhu izrade smjernica za praćenje rizičnih bolesnika. Iako...