title: Experimental rhinovirus 16 infection increases intercellular adhesion molecule-1 expression in bronchial epithelium of asthmatics regardless of inhaled steroid treatment.
abstract: BACKGROUND
  Rhinovirus infections in airway epithelial cells in vitro have been shown to upregulate intercellular adhesion molecule-1 (ICAM-1) expression. Epithelial ICAM-1, in its dual role as the major rhinovirus receptor and as adhesion molecule for inflammatory cells may be involved in the pathogenesis of rhinovirus-induced exacerbations of asthma.
  
  
  OBJECTIVE
  We aimed to investigate the effect of experimental rhinovirus 16 (RV16) infection on ICAM-1 expression in bronchial mucosal biopsies in asthma. In addition, the effect of 2 weeks pretreatment with inhaled budesonide (800 microg b.d.) on RV16-associated changes in ICAM-1 expression was studied.
  
  
  METHODS
  The study had a parallel, placebo-controlled design in 25 steroid-naive nonsmoking atopic asthmatic subjects. After 2 weeks budesonide (BUD) or placebo (PLAC) pretreatment bronchoscopy was performed 2 days before (day -2) and 6 days after (day 6) RV16 inoculation (on days 0 and 1). Immunohistochemical staining for ICAM-1 was performed on snap-frozen bronchial biopsies. ICAM-1 staining intensity on the basal epithelial cells was scored semiquantitatively from 1 (weak) to 3 (intense). Similarly, epithelial intactness was noted (1 = basal cells only, 2 = basal and parabasal cells, 3 = intact epithelium).
  
  
  RESULTS
  ICAM-1 scores were not significantly different between the groups at day -2 (P > or = 0.08). Subsequent RV16 infection was associated with a trend towards an increase in ICAM-1 expression in the BUD-group (P = 0.07), whereas the increase was significant in the PLAC-group (P = 0.03). However, the increase was not significantly different between the groups (P = 0.74). Epithelial intactness score was not different between the groups before RV16 infection (P > or = 0.07), and no significant changes were observed in either group (P > or = 0.59). Moreover, ICAM-1 score did not correlate significantly with epithelium score in either group, at any time-point (P > or = 0.27).
  
  
  CONCLUSIONS
  We conclude that an RV16 common cold in atopic asthmatic subjects is associated with increased ICAM-1 expression in the bronchial epithelium, which is not related to epithelial intactness. Glucocorticoid treatment does not appear to prevent the RV16-associated increased ICAM-1 expression. This suggests that other treatment modalities are required to protect against the spreading of infection during rhinovirus-induced exacerbations in asthma.
authors.affiliation: Department of Preventive Medicine, University of Wisconsin, Madison, Wisconsin, USA.
authors.forename: K
authors.initials: K
authors.lastname: Grünberg
authors.forename: R F
authors.initials: RF
authors.lastname: Sharon
authors.forename: T J
authors.initials: TJ
authors.lastname: Hiltermann
authors.forename: J J
authors.initials: JJ
authors.lastname: Brahim
authors.forename: E C
authors.initials: EC
authors.lastname: Dick
authors.forename: P J
authors.initials: PJ
authors.lastname: Sterk
authors.forename: J H
authors.initials: JH
authors.lastname: Van Krieken
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D001999:Bronchoscopy; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D003139:Common Cold / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007124:Immunoenzyme Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D008297:Male; D020545:Respiratory Mucosa / Q000378:metabolism*; D012229:Rhinovirus / Q000502:physiology*
chemical_list: D000893:Anti-Inflammatory Agents; D018799:Intercellular Adhesion Molecule-1; D019819:Budesonide