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The Significances of Chest X-ray Findings and Serum IFN-γ, IL-5, ECP as Predictors of Prognosis of Bronchiolitis and Bronchopneumonia in Infants

Journal of the Korean Pediatric Society 2003;46(3):230-235.
Published online March 15, 2003.
The Significances of Chest X-ray Findings and Serum IFN-γ, IL-5, ECP as Predictors of Prognosis of Bronchiolitis and Bronchopneumonia in Infants
Su Hyun Cho, Hyun Seung Lee, Mi Hee Lee, Joon Sung Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
영아의 세기관지염과 기관지 폐렴의 예후 지표로서 혈청 IFN-γ, IL-5 및 ECP치와 흉부 방사선 소견의 의의
조수현, 이현승, 이미희, 이준성
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Joon Sung Lee, Email: jslee@catholic.ac.kr
Abstract
Purpose
: Lower respiratory tract infections in infant and young children are often due to a virus, especially the Respiratory syncytial(RS) virus. Chest X-ray findings in bronchiolitis and bronchopneumonia are different. The radiographic hallmark of bronchiolitis is pulmonary hyperinflation and similar to that of bronchial asthma. Bronchiolitis is predisposed to later development of bronchial asthma. To evaluate the difference of immuno-pathophysiology between bronchiolitis and bronchopneumonia, we measured IFN-γ(Th1 cytokine), IL-5(Th2 cytokine) and ECP. We also investigated whether X-ray findings in infants with viral infected respiratory disease are useful in predicting the development of asthma.
Methods
: We measured IL-5, ECP, IFN-γ levels in serum from 21 infants with bronchiolitis and 21 infants with bronchopneumonia and 16 infants without pulmonary viral diseases.
Results
: IL-5 levels of bronchiolitis and bronchopneumonia were significantly higher than those of the control(P=0.02, P=0.042). IL-5 levels of bronchiolitis were higher than those of bronchopneumonia but there was no significant difference. IFN-γ levels of bronchopneumonia were higher than those of bronchiolitis but there was no significant difference. ECP levels of bronchiolitis and bronchopneumonia were higher than those of the control but only those of bronchiolitis were significantly higher than those of the control(P=0.045). IL-5 and ECP levels did not show any significant correlation in bronchiolitis, bronchopneumonia and control groups.
Conclusion
: We cannot prove the distinct differences in serum Th1/Th2 cytokine profiles between bronchiolitis and bronchopneumonia in infants. These results suggest that the different findings on chest X-ray between bronchiolitis and bronchopneumonia could not be a predictor of later development of asthma.
Key Words: Bronchiolitis, Bronchopneumonia, Chest X-ray, IL-5, IFN-γ, ECP


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