Pulmonary Innate Immunity in Children with Protracted Bacterial Bronchitis

Anne Chang; Stephanie Yerkovich; Peter Gibson; Sophie Anderson-James; Helen Petsky; Melanie Carroll; Ian Brent Masters; Julie Marchant; Danielle Wurzel; John Upham

doi:10.1016/j.jpeds.2012.03.049

Pulmonary Innate Immunity in Children with Protracted Bacterial Bronchitis

Anne Chang, Stephanie Yerkovich, Peter Gibson, Sophie Anderson-James, Helen Petsky, Melanie Carroll, Ian Brent Masters, Julie Marchant, Danielle Wurzel, John Upham

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To determine bronchoalveolar lavage (BAL) levels of 3 innate immunity components (human β-defensin-2 [hBD2], mannose-binding lectin [MBL], and surfactant protein-A [SP-A]), the relationship with airway neutrophilia and infection, and cytokine production of stimulated BAL cells in children with current protracted bacterial bronchitis (PBB), children with resolved PBB (PBB well), and controls.

Study design: BAL of 102 children (mean age 2.8 years) fulfilling predefined criteria of current PBB (n = 61), PBB well (n = 20), and controls (n = 21) was cultured (quantitative bacteriology) and viruses examined by polymerase chain reaction. hBD2, MBL, and SP-A were measured, and cytokine production by lipopolysaccharide-stimulated BAL cells was determined.

Results: Median hBD2 and MBL levels were significantly higher in the current PBB group (hBD2 = 164.4, IQR 0-435.5 pg/mL; MBL = 1.7, 0.4-4 ng/mL) than in the PBB well group (hBD2 = 0, IQR 0-85.2; MBL = 0.6, IQR 0.03-2.9) and controls (hBD2 = 3.6, IQR 0-126; MBL = 0.4, IQR 0.02-79). hBD2 was significantly higher in children with airway infection (n = 54; median 76.9, IQR 0-397.3) compared with those without (n = 48; 0, IQR 0-236.3), P = .04. SP-A levels and cytokine production of stimulated BAL cells were similar between groups.

Conclusion: In children’s airways, hBD2, but not MBL and SP-A, relates to inflammation and infection. In children with PBB, mechanisms involving airway hBD2 and MBL are augmented. These pulmonary innate immunity components and the ability of BAL cells to respond to stimuli are unlikely to be deficient.

Original language	English
Article number	e1
Pages (from-to)	621-625
Number of pages	5
Journal	Journal of Pediatrics
Volume	161
Issue number	4
DOIs	https://doi.org/10.1016/j.jpeds.2012.03.049
Publication status	Published - Oct 2012

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10.1016/j.jpeds.2012.03.049

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@article{b6a6860d32b4427d9b71bb352306d694,

title = "Pulmonary Innate Immunity in Children with Protracted Bacterial Bronchitis",

abstract = "Objective: To determine bronchoalveolar lavage (BAL) levels of 3 innate immunity components (human β-defensin-2 [hBD2], mannose-binding lectin [MBL], and surfactant protein-A [SP-A]), the relationship with airway neutrophilia and infection, and cytokine production of stimulated BAL cells in children with current protracted bacterial bronchitis (PBB), children with resolved PBB (PBB well), and controls.Study design: BAL of 102 children (mean age 2.8 years) fulfilling predefined criteria of current PBB (n = 61), PBB well (n = 20), and controls (n = 21) was cultured (quantitative bacteriology) and viruses examined by polymerase chain reaction. hBD2, MBL, and SP-A were measured, and cytokine production by lipopolysaccharide-stimulated BAL cells was determined.Results: Median hBD2 and MBL levels were significantly higher in the current PBB group (hBD2 = 164.4, IQR 0-435.5 pg/mL; MBL = 1.7, 0.4-4 ng/mL) than in the PBB well group (hBD2 = 0, IQR 0-85.2; MBL = 0.6, IQR 0.03-2.9) and controls (hBD2 = 3.6, IQR 0-126; MBL = 0.4, IQR 0.02-79). hBD2 was significantly higher in children with airway infection (n = 54; median 76.9, IQR 0-397.3) compared with those without (n = 48; 0, IQR 0-236.3), P = .04. SP-A levels and cytokine production of stimulated BAL cells were similar between groups.Conclusion: In children{\textquoteright}s airways, hBD2, but not MBL and SP-A, relates to inflammation and infection. In children with PBB, mechanisms involving airway hBD2 and MBL are augmented. These pulmonary innate immunity components and the ability of BAL cells to respond to stimuli are unlikely to be deficient.",

keywords = "amoxicillin plus clavulanic acid, beta defensin 2, cytokine, mannose binding lectin, surfactant protein A, antibiotic therapy, article, bacterium culture, bronchitis, bronchoscopy, child, childhood disease, controlled study, coughing, cytokine production, female, human, innate immunity, lung lavage, macrophage, major clinical study, male, monocyte, Mycoplasma pneumoniae, neutrophil, polymerase chain reaction, preschool child, priority journal, protracted bacterial bronchitis, beta-Defensins, Bronchitis, Chronic, Bronchoalveolar Lavage Fluid, Bronchoscopy, Child, Preschool, Female, Humans, Immunity, Innate, Infant, Male, Mannose-Binding Lectin, Pulmonary Surfactant-Associated Protein A",

author = "Anne Chang and Stephanie Yerkovich and Peter Gibson and Sophie Anderson-James and Helen Petsky and Melanie Carroll and Masters, {Ian Brent} and Julie Marchant and Danielle Wurzel and John Upham",

