Rhinovirus-16 colds in healthy and in asthmatic subjects: similar changes in upper and lower airways.
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-gamma, 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.
Fleming
H E
HE
Divisions of Pulmonary Medicine and of Allergy and Immunology, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, CA, USA.
Little
F F
FF
Schnurr
D
D
Avila
P C
PC
Wong
H
H
Liu
J
J
Yagi
S
S
Boushey
H A
HA
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000378:metabolism; D001249:Asthma / Q000276:immunology / Q000821:virology*; D003139:Common Cold / Q000276:immunology / Q000821:virology*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000378:metabolism; D007958:Leukocyte Count; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D012137:Respiratory System / Q000276:immunology / Q000821:virology; D012229:Rhinovirus / Q000472:pathogenicity*; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology / Q000821:virology*
D000914:Antibodies, Viral; D007378:Interleukins