Research Article: Clinical characteristics and cytokine profiles of children with acute lower respiratory tract infections caused by human rhinovirus

Date Published: July 3, 2018

Publisher: Public Library of Science

Author(s): Jong Gyun Ahn, Dong Soo Kim, Ki Hwan Kim, Alexander Larcombe.


The clinical profile of human rhinovirus (HRV) with regard to lower respiratory infections remains unclear. We analyzed the clinical features and cytokine responses of HRV isolates in children with respiratory infections. Quantitative analysis and genotyping of the HRV-positive samples from 601 nasopharyngeal aspirates (NPAs) were performed using VP4/VP2 sequencing. To compare T-helper1 (Th1) type (IFN-γ, TNF-α) and Th2 type (IL-4, IL-10) cytokine responses between HRV-A, B and C, the levels of the four cytokines were measured. The HRV-positive children had shorter fever duration (P = 0.018), and higher frequencies of chest retraction (P = 0.002) and wheezing (P = 0.022) than did the HRV-negative group. HRV-A was identified in 55 cases (58.5%), HRV-B in 8 (8.5%), and HRV-C in 31 (33.0%). There were no significant differences in the clinical data or NPA cytokines levels between patients with HRV-A and HRV-C infections. HRV is an important pathogen of the lower respiratory tract in young children. HRV-A and HRV-C are the dominant species that cause respiratory difficulty in young children.

Partial Text

Human rhinovirus (HRV) is the most common viral respiratory agent in humans. Although it is the predominant cause of the common cold, HRV was recently found to be associated with an extensive range of more severe respiratory illnesses. This virus has been implicated in pneumonia, bronchiolitis, and exacerbation of asthma and chronic obstructive pulmonary disease [1–4].

This study demonstrates that HRV is an important cause of lower respiratory infection in young children that is associated with symptoms of respiratory distress, such as chest retraction and wheezing. Our findings corroborate several recent studies reporting that HRV, which had previously only been known to cause upper respiratory infection, could play an important role in lower respiratory infection [1,10–12]. In our study, the majority of HRV genotypes were HRV-A (58.5%) and HRV-C (33.0%). The results of this study correspond with those of earlier studies, which found that HRV-A and -C were the predominant species, although the detection order depends on the geographic region [1,13–18].

HRV is an important pathogen of the lower respiratory tract in young children. In particular, HRV-A and HRV-C are the dominant species that cause respiratory difficulties including wheezing and chest retraction. HRV-B may cause minor lower respiratory infections in relatively older children. Further studies are needed to clarify the pathogenesis of HRV, and to define the specific clinical roles of each species.




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