Enhanced severity of virus associated lower respiratory tract disease in asthma patients may not be associated with delayed viral clearance and increased viral load in the upper respiratory tract

• Published in: Journal of clinical virology Vol. 41; no. 2; pp. 116 - 121
• Main Authors: van Elden, Leontine J.R, Sachs, Alfred P.E, van Loon, Anton M, Haarman, Monique, van de Vijver, David A, Kimman, Tjeerd G, Zuithoff, Peter, Schipper, Pauline J, Verheij, Theo J.M, Nijhuis, Monique
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.02.2008; Elsevier Science
• Subjects: Adolescent; Adult; Allergy and Immunology; Asthma; Asthma - complications; Biological and medical sciences; Exacerbation; Female; Fundamental and applied biological sciences. Psychology; Human rhinovirus; Human rhinovirus (HRV); Human viral diseases; Humans; Infectious Disease; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Respiratory Tract Infections - physiopathology; Respiratory Tract Infections - virology; Respiratory virus dynamics; Severity of Illness Index; Viral diseases; Viral Load; Virology; Virus Diseases - physiopathology; Virus Diseases - virology; Virus Shedding; Viruses - classification; Viruses - isolation & purification; Exacerbation; Respiratory virus dynamics; Human rhinovirus (HRV); Asthma; Human; Lung disease; Microbiology; Respiratory disease; Picornaviridae; Clearance; Respiratory system; Human rhinovirus; Virology; Virus; Associated virus; Respiratory tract; Bronchus disease; Obstructive pulmonary disease; Viral load; Rhinovirus
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2007.10.028

Abstract Background Viral respiratory infections, particularly human rhinovirus (HRV) infections, are the most common cause of asthma exacerbation. HRV infections usually lead to more severe and longer duration of lower respiratory tract (LRT) symptoms in asthmatics than in otherwise healthy individuals. However, the exact mechanism by which viruses contribute to exacerbation of asthma is unknown. Objectives The main objective of our study was to investigate the relationship of the enhanced severity of LRT symptoms to viral dynamics or cytokine responses in the upper respiratory tract (URT). Study design Therefore, we conducted a longitudinal study in which asthmatics and healthy controls were followed during natural viral respiratory tract infections. Results Our study confirmed that viral respiratory tract infections caused more severe problems of the LRT in asthma patients as compared to healthy controls. However, for all subjects, the severity of LRT symptoms were not related to viral load or prolonged viral shedding in the URT. In addition, we did not detect differences in proinflammatory cytokines in the URT between asthmatics and controls. Conclusion Persistence of the virus, as well as viral load in the URT, may not be associated with the induction and/or persistence of asthmatic symptoms.