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Depts of 1 Child Health, 3 Epidemiology and Public Health4 Microbiology and Immunology, and 2 Centre for Mechanisms of Human Toxicity, University of Leicester, Leicester, UK
CORRESPONDENCE: M.C. Mckean, Children's Asthma Centre, Dept of Child Health, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK. Fax: 44 1162525846
Keywords: paediatrics, viral infection, wheezing
Received: August 17, 2000
Accepted January 19, 2001
This study was supported by the National Asthma Campaign (UK), GlaxoWellcome (UK), Merck Sharpe Dohme (UK) and the Midlands Asthma and Allergy Research Association (UK).
Episodic wheezing associated with viral infections of the upper respiratory tract (URT) is a common problem in young children but also occurs in adults. It is hypothesized that an experimental infection with human coronavirus (HCoV), the second most prevalent common cold virus, would cause lower respiratory tract (LRT) changes in adults with a history of viral wheeze.
Twenty-four viral wheezers (15 atopic) and 19 controls (seven atopic) were inoculated with HCoV 229E and monitored for the development of symptoms, changes in airway physiology and provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20). At baseline, viral wheezers were similar to controls in PC20 (mean±sd log2PC20: 5.1±1.9 and 5.8±1.4 g·L–1, respectively) but had a lower FEV1 than controls (mean±sd 85.8±11.4 and 95.6±13.2% predicted, respectively p<0.05). Nineteen viral wheezers and 11 controls developed colds. Viral wheezers with colds reported significantly more URT symptoms than controls (median scores (interquartile range): 24 (10–37) and 6 (4–15), respectively p=0.014). Sixteen viral wheezers and no controls reported LRT symptoms (wheeze, chest tightness and shortness of breath). The viral wheezers with colds had small (3–4%) reductions in FEV1 and peak expiratory flow on days with LRT symptoms (days 3–6), but a progressive reduction in PC20 from baseline on days 2, 4 and 17 after inoculation (by 0.82, 1.35 and 1.82 doubling concentrations, respectively). The fall in PC20 affected both atopic and nonatopic subjects equally. There were no changes in FEV1 or PC20 in controls.
An adult model of viral wheeze that is independent of atopy and therefore, of classical atopic asthma was established.
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