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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Persistence of rhinovirus RNA after asthma exacerbation in children
Clinical and Experimental Allergy, Volume 35, No. 5, Year 2005
Notification
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Description
Background: Rhinoviruses (RVs) are believed to cause most asthma exacerbations but their role in the severity of acute asthma and subsequent recovery of airway function is not defined. The importance of atopy in virus-host interactions is also not clear. Objective: We postulated that RV infection and atopic skin prick responses influence the severity of asthma exacerbations as measured by peak expiratory flow (PEF). Methods: Patients aged 4-12 years admitted with acute severe asthma to a hospital emergency room (ER) were recruited. PEF measurements were obtained and nasal aspirates (NA) were taken. Atopy was diagnosed by skin prick responses to allergen and the presence of RV RNA and respiratory syncytial virus (RSV) RNA in NAs was detected using validated PCR assays. Patients were restudied after 6 weeks and after 6 months. Results: Fifty children with acute asthma (mean age ± SD, 7.4 ± 2.7) were enrolled; atopy was present in 37 (74%). RV RNA was detected in 41 (82%) and RSV RNA in six (12%) subjects. After 6 weeks 41 patients were restudied and RV RNA was again detected in 18 (44%). RV RNA was detected after 6 months in four of 16 patients restudied (25%; P = 0.008 vs. ER) and in two of nine children from a control group with stable asthma (22%; P = 0.009 vs. ER). Overall PEF measurements were reduced in asthmatics admitted to ER (% predicted, 63.4 ± 16.4%) but did not differ between patients with RV RNA, RSV RNA or neither virus present. In subjects with RV RNA detectable in ER and after 6 weeks, measurements of PEF in ER were significantly lower than in patients in whom RV RNA was present in ER but absent after 6 weeks (P = 0.009). Regression analysis linked persistence of RV RNA, but not skin prick responses to allergen, to severity of PEF reductions in ER. Conclusion: RV RNA was detectable in >40% of asthmatic children 6 weeks after an acute exacerbation. Asthma exacerbations were more severe in patients with persistence of RV RNA suggesting that the severity of acute asthma may be linked to prolonged and possibly more severe RV infections. © 2005 Blackwell Publishing Ltd.
Authors & Co-Authors
Kling, Sharon
South Africa, Stellenbosch
Stellenbosch University
Donninger, Howard
South Africa, Stellenbosch
Stellenbosch University
Williams, Zelda
South Africa, Stellenbosch
Stellenbosch University
Australia, Clayton
Faculty of Medicine, Nursing and Health Sciences
Vermeulen, Jan H.
South Africa, Cape Town
Medi-clinic Constantiaberg
Weinberg, Eugene G.
South Africa, Cape Town
Red Cross War Memorial Children's Hospital
Latiff, K.
Australia, Clayton
Faculty of Medicine, Nursing and Health Sciences
Ghildyal, R.
Australia, Clayton
Faculty of Medicine, Nursing and Health Sciences
Bardin, Philip G.
Australia, Clayton
Faculty of Medicine, Nursing and Health Sciences
Australia, Clayton
Monash Medical Centre
Statistics
Citations: 131
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1111/j.1365-2222.2005.02244.x
ISSN:
09547894
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Study Approach
Quantitative