Abstract
We studied children with croup (C) or upper respiratory illness (URI) alone due to PV to determine if abnormalities of immune regulation play a role in the pathogenesis of C. The presence of PV-specific IgE in nasopharyngeal secretions (NPS) was determined by an ELISA test. Whole blood lymphocyte transformation (LTF) responses to PV antigen were determined in vitro, and histamine was added to LTF assays in order to determine the degree of suppression of PV-specific LTF responses.
As expected, patients with C had significantly greater titers of PV-specific IgE in NPS than patients with URI alone (mean titer = 4.2 ± 1 vs. 1.6 ± 1, p<0.05). LTF responses to PV antigen were also greater in patients with C than in patients with URI (mean stimulation index = 3.7 ± 0.8 vs. 2.6 ± 0.4, p<0.01). The addition of histamine at 10−8 and 10−6 M to LTF assays resulted in a 70% suppression of the LTF response at each histamine concentration in URI patients, but only in a 36% and 40% suppression, respectively, in C patients (p<0.05). For the entire study group, the magnitude of histamine-induced suppression was inversely correlated with the peak titer of PV-IgE produced (p<0.01). Reduced function of a suppressor cell regulating both IgE production and lymphoproliferative responses to PV antigen may underlie the pathogenesis of PV-induced croup, and links this disease to bronchiolitis and to atopic disease states.
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Welliver, R., Sun, M. & Losi, D. PATHOGENESIS OF PARAINFLUENZA VIRUS (PV)-INDUCED CROUP: ROLE OF DEFICIENT REGULATION OF CELL-MEDIATED IMMUNE RESPONSE AND IGE PRODUCTION. Pediatr Res 18 (Suppl 4), 267 (1984). https://doi.org/10.1203/00006450-198404001-01042
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DOI: https://doi.org/10.1203/00006450-198404001-01042