Association of rhinovirus with exacerbations in young children affected by cystic fibrosis: Preliminary data

Abstract

Rhinovirus (RV) is a common respiratory viral infection linked to worsening of chronic respiratory diseases including cystic fibrosis (CF) and asthma. RV was tested by RT-PCR in samples (n = 465) collected from the upper (nasal swab, oropharyngeal suction, and sputum) and lower (bronchoalveolar washings) respiratory tract of 110 children with CF. Air samples (n = 52) collected from the operating theatres and outpatient clinics were tested for RV. RV was found in 43% of children <5 years suffering an exacerbation, and 12% of older children (5-17 years). RV particles were detected in the air of clinic rooms. Detection of RV is important in better understanding viral infections in patients with CF.

Early respiratory viral infections in infants with cystic fibrosis

“…Our finding of human rhinovirus being the most commonly detected virus agrees with recent publications showing a high prevalence of HRV in early life, both in healthy children and those with CF [ [19] , [20] , [21] ]. Older studies commonly report RSV, influenza and adenovirus in the youngest populations, detected using immunofluorescence staining or virus isolated from tissue or respiratory secretions [ 8 , 9 ].…”

Respiratory viral infections in Western Australians with cystic fibrosis

“…to epithelial cells as a possible mechanism to facilitate secondary bacterial infections [24]. Therefore our findings support the conclusions of previous studies that people with CF have high rates of RV infection, further implicating this virus as a potential major cause of respiratory illness in CF patients [3,9,13,14,25]. Preventing hospitalisation is a major goal for the management of chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), asthma [26] and CF.…”

“…The most frequently detected respiratory virus in adults and children with CF was RV, however, RV was not detected more often in CF patients than in non-CF patients. Previous studies have also reported RV to be the most common cause of VRI in CF patients [9][10][11][12][13][14]22], possibly due to the upregulation of the cellular receptors for RV, ICAM-1 and LDL, in CF epithelial cells [23]. Moreover, RV infection can increase adherence of Staphylococcus spp.…”

“…Even fewer studies have been conducted over the span of a defined respiratory virus season. Nevertheless, recent studies have identified that human rhinovirus (RV) is frequently associated with pulmonary exacerbations in people with CF [13,14], and viruses such as influenza virus A (Flu A) and B, (Flu B), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and parainfluenza viruses 1, 2 and 3 (PIV 1-3) can be regularly detected [9,10,15,16].…”

In vivo experimental models of infection and disease

“…Respiratory viruses have also been identified as triggers of exacerbations in other airway diseases such as cystic fibrosis 132,133 and bronchiectasis 134,135 and there is evidence of impaired antiviral immunity in these diseases. 136 Experimental infection studies may help to define the role of virus infection in these patient populations.…”