Thymus activity measured by T-cell receptor excision circles in patients with different severities of respiratory syncytial virus infection

BMC Infectious Diseases

Research Article

Kiran Aftab Gul¹  Hans O. Fjærli²  Tonje Sonerud³  Britt Nakstad⁴  Christopher S. Inchley⁴  Tore Gunnar Abrahamsen⁵ 

[1] Department of Pediatric Research, Women and Children’s Division, Oslo University Hospital Rikshospitalet, Oslo, Norway;Department of National Newborn Screening, Women and Children’s Division, Oslo University Hospital Rikshospitalet, Oslo, Norway;Clinic of Pediatric and Adolescent Medicine, Women and Children’s Division, Oslo University Hospital Rikshospitalet, Oslo, Norway;Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway;Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway;Department of Clinical Molecular Biology and Laboratory Sciences (EpiGen), University of Oslo, Akershus University Hospital, Lørenskog, Norway;Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Clinic of Pediatric and Adolescent Medicine, Women and Children’s Division, Oslo University Hospital Rikshospitalet, Oslo, Norway;

关键词: Respiratory syncytial virus;    Thymus;    T-cell receptor excision circles;    Children;    Bronchiolitis;   

DOI  :  10.1186/s12879-016-2148-0

 received in 2016-07-11, accepted in 2016-12-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRespiratory syncytial virus (RSV) infection is an important cause of hospitalization in previously healthy infants. Immunological mechanisms predisposing infants to severe disease are poorly understood. Early biomarkers for disease severity may assist clinical decisions. We investigated T-cell receptor excision circles (TREC), episomal DNA made during thymic T-cell receptor rearrangement, and a marker for thymus activity, both during disease and in neonatal screening cards as a risk factor for RSV disease severity.MethodsOne hundred thirteen patients hospitalized with RSV infection <12 months of age, grouped by disease severity, were available for this investigation, in which we conducted both a prospective and a case-control study. The prospective study included 47 RSV positive infants (mild n = 13, moderate n = 10, severe n = 24). TREC counts were determined by PCR of DNA extracted from EDTA-blood collected on hospitalization, and corrected for lymphocytes using ANCOVA. The case-control study included 85 newborns who later in infancy became RSV positive (mild n = 32, moderate n = 24, severe n = 29) and 47 newborns who never developed RSV disease as healthy controls included from health centres in the same catchment area. TRECs were measured using DNA extracted from dry blood spots from stored neonatal screening cards, followed by PCR. Student’s T-test compared patients with controls, ANOVA compared disease severity groups.ResultsDuring RSV infection patients in the severe disease group had significantly lower (p = 0.017) TREC/200 μL blood compared to the other two disease groups, after correction for lymphocyte count. Newborn TREC levels, were significantly higher in RSV patients compared to controls (p < 0.0001). No significant differences in TREC copies at birth were found between disease severities.ConclusionDuring acute RSV infection a lower number of TREC is found in the severe disease group. TREC has potential as an immunological marker for severe RSV infection. Higher neonatal TREC counts indicate that infants later presenting with severe RSV do not have reduced thymic activity at birth and probably no congenital T-cell defect.

【 授权许可】

CC BY   
© The Author(s). 2017