Abstract
Allergen exposure and rhinovirus (RV) infections are common triggers of acute wheezing exacerbations in early childhood. The identification of such trigger factors is difficult but may have therapeutic implications. Increases of IgE and IgG in sera, were shown against allergens and the N-terminal portion of the VP1 proteins of RV species, respectively, several weeks after allergen exposure or RV infection. Hence, increases in VP1-specific IgG and in allergen-specific IgE may serve as biomarkers for RV infections or allergen exposure. The MeDALL-allergen chip containing comprehensive panels of allergens and the PreDicta RV chip equipped with VP1-derived peptides, representative of three genetic RV species, were used to measure allergen-specific IgE levels and RV-species-specific IgG levels in sera obtained from 120 preschool children at the time of an acute wheezing attack and convalescence. Nearly 20% of the children (22/120) showed specific IgE sensitizations to at least one of the allergen molecules on the MeDALL chip. For 87% of the children, increases in RV-specific IgG could be detected in the follow-up sera. This percentage of RV-specific IgG increases was equal in IgE-positive and -negative children. In 10% of the children, increases or de novo appearances of IgE sensitizations indicative of allergen exposure could be detected. Our results suggest that, in the majority of preschool children, RV infections trigger wheezing attacks, but, in addition, allergen exposure seems to play a role as a trigger factor. RV-induced wheezing attacks occur in IgE-sensitized and non-IgE-sensitized children, indicating that allergic sensitization is not a prerequisite for RV-induced wheeze.
Highlights
Allergen exposure in sensitized individuals and rhinovirus (RV) infections are common triggers for acute wheezing attacks during early childhood [1] and for exacerbations of respiratory diseases in adults [2]
Several possibilities may be considered in regard to how allergic sensitization and RV infections can act synergistically to promote the development of asthma [13]
The measurement of RV-species-specific IgG increases after controlled RV-infection or RV-triggered wheezing attacks has already been demonstrated in several studies [22,23,24]
Summary
Allergen exposure in sensitized individuals and rhinovirus (RV) infections are common triggers for acute wheezing attacks during early childhood [1] and for exacerbations of respiratory diseases in adults [2]. Wheezing episodes that are caused by RVs in children less than three years of age augment the risk of the subsequent development of asthma [12] In this context, several possibilities may be considered in regard to how allergic sensitization and RV infections can act synergistically to promote the development of asthma [13]. It was shown that rhinovirus infections may induce damage to the respiratory epithelial barrier and, may facilitate the penetration of allergens into the sub-epithelial tissues, where they may cause an increased allergic inflammation [14,15,16] It is, important to have diagnostics that allow the complete mapping of the molecular sensitization profiles of allergic patients, as well as the measurement of the effects of allergen exposure that cause symptoms via serology. The comprehensive analysis of IgE sensitizations in the children with microarrayed allergens allowed the determination of the frequency of RV-triggered wheezing attacks in IgE-sensitized versus non-sensitized children
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