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Review
. 2019 Aug;39(3):335-344.
doi: 10.1016/j.iac.2019.03.003. Epub 2019 May 15.

Rhinovirus and Asthma Exacerbations

Joshua L Kennedy  1 , Sarah Pham  2 , Larry Borish  3
Affiliations
Review

Rhinovirus and Asthma Exacerbations

Joshua L Kennedy et al. Immunol Allergy Clin North Am. 2019 Aug.

Abstract

Rhinovirus (RV) is ubiquitous and typically causes only minor upper respiratory symptoms. However, especially in children and adolescent asthmatics, RV is responsible for most exacerbations. This ability of RV to drive exacerbations typically requires the concomitant presence of exposure to a bystander allergen. Susceptibility to RV-mediated exacerbations is also related to the genetic background of the host, which contributes to greater infectivity, more severe infections, altered immune responses, and to greater inflammation and loss of asthma control. Given these responses, there are several treatments available or being developed that should improve the control of exacerbations related to RV infection.

Keywords: Allergy; Asthma; Genetics; IgE; Rhinovirus.

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Conflict of interest statement

Disclosures:

Sarah Pham reports no conflicts of interest.

Figures

Figure 1:
Figure 1:. RV39 infection of Human Precision Cut Lung Slices (PCLS) from Asthma Donors.
(A) Comparison of carbachol (CCh)-induced airway responsiveness in donors with and without asthma before and after infection with RV39. RV39 infection causes airway hyper-responsiveness to CCh only in PCLS from donors with a history of asthma. (B-E) IL25, TSLP, IL13, and IL-33 gene expression from RV39 infected PCLS. There are significant increases in the expression of IL-25, TSLP, and IL-13 in the PCLS from asthma donors compared to controls without asthma. (F, G) IL-33 and TSLP protein levels in supernatants from RV39 infected PCLS in donors with and without asthma. There are significantly increased TSLP protein levels in those donors with a history of asthma after infection with RV39. * p<0.05 Adapted from Kennedy JL, Koziol-White CJ, Jeffus S, et al. Effects of rhinovirus 39 infection on airway hyperresponsiveness to carbachol in human airways precision cut lung slices. J Allergy Clin Immunol 2018; 141(5): 1888; with permission.
Figure 2:
Figure 2:
Probability of current wheezing based on increasing specific IgE to D. pteronyssinus in children with (A) negative tests for RV and (B) positive tests for RV. The presence of high titers of specific IgE to dust mite in combination with RV leads to greatly increased risk for current wheezing. From Soto-Quiros M, Avila L, Platts-Mills TA, et al. High titers of IgE antibody to dust mite allergen and risk for wheezing among asthmatic children infected with rhinovirus. J Allergy Clin Immunol 2012; 129(6): 1504; with permission.
See this image and copyright information in PMC

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