Impact of Rhinovirus Infections in Children

Abstract

Rhinovirus (RV) is an RNA virus that causes more than 50% of upper respiratory tract infections in humans worldwide. Together with Respiratory Syncytial Virus, RV is one of the leading causes of viral bronchiolitis in infants and the most common virus associated with wheezing in children aged between one and two years. Because of its tremendous genetic diversity (>150 serotypes), the recurrence of RV infections each year is quite typical. Furthermore, because of its broad clinical spectrum, the clinical variability as well as the pathogenesis of RV infection are nowadays the subjects of an in-depth examination and have been the subject of several studies in the literature. In fact, the virus is responsible for direct cell cytotoxicity in only a small way, and it is now clearer than ever that it may act indirectly by triggering the release of active mediators by structural and inflammatory airway cells, causing the onset and/or the acute exacerbation of asthmatic events in predisposed children. In the present review, we aim to summarize the RV infection’s epidemiology, pathogenetic hypotheses, and available treatment options as well as its correlation with respiratory morbidity and mortality in the pediatric population.

The Role of Lung and Gut Microbiota in the Pathology of Asthma

“…It has been observed that the composition and abundance of the URT and LRT virome differs among healthy subjects and asymptomatic and symptomatic patients with chronic respiratory diseases, but detailed longitudinal studies are needed for better comprehension of the causal relationships (Sundell et al, 2019;Freer et al, 2018). Complex interactions between viruses and additional environmental and intrinsic factors are probably responsible for the longer but transient presence of some viruses in the respiratory tract of asthmatic patients or the development of fully blown infections leading to severe exacerbations (Vandini et al, 2019;Sarna et al, 2018).…”

Rhinovirus Infection in Children with Acute Bronchiolitis and Its Impact on Recurrent Wheezing and Asthma Development

“…The great heterogeneity of these results may be due to the differences between the described researches, such as study design, sample size, and considered outcomes, but also may be partially related to the fact that RV is a very ubiquitous virus. Its prevalence among asymptomatic children has been reported up to 40% [ 38 ], and its detection in nasal specimens, together with other viruses during acute bronchiolitis, may lead to giving RV a causative role that it possibly does not always have [ 39 ].…”

“…However, it alters the epithelial barrier’s function, dissociating the zonula occludens-1 from tight junction complex through the release of reactive oxygen species during viral replication [ 50 ]. This alteration can allow the absorption of higher amounts of aeroallergens, strictly related to the development of wheezing and asthma [ 39 ]. Moreover, different RV types use several specific vehicles to enter into airway epithelium: RV-A and -B types use ICAM-1 or the low-density lipoprotein receptor (LDL-R), while recently, the cadherin-related family member 3 has been identified as a receptor for RV-C [ 36 , 39 ].…”

“…This alteration can allow the absorption of higher amounts of aeroallergens, strictly related to the development of wheezing and asthma [ 39 ]. Moreover, different RV types use several specific vehicles to enter into airway epithelium: RV-A and -B types use ICAM-1 or the low-density lipoprotein receptor (LDL-R), while recently, the cadherin-related family member 3 has been identified as a receptor for RV-C [ 36 , 39 ]. These different ways of access may partially justify the recurrent finding that RV-A and RV-C are more often associated with wheezing in asthma exacerbations [ 39 ].…”

“…Moreover, different RV types use several specific vehicles to enter into airway epithelium: RV-A and -B types use ICAM-1 or the low-density lipoprotein receptor (LDL-R), while recently, the cadherin-related family member 3 has been identified as a receptor for RV-C [ 36 , 39 ]. These different ways of access may partially justify the recurrent finding that RV-A and RV-C are more often associated with wheezing in asthma exacerbations [ 39 ]. Another peculiar aspect concerns the genetic variations at locus 17q21, which are related to the risk of asthma.…”