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ROLE OF VIRUL SPECIFIC Ige IN THE RELEASE OF LEUKOTRIENE C4 (LTC4) IN NASOPHARYNGEAL SECRETIONS (NPS) OF INPANTS WITH RESPIRATORY SUNCYTIAL VIRUS (RSV) INFECTION

Samples of NPS from groups of infants with bronchiolitis or upper respiratory illness alone during infection with RSV were analyzed for LTC4 content using a reverse-phase high-pressure liquid chromatography (HPLC) assay and confirmed by radioimmunoassay. Titers of RSV-specific IgE in NPS specimens were determined using an ELISA assay. LTC4 was present in 67% of samples obtained in the first week after the onset of illness and was detectable in progressively lower concentrations in samples obtained up to 27 days after the onset of illness, but not beyond. LTC4 was detectable in samples of NPS obtained in the acute phase of illness from 73% of infants with bronchiolitis due to RSV, and in about 30% of samples of NPS obtained during the same interval from infants with upper respiratory illness alone, significantly, however, quantities of LTC4 measured in NPS could be directly correlated with the magnitude of the peak RSV-IgE response in secretions (r=0.557, p<0.02). LTC4 was not detected in NPS specimens from any of the patients who did not develop an RSV-IgE response. These studies lend support to previous investigations suggesting that severe bronchiolitis due to RSV results from IgE-mediated hypersensitivity reactions to viral antigens, with release of chemical mediators of airway obstruction. Their implications should be considered in new approaches to therapy for RSV bronchiolitis.