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

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:135

Article

Tovey, Euan R.¹  Stelzer-Braid, Sacha^2,3  Toelle, Brett G.^1,4  Oliver, Brian G.^1,5  Reddel, Helen K.¹  Willenborg, Christiana M.²  Belessis, Yvonne^6,7  Garden, Frances L.^1,8,9  Jaffe, Adam^6,7  Strachan, Roxanne⁷  Eyles, Darryl^10,11  Rawlinson, William D.^2,7  Marks, Guy B.^1,9 

[1] Univ Sydney, Woolcock Inst Med Res, Sydney, NSW 2006, Australia

[2] Prince Wales Hosp, SEALS, Virol Res Lab, Sydney, NSW, Australia

[3] Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia

[4] Sydney Local Hlth Dist, Sydney, NSW, Australia

[5] Univ Technol Sydney, Sydney, NSW 2007, Australia

[6] Univ New S Wales, Sch Womens & Childrens Hlth, Sydney, NSW, Australia

[7] Sydney Childrens Hosp, Sydney, NSW, Australia

[8] Ingham Inst Appl Med Res, Sydney, NSW, Australia

[9] Univ New S Wales, South Western Sydney Clin Sch, Sydney, NSW, Australia

[10] Univ Queensland, Queensland Brain Inst, Brisbane, Qld, Australia

[11] Pk Ctr Mental Hlth, Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia

关键词: Virus;    rhinovirus;    asthma;    asthma control;    children;    mixed-model analysis;    respiratory;   

DOI  :  10.1016/j.jaci.2014.10.020

来源: Elsevier

【 摘 要 】

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 5.0001; 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.

【 授权许可】

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