RT Journal Article
SR Electronic
T1 Rhinovirus infection activates coagulation through eosinophilic airway inflammation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 4694
VO 40
IS Suppl 56
A1 Christof Majoor
A1 Pieter Kamphuisen
A1 Marianne van de Pol
A1 Joost Meijers
A1 Tom van der Poll
A1 Anita Böing
A1 Rienk Nieuwland
A1 Sebastian Johnston
A1 Peter J. Sterk
A1 Elisabeth Bel
A1 René Lutter
A1 Koen van der Sluijs
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/4694.abstract
AB Introduction: Exacerbations in asthma are most commonly caused by rhinoviruses. Inflammatory conditions, like asthma, are known to activate hemostasis. Vice versa, a prothrombotic state in the lung can also induce or aggravate pulmonary inflammation.Hypothesis:Rhinovirus infection activates coagulation in patients with asthma, but not in normal control subjects.Methods:14 patients with mild asthma and 14 healthy controls were nasally inoculated with rhinovirus type 16 (10 TCID50) using a validated method. Bronchoalveolar lavage fluid (BALF) was retrieved by bronchoscopy at t=-1 and t=6 days. Microparticle-associated tissue factor(TF) activity in BALF was examined by a fibrin generation test (FGT). Thrombin-antithrombin complexes (TAT) and Eosinophil Cationic Protein (ECP) in BALF were measured by immunoassay. Eosinophils were counted on cytospin preparations.Results:On day 6 after rhinovirus infection, FGT in BALF became significantly shorter in asthma (t=-1: 672s vs. t=6: 516s (medians); p=0.013), whereas there was no change in healthy controls (t=-1: 695s vs. t=6: 707s (medians); p=0.75). At t=6 days, FGT correlated (Spearman) with TAT, eosinophils and ECP (r = -0.607, -0.583 and -0.682 resp., all p<0.01) and TAT with eosinophils and ECP (r = 0.482, 0.538, both p<0.05).Conclusion: Rhinovirus infection significantly shortens the clotting time (FGT) when induced by microparticles isolated from BALF of asthma patients, reflecting enhanced coagulant activity of TF-exposing microparticles. The strong correlations between FGT, TAT, eosinophils and ECP after rhinovirus infection in asthma suggest that eosinophils may play a critical role in the coagulation activation during viral airway infection.