year = "2012",

month = oct,

doi = "10.1016/j.jpeds.2012.03.049",

language = "English",

volume = "161",

pages = "621--625",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby International",

number = "4",

}

TY - JOUR

T1 - Pulmonary Innate Immunity in Children with Protracted Bacterial Bronchitis

AU - Chang, Anne

AU - Yerkovich, Stephanie

AU - Gibson, Peter

AU - Anderson-James, Sophie

AU - Petsky, Helen

AU - Carroll, Melanie

AU - Masters, Ian Brent

AU - Marchant, Julie

AU - Wurzel, Danielle

AU - Upham, John

PY - 2012/10

Y1 - 2012/10

N2 - Objective: To determine bronchoalveolar lavage (BAL) levels of 3 innate immunity components (human β-defensin-2 [hBD2], mannose-binding lectin [MBL], and surfactant protein-A [SP-A]), the relationship with airway neutrophilia and infection, and cytokine production of stimulated BAL cells in children with current protracted bacterial bronchitis (PBB), children with resolved PBB (PBB well), and controls.Study design: BAL of 102 children (mean age 2.8 years) fulfilling predefined criteria of current PBB (n = 61), PBB well (n = 20), and controls (n = 21) was cultured (quantitative bacteriology) and viruses examined by polymerase chain reaction. hBD2, MBL, and SP-A were measured, and cytokine production by lipopolysaccharide-stimulated BAL cells was determined.Results: Median hBD2 and MBL levels were significantly higher in the current PBB group (hBD2 = 164.4, IQR 0-435.5 pg/mL; MBL = 1.7, 0.4-4 ng/mL) than in the PBB well group (hBD2 = 0, IQR 0-85.2; MBL = 0.6, IQR 0.03-2.9) and controls (hBD2 = 3.6, IQR 0-126; MBL = 0.4, IQR 0.02-79). hBD2 was significantly higher in children with airway infection (n = 54; median 76.9, IQR 0-397.3) compared with those without (n = 48; 0, IQR 0-236.3), P = .04. SP-A levels and cytokine production of stimulated BAL cells were similar between groups.Conclusion: In children’s airways, hBD2, but not MBL and SP-A, relates to inflammation and infection. In children with PBB, mechanisms involving airway hBD2 and MBL are augmented. These pulmonary innate immunity components and the ability of BAL cells to respond to stimuli are unlikely to be deficient.

AB - Objective: To determine bronchoalveolar lavage (BAL) levels of 3 innate immunity components (human β-defensin-2 [hBD2], mannose-binding lectin [MBL], and surfactant protein-A [SP-A]), the relationship with airway neutrophilia and infection, and cytokine production of stimulated BAL cells in children with current protracted bacterial bronchitis (PBB), children with resolved PBB (PBB well), and controls.Study design: BAL of 102 children (mean age 2.8 years) fulfilling predefined criteria of current PBB (n = 61), PBB well (n = 20), and controls (n = 21) was cultured (quantitative bacteriology) and viruses examined by polymerase chain reaction. hBD2, MBL, and SP-A were measured, and cytokine production by lipopolysaccharide-stimulated BAL cells was determined.Results: Median hBD2 and MBL levels were significantly higher in the current PBB group (hBD2 = 164.4, IQR 0-435.5 pg/mL; MBL = 1.7, 0.4-4 ng/mL) than in the PBB well group (hBD2 = 0, IQR 0-85.2; MBL = 0.6, IQR 0.03-2.9) and controls (hBD2 = 3.6, IQR 0-126; MBL = 0.4, IQR 0.02-79). hBD2 was significantly higher in children with airway infection (n = 54; median 76.9, IQR 0-397.3) compared with those without (n = 48; 0, IQR 0-236.3), P = .04. SP-A levels and cytokine production of stimulated BAL cells were similar between groups.Conclusion: In children’s airways, hBD2, but not MBL and SP-A, relates to inflammation and infection. In children with PBB, mechanisms involving airway hBD2 and MBL are augmented. These pulmonary innate immunity components and the ability of BAL cells to respond to stimuli are unlikely to be deficient.

KW - amoxicillin plus clavulanic acid

KW - beta defensin 2

KW - cytokine

KW - mannose binding lectin

KW - surfactant protein A

KW - antibiotic therapy

KW - article

KW - bacterium culture

KW - bronchitis

KW - bronchoscopy

KW - child

KW - childhood disease

KW - controlled study

KW - coughing

KW - cytokine production

KW - female

KW - human

KW - innate immunity

KW - lung lavage

KW - macrophage

KW - major clinical study

KW - male

KW - monocyte

KW - Mycoplasma pneumoniae

KW - neutrophil

KW - polymerase chain reaction

KW - preschool child

KW - priority journal

KW - protracted bacterial bronchitis

KW - beta-Defensins

KW - Bronchitis, Chronic

KW - Bronchoalveolar Lavage Fluid

KW - Bronchoscopy

KW - Child, Preschool

KW - Female

KW - Humans

KW - Immunity, Innate

KW - Infant

KW - Male

KW - Mannose-Binding Lectin

KW - Pulmonary Surfactant-Associated Protein A

U2 - 10.1016/j.jpeds.2012.03.049

DO - 10.1016/j.jpeds.2012.03.049

M3 - Article

VL - 161

SP - 621

EP - 625

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 4

M1 - e1

ER -

Pulmonary Innate Immunity in Children with Protracted Bacterial Bronchitis

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