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Previous issue date: 2016-08-29 / Funda??o de Amparo ? Pesquisa do Estado do Rio Grande do Sul - FAPERGS / Background/Aim: According to experimental data, interferon type I has a key role in innate immune response against influenza infection. Studies on humans are still scarce and the characterization of interferon response in children may help to identify patients at risk. Our aim is to compare respiratory levels of interferon-? and influenza disease severity in pediatric patients. Methods: Children aged less than five years of age with influenza-like illness seeking pediatric care within the first 72 hours of disease onset were prospectively included. Clinical and demographic data and respiratory secretions through nasal wash were obtained. Influenza infection was confirmed with Reverse-Transcription Polymerase Chain Reaction and respiratory levels of interferon-? were measured by ELISA. Enrolled individuals were followed until the end of disease. Patients whose influenza infection was excluded were used as control group. Results: Twenty four patients with confirmed influenza infection were included, five of them requiring hospitalization. Subtypes A(H3N2) and B were confirmed in ten and fourteen patients, respectively. Seventy-six patients without influenza, 39 of them hospitalized, were included as controls. Age younger than 6 months was significantly more frequent in individuals from both hospitalized groups compared to outpatients (59% vs 23.2%, p<0.01). All other clinical and demographical data were similar among groups. Median levels of interferon-? were significantly higher in outpatients with influenza than both inpatients with influenza and patient without influenza, hospitalized or not (p<0.001). Median in pg/ml (interquartile amplitude) were 263.2 (58.3-634), 0 (0-49), 0 (0-2.6) and 0 (0-19.4) in four groups above, respectively. Conclusion: Lower levels of interferon-? in patients with more severe influenza reinforce experimental evidence about its protective role in influenza infection severity. / Introdu??o/objetivo: Interferon tipo I exerce um papel central na resposta imune inata contra a infec??o por influenza de acordo com dados experimentais. Evid?ncias em humanos ainda s?o incipientes e a caracteriza??o da resposta do interferon pode auxiliar na estratifica??o de risco. Nosso objetivo ? comparar os n?veis de interferon-? em secre??es respirat?rias entre pacientes hospitalizados e ambulatoriais com infec??o por influenza confirmada laboratorialmente. M?todos: Foram inclu?dos prospectivamente pacientes com idade inferior a cinco anos com s?ndrome gripal atendidos no hospital com menos de 72 horas do in?cio do quadro cl?nico. Dados cl?nicos e demogr?ficos, al?m de secre??es respirat?rias atrav?s de lavado nasal foram coletados. A infec??o por influenza foi confirmada por Reverse-Transcription Polymerase Chain Reaction. N?veis respirat?rios de interferon-? foram aferidos por ELISA. Os pacientes inclu?dos, inclusive os n?o hospitalizados, foram seguidos at? o final do quadro cl?nico. Pacientes com infec??o por influenza descartada foram utilizados como grupo controle. Resultados: Vinte e quatro pacientes com infec??o por influenza confirmada foram inclu?dos, cinco destes hospitalizados. Os subtipos A(H3N2) e B foram confirmados em dez e quatorze pacientes, respectivamente. Setenta e seis pacientes sem influenza, 39 desses hospitalizados, foram utilizados como controles. A idade inferior a seis meses foi significativamente mais frequente nos pacientes hospitalizados, com ou sem influenza (59% vs 23.2%, p<0.01). Todas as outras vari?veis cl?nicas e demogr?ficas foram semelhantes entre os grupos. Os n?veis de interferon-? foram significativamente maiores em crian?as com influenza n?o hospitalizadas em compara??o com crian?as hospitalizadas com influenza e com os controles hospitalizados e n?o hospitalizados (p<0.001). A mediana em pg/ml (amplitude interquartil) foi 263.2 (58.3-634), 0 (0-49), 0 (0-2.6) e 0 (0-19.4) nos quatro grupos acima, respectivamente. Conclus?o: Os n?veis mais baixos de interferon-? nos pacientes com quadros mais graves de influenza refor?am evid?ncias experimentais sobre o papel protetor do interferon na infec??o por esse v?rus.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6991 |
| Date | 29 August 2016 |
| Creators | Scotta, Marcelo Comerlato |
| Contributors | Mattiello, Rita |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a, PUCRS, Brasil, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 3098206005268432148, 600, 600, 600, 600, -8624664729441623247, -969369452308786627, -3614735573891122254 |
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