Levels And Clinical Significance Of IL-18、 MCP-1in Serum From Children With Bronchiolitis

Background：bronchiolitis is one of the common asthmatic diseases inchildren which characterized by wheezing owing to airway obstruction, mostcases are caused by viruses,occurring in a seasonal pattern, with highestincidence in the winter in temperate climates, and in the rainy season in warmercountries. Clinical features are fever, nasaldischarge, cough and wheezy. Onexamination there are inspiratory crackles and high-pitched expiratory wheeze.In recent years, more and more studies have found that the clinical symptomsof bronchiolitis are similar to asthma. Moreover, it has a high incidence ofrepeated wheeze, and is closely related to bronchial asthma. So far themechanism of bronchiolitis remained unclear, but immunology pathogenesiswas recognized at home and abroad, and in this process,cytokines play animportant role.Interleukin-18(IL-18) is a pleiotropic cytokine and induce the expressionof IFN-γ and is involved in the differentiation of Th1as well as in Th1response resulting in production of Th2type cytokine, which suggests IL-18may play an important role in the diseases mediated by Th1or Th2. IL-18hasbeen given attention in the asthma pathogenesis, but its role in bronchilitisneeds to be studied further. Monocyte chemoattractant protein1(MCP-1) is animportant chemokine, regulates the migration and infiltration of many cells andis involved in airway inflammation and pathogenesis of tissue damage. MCP-1may be involved in the pathogenesis of bronchilitis and the aim of the study isto investigate the roles of IL-18and MCP-1in bronchilitis.Objective: Through study the Immunology pathogenesis of bronchiolitis,to investigate the effect of IL-18and MCP-1in the pathogenesis ofbronchiolitis and the relation of disease severity and atopy. Methods:The object of this study is enrolled patients with bronchiolitisadmitted to the First Bethune Hospital of Jilin University pediatrics departmentfrom Novermber2010to December2011. Patients without infection during thesame period in the Department of Pediatric Surgery were selected as the controlgroup. Serum IL-18、MCP-1are measured in38cases of children with theacute phase of bronchiolitis,20cases with bronchiolitis in the recovery phaseand20cases of the control group without infectious diseases bydouble-antibody sandwich enzymelinked immunosorbent assay (ELISA). Alldata is statistically analyzed by the software SPSS18.0.Results:1.The levels of serum IL-18and MCP-1in patients with bronchiolitis ofthe acute phase were higher than those in the convalescence stage ofbronchiolitis and the control group,there was statistically significant differenceof them.(P<0.01).2.There was no statistically significant difference in the levels of serumIL-18and MCP-1between the convalescence stage of bronchiolitis and thecontrol group.(P>0.05).3.The levels of serum IL-18and MCP-1in patients with bronchiolitis ofthe severe group were higher than the mild group,there was statisticallysignificant difference of them.(P<0.01).4.There was no statistically significant difference in the levels of serumIL-18and MCP-1between the atopy group and the non-atopy group.(P>0.05).Conclusions:1. The levels of serum IL-18and MCP-1in the acute phase ofbronchiolitis were higher than those in the control group, and in theconvalescence stage they had dropped, which suggests that IL-18and MCP-1are involved in the pathogenesis of bronchiolitis.2. The levels of serum IL-18and MCP-1in patients with bronchiolitis of the severe group were also higher, which suggests that IL-18and MCP-1arerelated with the disease severity.3. There was no statistically significant difference in the levels of theserum IL-18and MCP-1between the atopy group and the non-atopy group,which suggests that IL-18and MCP-1may have no relation with atopic quality.4. The levels of serum IL-18and MCP-1is positively related.