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J Allergy Clin Immunol. 2015 Mar;135(3):663-9.e12. doi: 10.1016/j.jaci.2014.10.020. Epub 2014 Dec 2.

Rhinoviruses significantly affect day-to-day respiratory symptoms of children with asthma.

Author information

1
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia. Electronic address: euan.tovey@sydney.edu.au.
2
Virology Research Laboratory, SEALS, Prince of Wales Hospital, Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, Australia.
3
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Sydney Local Health District, Sydney, Australia.
4
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; University of Technology Sydney, Sydney, Australia.
5
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
6
Virology Research Laboratory, SEALS, Prince of Wales Hospital, Sydney, Australia.
7
School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Sydney Children's Hospital, Sydney, Australia.
8
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Ingham Institute of Applied Medical Research, New South Wales, Sydney, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
9
Sydney Children's Hospital, Sydney, Australia.
10
Queensland Brain Institute, University of Queensland, Brisbane, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Australia.
11
Virology Research Laboratory, SEALS, Prince of Wales Hospital, Sydney, Australia; Sydney Children's Hospital, Sydney, Australia.
12
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.

Abstract

BACKGROUND:

Viruses are frequently associated with acute exacerbations of asthma, but the extent to which they contribute to the level of day-to-day symptom control is less clear.

OBJECTIVE:

We sought to explore the relationship between viral infections, host and environmental factors, and respiratory symptoms in children.

METHODS:

Sixty-seven asthmatic children collected samples twice weekly for an average of 10 weeks. These included nasal wash fluid and exhaled breath for PCR-based detection of viral RNA, lung function measurements, and records of medication use and asthma and respiratory symptoms in the previous 3 days. Atopy, mite allergen exposure, and vitamin D levels were also measured. Mixed-model regression analyses were performed.

RESULTS:

Human rhinoviruses (hRVs) were detected in 25.5% of 1232 nasal samples and 11.5% of breath samples. Non-hRV viruses were detected in less than 3% of samples. hRV in nasal samples was associated with asthma symptoms (cough and phlegm: odds ratio = 2.0; 95% CI = 1.4-2.86, P = .0001; wheeze and chest tightness: odds ratio = 2.34, 95% CI = 1.55-3.52, P < .0001) and with cold symptoms, as reported concurrently with sampling and 3 to 4 days later. No differences were found between the 3 hRV genotypes (hRV-A, hRV-B, and hRV-C) in symptom risk. A history of inhaled corticosteroid use, but not atopic status, mite allergen exposure, or vitamin D levels, modified the association between viruses and asthma symptoms.

CONCLUSION:

The detection of nasal hRV was associated with a significantly increased risk of day-to-day asthma symptoms in children. Host, virus genotype, and environmental factors each had only a small or no effect on the relationship of viral infections to asthma symptoms.

KEYWORDS:

Virus; asthma; asthma control; children; mixed-model analysis; respiratory; rhinovirus

PMID:
25476729
DOI:
10.1016/j.jaci.2014.10.020
[Indexed for MEDLINE]

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