Influence of atopy on the clinical manifestations of coronavirus infection in adult volunteers

Abstract

Summary In an attempt to understand the relationship between viral upper respiratory tract infection and the underlying virological and immunological mechanisms, thirty‐four volunteers were inoculated intranasally with coronavirus 229E; subsequent virus shedding and/or antibody rises, indicating active infection, were observed in twenty‐nine. There was a greater increase in independently measured scores of clinical severity, e.g. cold symptoms, in those with detectable IgE in nasal secretions (P < 0.01). A similar association was found between clinical scores and serum IgE concentrations 150 IU/ml, but the relationship with systemic atopy, as assessed by skin‐prick tests to common allergens, was less marked. A more detailed study of twelve of the infected volunteers failed to explain these findings on the basis of mast ceil mediator release, as concentrations of leukotriene B4, the sulphidopeptide leukotriene C4, and histamine, were not appreciably elevated in the nasal secretions following virus inoculation. Similarly, there was no evidence that circulating coronavirus specific IgE was produced. Thus, this study suggests that atopy may be related to the severity of cold symptoms produced by coronavirus 229E, although the exact connection has yet to be determined.

The effect of intranasal nedocromil sodium on viral upper respiratory tract infections in human volunteers

“…Could similar mechanisms account for the beneficial effect, shown here, of nedocromil sodium on the symptomatology of experimental colds? The recent study reported by the Common Cold Unit failed to show raised levels of LTB4 and LTC4 or histamine [8], mediators which have been implicated in asthma, in the nasal secretions of subjects following viral inoculation. However, the inability to detect these mediators by direct methods does not exclude them from playing a role, albeit minor, in the common cold.…”

“…Pharmaceutical Division, Loughborough. Leicestershire LEI 1 ORH, U.K. sible for part or all of the inflammatory response to viral infection of the upper respiratory tract have been unsuccessful or at best inconclusive [8][9][10]. The aim of the present studies was to investigate the effect of nedocromil sodium on symptoms resulting from infection with two different respiratory viruses.…”

A view from the common cold unit

“…It was also possible to document the way viruses damage cilia and slow mucociliary transport (Wilson et al, 1989) to look for the role of atopy and possible mediators in producing respiratory symptoms (Callow et al, 1988) and to document local physiological parameters such as nasal blood flow (Bende et al, 1989). Psychological factors, such as personality and 'stress' were also found to be important.…”

“…We do not have equally precise information for colds. Rather low amounts of leukotrines, prostaglandins and histamine have been found in nasal secretions in colds (Callow et al, 1988) and blocking cholinergic transmission has limited effect on cold symptoms (Gaffey et al, 1988). On the other hand an inhibitor of mast cell degranulation, which impedes mediator release, has some beneficial effect on colds -even though this has not been proved to be due to an effect on mediators (Barrow et al, 1990a).…”

A study of the efficacy of the bradykinin antagonist, NPC 567, in rhinovirus infections in human volunteers

“…Attempts to demonstrate the presence of certain mediators of tissue reaction to infection, e.g. histamine and leukotrienes, in the nasal secretions of individuals with colds have proved negative or, at best, equivocal (Egglestone et al, 1984;Naclerio et al, 1987;Callow et al, 1988;Proud et al, 1990). However, kinins, including bradykinin, have been shown to be generated during the coryzal phase of both experimental (Naclerio et al, 1987) and natural (Proud et al, 1990) rhinovirus infections and the intranasal administration of bradykinin produces symptoms indistinguishable from those of a rhinovirus cold (Proud et al, 1988).…”