Association of rhinovirus infections with asthma

Abstract

Rhinoviruses are the most common cause of the common cold, but they can cause more severe illnesses in people with underlying lung disorders such as asthma, chronic obstructive pulmonary disease, or cystic fibrosis. Epidemiologic studies with sensitive detection methods such as PCR have identified rhinovirus infection as a major source of asthma exacerbations in both children and adults, especially during the spring and fall. Since rhinoviruses cause little tissue destruction, it is presumed that the immune response to the infection may play an important role in the pathogenesis of rhinovirus-induced exacerbations of asthma. This review examines the epidemiologic association between rhinovirus infections and exacerbations of asthma and outlines current information on immune responses to rhinovirus infection and potential connections between antiviral responses and preexisting allergic inflammation. Finally, current and future strategies for treating rhinovirus infections and virus-induced exacerbations of asthma are discussed.

FIG. 1

Effect of allergy on RV16-induced changes in lower-airway histamine responsiveness. Subjects were grouped according to the presence or absence of allergy, and histamine PD₂₀ was plotted precold (pre), and 2 days following RV16 inoculation (cold). Heavy horizontal lines represent group mean data. n.s., not significant. Reprinted from reference with permission of the publisher.

FIG. 2

Potential mechanisms for lower-airway dysfunction caused by RV infections.

FIG. 3

Mechanisms of RV-induced exacerbations of asthma, and therapeutic implications. See the text for details. Abbreviations: sICAM-1, soluble ICAM-1; PKR, double-stranded-RNA-activated protein kinase; CS, corticosteroids.