Medline ® Abstracts for References 1,4
of 'Epidemiology, clinical manifestations, and pathogenesis of rhinovirus infections'
Role of viral infections, atopy and antiviral immunity in the etiology of wheezing exacerbations among children and young adults.
Heymann PW, Platts-Mills TA, Johnston SL
Pediatr Infect Dis J. 2005;24(11 Suppl):S217.
BACKGROUND: At least 101 serotypes of rhinoviruses have been identified. Rhinoviruses have often been associated with trivial upper respiratory infections but more recent evidence suggests that they play a significant role in the pathogenesis of asthma exacerbations.
METHODS: The impact of rhinoviruses as a cause of respiratory morbidity in infancy and the role of rhinoviruses in causing asthma exacerbations in the children and adult population is discussed. Past and current experimental and epidemiologic evidence was assessed to suggest a causal role rather than just an association. Mechanism of susceptibility to virus infection in asthmatics were discussed, as were data indicating important interactions between allergic sensitization and rhinovirus infections in risk of asthma exacerbations.
RESULTS: Asthmatic individuals have increased severity and duration of lower airway symptoms and greater declines in lung function upon infection with rhinovirus, suggesting greater susceptibility to rhinovirus infection because of impaired antiviral immunity. Early virus-induced apoptosis, which aborts virus replication, was impaired in asthmatics. Treating allergic airway inflammation may reduce the frequency and severity of symptoms triggered by rhinoviruses.
CONCLUSIONS: The evidence in children and young adults suggests that atopy and allergic inflammation in the airways may be critical determinants of an adverse response to rhinovirus. Increased awareness of the spectrum of age groups that are affected by rhinoviruses is needed to encourage the development of new treatments and strategies that may be helpful in reducing the frequency and severity of symptoms triggered by rhinoviruses.
Department of Pediatrics, University of Virginia Asthma and Allergic Diseases Center, PO Box 800386, Charlottesville, VA 22908, USA. firstname.lastname@example.org
Winther B, Gwaltney JM Jr, Mygind N, Hendley JO
Am J Rhinol. 1998;12(1):17.
Upper respiratory viruses cause self-limited illness characterized by acute rhinitis. In rhinovirus colds the symptoms are thought to be caused by the host response rather than viral damage of the nasal epithelium. Rhinovirus triggers an inflammatory cascade, evidenced by the presence of inflammatory mediators (e.g., IL-8) and proinflammatory cytokines (e.g., kinins) in nasal secretions, which results in symptomatic illness. In contrast to rhinovirus and coronavirus, which do not cause discernible epithelial damage, influenza virus and adenovirus do damage the nasal epithelium. Appropriate antiviral therapy will depend on the causative virus. Treatment of rhinovirus colds may require an antiviral agent (e.g., interferon alpha) in combination with antiinflammatory medication.
Department of Otolaryngology, Head and Neck Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.