Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Institute of Virology and Microbiology, Witten/Herdecke University, 58453 Witten, Germany.
Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany.
Viruses. 2022 Feb 27;14(3):491. doi: 10.3390/v14030491.
Respiratory viruses play an important role in asthma exacerbation, and early exposure can be involved in recurrent bronchitis and the development of asthma. The exact mechanism is not fully clarified, and pathogen-to-host interaction studies are warranted to identify biomarkers of exacerbation in the early phase. Only a limited number of international exacerbation cohorts were studied. Here, we have established a local pediatric exacerbation study in Germany consisting of children with asthma or chronic, recurrent bronchitis and analyzed the viriome within the nasopharyngeal swab specimens derived from the entire cohort ( = 141). Interestingly, 41% of exacerbated children had a positive test result for human rhinovirus (HRV)/human enterovirus (HEV), and 14% were positive for respiratory syncytial virus (RSV). HRV was particularly prevalent in asthmatics (56%), wheezers (50%), and atopic (66%) patients. Lymphocytes were decreased in asthmatics and in HRV-infected subjects, and patients allergic to house dust mites were more susceptible to HRV infection. Our study thus confirms HRV infection as a strong 'biomarker' of exacerbated asthma. Further longitudinal studies will show the clinical progress of those children with a history of an RSV or HRV infection. Vaccination strategies and novel treatment guidelines against HRV are urgently needed to protect those high-risk children from a serious course of disease.
呼吸道病毒在哮喘恶化中起重要作用，早期暴露可能与复发性支气管炎和哮喘的发展有关。确切机制尚未完全阐明，需要进行病原体与宿主相互作用的研究，以确定早期加重阶段的生物标志物。仅有少数国际加重队列进行了研究。在这里，我们在德国建立了一个当地的儿科加重研究，包括哮喘或慢性、复发性支气管炎的儿童，并分析了来自整个队列（= 141）的鼻咽拭子标本中的病毒组。有趣的是，41%的加重儿童的人鼻病毒（HRV）/人肠病毒（HEV）检测结果为阳性，14%的呼吸道合胞病毒（RSV）检测结果为阳性。HRV 在哮喘患者（56%）、喘息者（50%）和特应性（66%）患者中尤为普遍。哮喘患者和 HRV 感染患者的淋巴细胞减少，对屋尘螨过敏的患者更容易感染 HRV。因此，我们的研究证实 HRV 感染是哮喘加重的一个强有力的“生物标志物”。进一步的纵向研究将显示那些有 RSV 或 HRV 感染史的儿童的临床进展。迫切需要针对 HRV 的疫苗接种策略和新的治疗指南，以保护这些高风险儿童免受严重疾病的影响。
