Human rhinovirus (HRV) induced changes in mild asthma: Time course of clinical and inflammatory biomarker changes

Abstract

The immune response to viral infections in patients with asthma has been shown to be different to that in healthy subjects. This clinical trial was performed to evaluate the HRV induced clinical and inflammatory biomarker changes of a Good Manufacturing Practice produced HRV16 strain in patients with asthma. 20 patients with mild (GINA 1) atopic asthma were recruited. Subjects had a full history and symptoms, pulmonary function and a range of serum inflammatory markers were measured before and at regular time points after viral challenge. Subjects were quarantined a day before inoculation and randomized to be given either a specific dose of virus (n=13) or placebo (n=7). Throughout the controlled quarantine period, timed serum samples were taken for analysis of inflammatory biomarkers over 8 days. Of the 13 subjects inoculated with virus, 11 (85%) became infected, and 4 of the infected (36%) had significant reductions in asthma control (ACQ score rise from baseline ≥ 0.5) and PEF. Infected subjects with asthma had a rapid onset of both upper and lower respiratory symptoms over 2 and 4 days respectively. Peripheral blood changes in neutrophils were significantly higher (p HRV16 induced clinical worsening of symptoms and reduction in PEF in patients with mild asthma. This was associated with rapid rises in blood neutrophils and reduction in lymphocytes, as well as elevations in serum CXCL10 (IP-10).