Published ahead of print on February 14, 2008, doi:10.1164/rccm.200607-973OC Am. J. Respir. Crit. Care Med., Volume 177, Number 10, May 2008, 1082-1089 A more recent version of this article appeared on May 15, 2008
Submitted on July 18, 2006 The Presence of Rhinovirus in Lower Airways of Patients with Bronchial AsthmaMonika Wos1,1 Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland, 2 Department of Thoracic Surgery, District Hospital, Cracow, Poland, 3 Division of Allergy and Immunology, Department of Medicine, University of Wisconsin - Madison, Madison, WI, USA * To whom correspondence should be addressed. 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. Objective. Our objective was to determine if stable asthmatic patients, who are free of clinical signs of a respiratory infection for at least 3 weeks, harbor HRV in their bronchi more frequently than non-asthmatic controls, and whether clinical features of asthma are associated with the presence of HRV. Methods. Immunohistochemistry (IHC) and indirect in situ RT-PCR method were used to detect the presence of HRV in bronchial mucosal biopsies in asthmatic patients and non-asthmatic controls. Measurements and Main Results. HRV was found by IHC in 9 of 14 bronchial biopsies from asthmatic subjects (64.3%) and 2 of 6 non-asthmatic controls (33.3%), p = 0.38. With the more sensitive, indirect in situ RT-PCR method, HRV was found in the mucosal biopsies of 73% of asthmatic patients and 22% non-asthmatic controls (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 asthmatic patients significantly more often than non-asthmatic subjects, and its presence was associated with clinical features of more severe disease. Key words: severe asthma, rhinovirus infection, persistent infection, asthma
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