Pulmonary Innate Immunity in Children with Protracted Bacterial Bronchitis
The Journal of Pediatrics, 05/18/2012
Chang AB et al. – In children’s airways, hBD2, but not mannose–binding lectin [MBL], and surfactant protein–A [SP–A], relates to inflammation and infection. In children with protracted bacterial bronchitis (PBB), mechanisms involving airway hBD2 and MBL are augmented. These pulmonary innate immunity components and the ability of bronchoalveolar lavage (BAL) cells to respond to stimuli are unlikely to be deficient.Methods
- 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.
- 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.