Amplified rhinovirus colds in atopic subjects

Abstract

Evidence suggests that atopic individuals may be predisposed to more severe rhinoviral colds coupled to a worsening of existing airway disease than those with asthma. The role of atopy and IgE levels, as well as their relationship to clinical disease expression have not been defined. We hypothesized that an allergic diathesis modulates rhinoviral colds and have initiated studies of normal, atopic and asthmatic subjects employing experimental rhinoviral infection, with measurements of symptom scores, viral shedding and cultures, albumin in nasal washes and serological responses. Twenty-two subjects (11 normal, 5 atopic, 6 atopic and asthmatic) participated and were inoculated with human rhinovirus serotype 16 (HRV 16). Measurements of neutralizing antibody and viral culture were performed at screening, pre-inoculation, during the cold and at 8-10 weeks convalescence. Daily symptoms were noted, nasal washes done, IgE measured and atopy was diagnosed by skin tests. Seventeen volunteers developed clinical colds as assessed by symptom scores, virus shedding was demonstrated (with positive culture) in all subjects and a fourfold or higher seroconversion occurred in 11/22. Neutralizing HRV antibody developed unexpectedly in 10 subjects between screening and inoculation and the presence of absence of this pre-inoculation antibody determined subsequent severity of colds in normal but not in atopic subjects. Atopic antibody positive individuals developed severe clinical colds that were independent of preinoculation antibody in contrast to normal subjects who developed mild colds in the presence of a neutralizing antibody (P = 0.01). Both atopic and normal antibody negative subjects developed severe colds.(ABSTRACT TRUNCATED AT 250 WORDS)

A Case‐Control Study of the Role of Cold Symptoms and other Historical Triggering Factors in Asthma Exacerbations

“…Despite the anti-inflammatory effects of corticosteroids, no effect has been shown on T lymphocyte infiltration (23), and we are not aware of previous reports showing an increase in the severity of viral respiratory infections related to inhaled steroids. Inhaled steroids have been shown in one study to prevent viral-induced asthma exacerbations in children (28), possibly by a reduction of the airway inflammatory changes caused by respiratory viral infections (25,26), which are especially pathogenic in atopic individuals (27,28).…”

Experimental rhinovirus infection in volunteers

“…Sensitivity of the assay was 1 µg·mL -1 and the coefficient of variation of repeated measurements was <5% [14].…”

“…This was undertaken on serum from all volunteers before admission to the study (baseline) as well as on the day prior to inoculation with HRV 16, on Day 5 of experimental disease and, finally, 8-10 weeks later, as described previously [14].…”

Rhinovirus infection in nonasthmatic subjects: effects on intrapulmonary airways

“…In this study, in nonatopic normal subjects, the cold scores were relatively low, especially when compared with the studies by GRÜ NBERG and coworkers [10,12], in which the same virus batch was used. Apparently, nonatopic healthy subjects have less severe cold symptoms than asthmatics, even though this is still a controversial issue [13,14].…”