Inflammatory and Bronchospastic Factors in Asthma Exacerbations Caused by Upper Respiratory Tract Infections

Abstract

It is still uncertain how viral respiratory infections cause acute exacerbations of bronchial asthma, although several mechanisms have been proposed. We studied the relationship between the airway narrowing and the inflammatory and bronchospastic factors in peripheral venous blood and urine, in 30 patients with asthma at the exacerbations caused by upper respiratory tract infections (URTIs). Acute exacerbations caused decreases in peak expiratory flow rate (PEFR) in all 30 patients with asthma. Asthma exacerbations caused the rises in serum levels of interleukin-6, soluble intercellular adhesion molecule-1 and eosinophil cationic protein, concentrations of urinary leukotriene E 4 and plasma histamine, compared with those in patients with asthma at a stable condition and those in 30 control subjects (p < 0.05). The values of PEFR at the exacerbations correlated with the levels of these factors. Treatment with oral glucocorticoids reversed the decreases in PEFR and the increases in these factors. At the onset of URTIs, rhinovirus and influenza type A virus were identified in 13 and 7 patients, respectively. Each of parainfluenza virus, adenovirus, and enterovirus was identified in one patient. These findings suggest that respiratory viral infections may cause acute asthma exacerbations via the production of mediators that induce inflammation and bronchospasm. bronchial asthma; virus infection; interleukin-6; ICAM-1; leukotriene; histamine

Serum Eosinophil Cationic Protein and 27 Cytokines/Chemokines in Acute Exacerbation of Childhood Asthma

“…Although previous reports showed serum ECP [7,8,9,10] and serum or plasma cytokine/chemokine production [7,10,11,12,13,14,15,16,17,18,19] in acute exacerbations of asthma, this is the first report to show the profiles of ECP and 27 cytokines/chemokines in serum samples of patients with acute and stable asthma, and in controls. In this study, serum ECP was significantly elevated in acute asthma compared with stable asthma and controls.…”

“…However, evidence suggests that treatment with inhaled corticosteroids does not improve airway inflammation induced by rhinovirus infection [23]. On the other hand, oral glucocorticoids improve lung function and decrease serum IL-6, soluble ICAM-1 and ECP levels [10]. In this study, treatment comprising systemic corticosteroids resulted in decreases in serum levels of ECP, IL-5, IL-6, IL-1ra and IP-10, but not IL-8, IL-10, G-CSF and MCP-1.…”

Differential Effects of Corticosteroids on Serum Eosinophil Cationic Protein and Cytokine Production in Rhinovirus- and Respiratory Syncytial Virus-Induced Acute Exacerbation of Childhood Asthma

“…However, treatment with inhaled corticosteroids does not improve airway inflammation induced by rhinovirus infection [30]. On the other hand, oral glucocorticoids improve lung function and decrease the elevation of serum IL-6, soluble ICAM-1, and ECP [31]. Recently, we reported that treatment that included systemic corticosteroids could decrease serum levels of ECP, IL-5, IL-6, IL-1ra, and IP-10 in acute exacerbation of childhood asthma [32].…”

Airway Remodeling in Asthma and its Influence on Clinical Pathophysiology

“…As we know, almost all patients with early asthma categorized into mild asthma, and some of these patients increase their severity over time. For instance, upper respiratory tract infections cause acute exacerbations of asthma (Yasuda et al 2005).…”