TY - JOUR
T1 - Rhinoviruses significantly affect day-to-day respiratory symptoms of children with asthma
AU - Tovey, Euan R.
AU - Stelzer-Braid, Sacha
AU - Toelle, Brett G.
AU - Oliver, Brian G.
AU - Reddel, Helen K.
AU - Willenborg, Christiana M.
AU - Belessis, Yvonne
AU - Garden, Frances L.
AU - Jaffe, Adam
AU - Strachan, Roxanne
AU - Eyles, Darryl
AU - Rawlinson, William D.
AU - Marks, Guy B.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - 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.
AB - 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.
KW - asthma
KW - asthma control
KW - children
KW - mixed-model analysis
KW - respiratory
KW - rhinovirus
KW - Virus
UR - http://www.scopus.com/inward/record.url?scp=84924359621&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2014.10.020
DO - 10.1016/j.jaci.2014.10.020
M3 - Article
C2 - 25476729
SN - 0091-6749
VL - 135
SP - 663-669.e12
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 3
ER -