Serum Interferon Gamma Induced Protein-10 in Atopic and Non Atopic Infants with Wheezy Chest

Abstract

CXCL10 (IP10) is over expressed in a diverse range of human diseases. It has been shown to be involved in the pathological processes of three main human disorders, infectious diseases,autoimmune diseases and cancer(Kanda et al.,2007). Our study was designed to investigate serum levels of IP-10 among infants presenting with wheezy chest to anticipate the role of this chemokine in those infants in relation to severity of illness, presence of signs of infection or evidence of atopy. Three groups of infants were enrolled in the study:Group Awhich includes 40 infants having wheezy chest at time of enrolment with age range 6 -18. GroupB:included25 infants having viral infection not causing wheezy chest and without patient or family history suggestive of allergy with age range 6-21 months.Group C: included25 healthy infants with no symptoms of infection at time of enrolment and without history of allergic manifestations with age range 8-23 months. The study was carried out in the emergency department and the outpatient clinic of the Children's hospital of Ain shams university, Cairo, Egypt, during the period from December 2014 to March 2015. Informed consents were obtained from parents or caregiver of patients before enrolment in the study. Each infant was subjected to clinicaland laboratory evaluation(complete blood count, serum IP-10 measurement, and CRP in addition to skin prick test).Concentration of serum IP-10 was assessed using an enzyme-linked immunosorbent assay. The results revealed astatistical significant difference in serum IP-10 level in the group of wheezy infants in comparison to the other two groups and was significantly lower in infants with viral infections without wheeze as compared to the healthy infants. Fourteen(35%) out of the forty patients of group A showed positive SPT results for one or more of the tested allergens while 26 patients (65%) had not. House dust mite 6/14 (42.9%) and egg allergens 5/14(35.1%) were the most commonly encountered allergens among group A patients. IP-10 levels in group A patients did not vary according to the type of milk feeding (breast, formula, breast andformula feeding). Also, the presence of signs of infection, or evidence of atopy did not have significant influence on IP-10 levels. However, serum IP-10 levels were found to be significantly higher among wheezy infants who required hospital admission in comparison to those who did not.Serum IP-10 level of 140 pg/ ml was found to havesome predictive value for hospital admission among infants with wheezy chest with sensitivity 90 % and specificity 86 %, while a level of 165 pg/ml showed 51 % sensitivity and 100 % specificity for requirement of hospital admission. Infants of group Awho had clinical manifestations suggestive of respiratory infections had higher levels of IP-10 than those in group B (respiratory infections only without wheezes), (p<0.001) denoting the strong influence of bronchospasm on the expression of this chemokine. In conclusion, our data suggest a possible link of serum IP-10 levels to infant wheezing which is not explained exclusively by the association with viral infection. These data might denote a possible future therapeutic role for IP-10 antagonist in severe cases of asthma or wheezing illness. However, our study is limited by the small sample size and the lack of follow-up sampling. Further wider scale studies are recommended for better elucidation of the IP-10 expression and role in wheezing illness at different age groups and the impact of targeting IP-10 in severe cases of pediatric asthma or other wheezing illnesses and its relation to various respiratorypathogens.