RT Journal Article
SR Electronic
T1 Human rhinovirus (HRV) induced changes in mild asthma: Time course of clinical and inflammatory biomarker changes
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2604
DO 10.1183/13993003.congress-2016.PA2604
VO 48
IS suppl 60
A1 Alex Mann
A1 Ganesh Balaratnam
A1 Jane Gunter
A1 Pawel Rucki
A1 Chris Poll
A1 John Efthimiou
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2604.abstract
AB 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<0.005) and lymphocytes significantly lower compared with placebo on Days 2 and 3 post inoculation. Serum levels of CXCL10 (IP-10, p<0.001) and other inflammatory biomarkers were significantly increased in infected subjects in the first few days post inoculation versus placebo.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).