Human rhinovirus in bronchial epithelium of infants with recurrent respiratory symptoms
Human rhinovirus in bronchial epithelium of infants with recurrent respiratory symptoms
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DOI：
10.1016/j.jaci.2006.04.032
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发表时间：
2006-09-01
影响因子：
14.2
通讯作者：
Makela, Mika J.
中科院分区：
文献类型：
--
作者：
Malmstrom, Kristiina;Pitkaranta, Anne;Makela, Mika J.
背景：人鼻病毒（HRV）是上呼吸道感染的常见原因。越来越多的证据表明，心率变异性在下呼吸道感染中也很重要，并且经常引起哮喘恶化。目的：我们通过获得反复出现哮喘样呼吸道症状的婴儿的支气管活检来评估下呼吸道心率变异性的存在。方法：一共有201种类固醇-对3至26个月大的婴儿进行肺功能研究，这些婴儿在前2个月内反复出现呼吸道症状至少4周使用身体体积描记法。对68例患儿进行了支气管镜检查，并对59例患儿的支气管活检组织进行了原位杂交检测。21例HRV阳性婴儿中有18例（86%）发现肺功能异常（气道传导性降低），26例HRV阴性婴儿中有15例（58%）发现肺功能异常（P = 0.037）。发生呼吸道感染前6周支气管镜检查与HRV阳性（P = 0.036）。结论：人鼻病毒是经常发现在下呼吸道反复呼吸道症状的婴儿，这些HRV+婴儿的大多数也表现出增加气道resistance.Clinical的影响：人鼻病毒是一种常见的病原体引起上，下呼吸道症状。对这些婴儿的随访将揭示支气管活检中HRV的存在和伴有反复呼吸道症状的肺功能异常是否预示着随后的哮喘。
Background: Human rhinoviruses (HRVs) are a common cause of upper respiratory tract infections. There is growing evidence that HRVs are also important in lower respiratory tract infections and often induce asthma exacerbations.Objective: We evaluated the presence of HRV in the lower respiratory tract by obtaining bronchial biopsies from infants with recurrent asthmalike respiratory symptoms.Methods: A total of 201 steroid-naive infants age 3 to 26 months with recurrent respiratory symptoms for at least 4 weeks within the preceding 2 months were studied for lung function using body plethysmography. Bronchoscopy was performed in 68 children, and bronchial biopsies were available from 59 infants for HRV detection with in situ hybridization.Results: Human rhinovirus was detected in 21 of 47 (45%) specimens. Abnormal lung function (decreased airways conductance) was found in 18 of 21 (86%) HRV+ infants and in 15 of 26 (58%) HRV- infants (P = .037). Occurrence of a respiratory infection in the 6 weeks preceding bronchoscopy correlated with HRV positivity (P = .036).Conclusion: Human rhinovirus is frequently found in the lower airways in infants with recurrent respiratory symptoms, and the majority of these HRV+ infants also showed increased airway resistance.Clinical implications: Human rhinovirus is a common pathogen causing upper and lower respiratory symptoms. Follow-up of these infants will reveal whether the presence of HRV in the bronchial biopsy and abnormal lung function with recurrent respiratory symptoms predicts subsequent asthma.