Neutrophil-endothelial interactions in respiratory syncytial virus bronchiolitis, a potential for prediction of severity of disease?
Amadu Juliana, Rens Zonneveld, Frans B. Plötz, Matthijs van Meurs, Jan Wilsschute
The exact molecular mechanism of neutrophil migration into the airway in respiratorysyncytial virus (RSV) infection is little studied.This paper reviews the to date evidence of activation of endothelial cells and neutrophils, interaction of neutrophils with endothelial cells and migration across endothelial cells in Respiratory Syncytial Virus (RSV) infection. In addition, the possible clinical relevance of systemically measurable soluble endothelial adhesion molecules is reviewed. The limited number of studies showed increased levels of soluble cell adhesion molecules (CAMs) in RSV LRTI but could not assess associations of soluble CAM levels with clinical outcomes.
Finally, this paper describes the to date evidence for the deleterious effects of neutrophils in RSV infection. Juliana at al. describe how massive influx of neutrophils also causes damage and consequently more symptoms. Assuming that there is a massive efflux of neutrophils into the lungs with subsequent endothelial and epithelial damage, and that this is the basis for severe disease, the authors propose larger studies and simultaneous measurements of markers of neutrophil and endothelial activation and integrity for prediction of severe disease.