Eastern Regional Meeting Abstracts

1 CYTOKINE AIRWAY RESPONSES TO ACUTE RHINOVIRUS INFECTION AND RESPIRATORY MORBIDITY IN SEVERE PREMATURE CHILDREN Geovanny F. Perez( Gustavo Nino, Krishna Pancham, Shehlanoor Huseni, Amisha Jain1, Carlos Rodriguez-Martinez, Diego Preciado, Mary RoseR Pulmonary and Sleep Medicine, Children’s National Medical Health Systems, Washington DC, United States; Center for Genetic Research Medicine, Children’s National Health Systems, Washington DC, United States; Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia and Division of Pediatric Otorhinolaryngology, Departments of Surgery and Pediatrics, George Washington University School of Medicine and Health Sciences, Washington DC, United States. Purpose of Study: Rhinovirus (RV) has been strongly linked to the pathogenesis of asthma in children. Prematurity is a risk factor for severe RV infection in early life, but is unknown if RV elicits pro-asthmatic airway cytokine responses in premature infants. This study investigated if young children born severely premature (G32 weeks gestation) exhibit airway secretion of Th2/Th17 cytokines during natural RV infections and if RV-induced Th2/Th17 responses are linked to more respiratory morbidity in premature children during the first two years of life. Methods Used: We measured Th2/Th17 nasal airway cytokines in a retrospective cohort of young children aged 0-2 years with PCR-confirmed RV infection or non-detectable virus. Protein levels of IL-4, IL13, TSLP and IL-17 were determined with multiplex magnetic bead immunoassays. Demographic and clinical variables were obtained by electronicmedical record (EMR) review. Summary of Results: The study comprised 214 children born full term (n=108), pre-term (n=44) or severely premature (n=62). Natural RV infection in severely premature children was associated with elevated airway secretion of Th2 (IL-4 and IL-13) and Th17 (IL-17) cytokines, particularly in subjects with history of bronchopulmonary dysplasia. Severely premature children with high RV-induced airway IL-4 had recurrent respiratory hospitalizations (median 3.65 hosp/year; IQR 2.8-4.8) and were more likely to have at least one pediatric intensive care unit admission during the first two years of life (OR 8.72; 95% CI 1.3-58.7; p=0.02). Conclusions: Severely premature children have increased airway secretion of Th2/Th17 cytokines during RV infections, which is associated with more respiratory morbidity in the first two years of life.