Nasopharyngeal Acute Phase Cytokines in Viral Upper Respiratory Infection

Abstract

The role of acute phase cytokines generated in the nasopharynx during viral upper respiratory infection (URI) in subsequent development of acute otitis media (AOM) has not been examined. We studied 326 virus-positive URI episodes in 151 children aged 6–36 months. Nasopharyngeal secretions collected within 1 to 7 days of URI onset were studied for viruses by conventional and molecular techniques, and for concentrations of IL-1β, IL-6, and TNFα by multiplex enzyme-linked immunosorbent assay. Children were followed up for 28 days to document AOM complication. IL-1β, IL-6, and TNFα concentrations correlated positively with each other (P < 0.001). IL-6 and TNFα concentrations were higher in males than in females (P = 0.01 and 0.02). IL-6 and TNFα concentrations were inversely correlated with age (P = 0.02 and 0.05). IL-6 concentrations correlated positively with duration of fever (P = 0.006) and correlated negatively with the number of days of URI symptoms (P = 0.026). Furthermore, IL-6 concentrations were significantly higher during adenovirus and influenza virus URIs as compared with enterovirus and rhinovirus URIs (P < 0.01). IL-1β concentrations were higher during URI episodes with AOM than those without AOM (P < 0.001). We found IL-6 nasopharyngeal secretions concentrations to be higher with adenovirus and influenza infection, and in children with systemic febrile response during URI. However, IL-1β was found to play a more important role in the development of AOM after URI. Additional studies are needed to further define the role of acute phase cytokines in virus-induced AOM.