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The Presence of Rhinovirus in Lower Airways of Patients with Bronchial Asthma

Monika Wo¹, Marek Sanak¹, Jerzy Soja¹, Henryk Olechnowicz², William W. Busse³ and Andrew Szczeklik¹

¹ Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland; ² Department of Thoracic Surgery, District Hospital, Krakow, Poland; and ³ Division of Allergy and Immunology, Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin

Correspondence and requests for reprints should be addressed to William W. Busse, M.D., University of Wisconsin, 600 Highland Avenue, Madison, WI 53792. E-mail: wwb{at}medicine.wisc.edu

Rationale: The common cold virus, human rhinovirus (HRV), is the most frequent cause of asthma exacerbations. However, a possible contribution of HRV to the pathogenesis of chronic, persistent asthma has not been defined.

Objectives: To determine if patients with stable asthma, who are free of clinical signs of a respiratory infection for at least 3 weeks, harbor HRV in their bronchi more frequently than nonasthmatic control subjects, and whether clinical features of asthma are associated with the presence of HRV.

Methods: Immunohistochemistry and the indirect in situ reverse transcription–polymerase chain reaction method were used to detect the presence of HRV in bronchial mucosal biopsies in patients with asthma and nonasthmatic control subjects.

Measurements and Main Results: HRV was found by immunohistochemistry in 9 of 14 bronchial biopsies from subjects with asthma (64.3%) and 2 of 6 nonasthmatic control subjects (33.3%) (P = 0.38). With the more sensitive indirect in situ reverse transcription–polymerase chain reaction method, HRV was found in the mucosal biopsies of 73% of patients with asthma and 22% of nonasthmatic control subjects (P < 0.001). Subjects positive for HRV had lower pulmonary function, higher numbers of blood eosinophils and leukocytes, and eosinophilic infiltration in bronchial mucosa.

Conclusions: HRV was detected in the lower airway tissue of patients with asthma significantly more often than in nonasthmatic subjects, and its presence was associated with clinical features of more severe disease.

Key Words: asthma • infections • rhinovirus

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject There is no previous information to indicate that rhinovirus may be a chronic infection in the lower airways of patients with asthma. What This Study Adds to the Field These observations suggest that rhinoviruses can become a chronic infection and contribute to the persistence and severity of airway disease.

 

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