Am. J. Respir. Crit. Care Med., Volume 160, Number 1, July 1999, 100-108

Rhinovirus-16 Colds in Healthy and in Asthmatic Subjects
Similar Changes in Upper and Lower Airways

H. EDWARD FLEMING, FRÉDÉRIC F. LITTLE, DAVID SCHNURR, PEDRO C. AVILA, HOFER WONG, JANE LIU, SHIGEO YAGI, and HOMER A. BOUSHEY

Divisions of Pulmonary Medicine and of Allergy and Immunology, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco; and the Viral and Rickettsial Disease Laboratory, California Department of Health Services, Berkeley, California

Rhinovirus (RV) infections appear to precipitate most asthma exacerbations. To investigate whether RV-16 induces different inflammatory changes in upper and lower airways of asthmatic and healthy subjects, we inoculated 10 nonatopic healthy and 11 atopic asthmatic adults with 2,000 TCID50 RV-16. Subjects recorded symptoms and peak flow daily; and they underwent spirometry, methacholine challenge (PC₂₀), nasal lavage, and sputum induction at baseline and on Days 2, 4, 15, and 29 d after inoculation. One asthmatic subject developed an exacerbation requiring prednisone treatment 5 d after inoculation. The cold symptom severity (Jackson score) did not differ between groups. During the cold, asthma symptoms increased slightly from baseline in the asthmatic group; and PC₂₀ decreased in the healthy group. However, peak flow, bronchodilator use, and spirometry did not change in either group. At baseline, asthmatics had higher neutrophils, eosinophils, and interleukin (IL)-6 in nasal lavage. After inoculation, both groups developed significant increases in nasal neutrophils, IL-6 and IL-8, and modest increases in sputum neutrophils and IL-6, but not IL-8. However, these changes did not differ between groups. IL-5, interferon-, and RANTES were detected only in nasal lavages from two asthmatic subjects, who had the most severe colds. IL-11 was not detected in any sample. We conclude that inflammatory responses of upper and lower airways during RV-16 colds are similar in asthmatic and healthy subjects, and that RV-16 infection is not by itself sufficient to provoke clinical worsening of asthma.

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