Affiliated Children's Hospital of Kunming Medical University, Kunming, China.
Yunnan Center for Disease Control and Prevention, Kunming, China.
Microbiol Spectr. 2024 Jul 2;12(7):e0385323. doi: 10.1128/spectrum.03853-23. Epub 2024 May 23.
Allergic rhinitis (AR) is a global health challenge that particularly affects the quality of life of children. Human rhinovirus (HRV) infection usually causes common cold in the upper respiratory tract (URT) and can also affect airway allergy development, such as asthma exacerbation, but its relationship with AR is poorly understood. The study aimed to gain insight into the characteristics of HRV that is prevalent in AR children and its role in AR severity. A total of 362 children with symptomatic AR were enrolled from southwestern China during 2022-2023, and nasal lavage samples were collected for HRV molecular characterization and cytokine measurement. HRV was detected in 40% of the AR children, with peak detection in autumn. The positive rate was not correlated with whether the subjects were under allergen-specific immunotherapy (AIT). Among the detected HRVs, 42% were species A, 36% were species B, and 22% were species C, involving 21 A genotypes, 6 B genotypes, and 7 C genotypes. HRV positivity was significantly associated with symptom severity (visual analog scale [VAS] score) and elevated levels of local nasal IgE, interleukin-25 (IL-25), IL-4, and CXCL13 in AR children who did not receive antiallergic treatment. All three species of HRV strains (A1B, A21, B27, B70, and C17) had been isolated and were able to infect respiratory epithelial tissue . Complete genome sequencing showed that the antigenic epitopes of the isolated HRVs had certain variations. Our work reveals the etiological characteristics of URT-HRV in AR children and suggests a role of HRV infection in the pathogenesis of childhood AR.
Our study revealed high human rhinovirus (HRV) detection rate in children with allergic rhinitis (AR), and HRV infection (A, B, or C species) is positively associated with the symptom severity in AR children. Elevated nasal IgE, interleukin-25 (IL-25), IL-4, and CXCL13 levels suggest a potential pathogenic mechanism by which HRV infection induces nasal type 2 immune/inflammation responses and local IgE production in AR patients. In addition, etiological analysis found that the main prevalent HRV species in AR children are A and B (~80%), which is different from acute respiratory infection and asthma exacerbation, where species A and C are dominant. The data reveal the distinct species prevalence characteristics of HRV infection in AR. Finally, we isolated all three species of HRV strains from nasal cavity of AR children with varying degrees of antigenic epitope mutations and in vitro infectivity, highlighting the importance of strengthening monitoring and intervention for respiratory HRV infection in AR children.
本研究旨在了解儿童变应性鼻炎（AR）中普遍存在的人类鼻病毒（HRV）的特征及其在 AR 严重程度中的作用。
2022-2023 年，我们从中国西南部招募了 362 名有症状的 AR 儿童，采集鼻冲洗样本进行 HRV 分子特征分析和细胞因子测定。
在 40%的 AR 儿童中检测到 HRV，秋季检出率最高。阳性率与受试者是否接受过敏原特异性免疫治疗（AIT）无关。在检测到的 HRV 中，42%为 A 种，36%为 B 种，22%为 C 种，涉及 21 种 A 基因型、6 种 B 基因型和 7 种 C 基因型。HRV 阳性与症状严重程度（视觉模拟评分[VAS]评分）和未经抗过敏治疗的 AR 儿童局部鼻 IgE、白细胞介素-25（IL-25）、IL-4 和 CXCL13 水平升高显著相关。三种 HRV 株（A1B、A21、B27、B70 和 C17）均已分离并能感染呼吸道上皮组织。全基因组测序显示，分离的 HRV 抗原表位存在一定变异。
我们的工作揭示了 URT-HRV 在 AR 儿童中的病因学特征，并提示 HRV 感染在儿童 AR 发病机制中的作用。鼻 IgE、白细胞介素-25（IL-25）、IL-4 和 CXCL13 水平升高提示 HRV 感染诱导 AR 患者鼻型 2 型免疫/炎症反应和局部 IgE 产生的潜在致病机制。此外，病因分析发现，AR 儿童中主要流行的 HRV 种为 A 和 B（~80%），与急性呼吸道感染和哮喘加重不同，其中 A 和 C 种占主导地位。数据揭示了 AR 中 HRV 感染的不同种流行特征。最后，我们从 AR 儿童鼻腔中分离出三种 HRV 株，其抗原表位突变程度不同，具有体外感染力，强调了加强对 AR 儿童呼吸道 HRV 感染监测和干预的重要性。
