Rhinoviruses significantly affect day-to-day respiratory symptoms of children with asthma - 05/03/15
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Abstract |
Background |
Viruses are frequently associated with acute exacerbations of asthma, but the extent to which they contribute to the level of day-to-day symptom control is less clear.
Objective |
We sought to explore the relationship between viral infections, host and environmental factors, and respiratory symptoms in children.
Methods |
Sixty-seven asthmatic children collected samples twice weekly for an average of 10 weeks. These included nasal wash fluid and exhaled breath for PCR-based detection of viral RNA, lung function measurements, and records of medication use and asthma and respiratory symptoms in the previous 3 days. Atopy, mite allergen exposure, and vitamin D levels were also measured. Mixed-model regression analyses were performed.
Results |
Human rhinoviruses (hRVs) were detected in 25.5% of 1232 nasal samples and 11.5% of breath samples. Non-hRV viruses were detected in less than 3% of samples. hRV in nasal samples was associated with asthma symptoms (cough and phlegm: odds ratio = 2.0; 95% CI = 1.4-2.86, P = .0001; wheeze and chest tightness: odds ratio = 2.34, 95% CI = 1.55-3.52, P < .0001) and with cold symptoms, as reported concurrently with sampling and 3 to 4 days later. No differences were found between the 3 hRV genotypes (hRV-A, hRV-B, and hRV-C) in symptom risk. A history of inhaled corticosteroid use, but not atopic status, mite allergen exposure, or vitamin D levels, modified the association between viruses and asthma symptoms.
Conclusion |
The detection of nasal hRV was associated with a significantly increased risk of day-to-day asthma symptoms in children. Host, virus genotype, and environmental factors each had only a small or no effect on the relationship of viral infections to asthma symptoms.
Le texte complet de cet article est disponible en PDF.Key words : Virus, rhinovirus, asthma, asthma control, children, mixed-model analysis, respiratory
Abbreviations used : c-ACT, CCQ, GAPDH, HDM, hRV, ICS, PEF, SPT
Plan
Supported by the National Health and Medical Research Council of Australia (grant 633238). |
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Disclosure of potential conflict of interest: E. R. Tovey has received research and salary support from the National Health and Medical Research Council (Australia) (Project 633238, Fellowship 571126). B. G. Oliver and G. B. Marks have received research support from the National Health and Medical Research Council (Australia), G.B.M.: Fellowship 1060614, Project 632857, 570919, 632781, 633238; B.G.O.: Fellowship 1026880, Project 1023131, 633238. H. K. Reddel is on the advisory board and DSMB for AstraZeneca; has served on advisory boards and DSMBs for Boehringer Ingelheim, GlaxoSmithKline, and Novartis; is on the DSMB for Merck; has had consultant arrangements with AstraZeneca, Biota, and Mundipharma; has received research support from AstraZeneca and GlaxoSmithKline; and has received payment for lectures from AstraZeneca, GlaxoSmithKline, and Novartis. A. Jaffe has previously served on medical advisory committees for Singulair (MSD), Xolair (Novartis), and Bronchitol (Pharmaxis). The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 135 - N° 3
P. 663 - mars 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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