Oxidative stress and inflamatory plasma biomarkers in respiratory syncytial virus bronchiolitis

Clin Respir J. 2017 Nov;11(6):839-846. doi: 10.1111/crj.12425. Epub 2016 Jan 6.


Introduction: Oxidative stress (OS) plays a crucial role in the pathogenesis of inflammatory lung diseases.

Objectives: (i) We determined whether acute bronchiolitis (AB) caused by respiratory syncytial virus (RSV) induced OS; (ii) assessed whether OS biomarkers correlated with the severity of RSV-AB; and (iii) studied whether the levels of interleukins are associated with OS biomarkers.

Methods: We performed an observational study by comparing healthy infants (Group 1) with RSV-AB infants, classified as Group 2 (pulse oximetry (SpO2 ) >93%), and Group 3 (SpO2 ≤ 92%), which needed oxygen therapy. Blood samples were collected to determine the levels of lipid peroxidation (LPO) products (LPO), total glutathione (TG), oxidised glutathione (GSSG), reduced glutathione (GSH), glutathione peroxidase (GPx), interleukins (ILs) IL-10, IL-6, IL-8, interferon-gamma (IFNγ), tumour necrosis factor-alpha (TNFα) and macrophage inflammatory proteins (MIP α and MIP β).

Results: Forty-six RSV-AB infants (47% needed oxygen therapy) and 27 healthy infants were included. The GSH/GSSG ratio was lower in RSV-AB infants than in Group 1 (P<0.001). GSSG and GPx were significantly higher in Group 3. GSSG predicted the need for oxygen therapy with an optimal cut-off point of 15 µM/g for haemoglobin. The GSH/GSSG ratio negatively correlated with IL-6 (P: 0.014), IL-8 (P: 0.014) and IL-10 (P: 0.033). Group 3 exhibited a direct correlation between GPx and IL-10 levels (P: 0.024) and between LPO and MIP β (P: 0.003).

Conclusions: RSV induced OS in AB. An increase in GSSG correlated with the disease severity in the infants. OS may contribute to the pathogenesis of RSV-AB.

Keywords: Interleukins; bronchiolitis; oxidative stress; respiratory syncytial virus.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Acute Disease
  • Biomarkers / metabolism*
  • Bronchiolitis / complications*
  • Bronchiolitis / metabolism
  • Bronchiolitis / therapy
  • Bronchiolitis / virology
  • Female
  • Glutathione / metabolism
  • Humans
  • Infant
  • Interferon-gamma / metabolism
  • Interleukin-10 / metabolism
  • Interleukins / metabolism
  • Lipid Peroxidation
  • Male
  • Oxidative Stress / physiology*
  • Oximetry / methods
  • Oxygen Inhalation Therapy / methods
  • Respiratory Syncytial Virus Infections / blood*
  • Respiratory Syncytial Virus Infections / physiopathology
  • Respiratory Syncytial Virus Infections / therapy
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Virus, Human / isolation & purification
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / metabolism


  • Biomarkers
  • IL10 protein, human
  • Interleukins
  • TNF protein, human
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interferon-gamma
  • Glutathione