Differential Airway Inflammatory Responses in Asthma Exacerbations Induced by Respiratory Syncytial Virus and Influenza Virus A

Background: Although respiratory viral infections cause acute exacerbations of asthma, the inflammatory responses vary depending on the causative virus. The purpose of this study was to compare the inflammatory responses in the airways of acute exacerbations of asthma induced by respiratory syncytial virus (RSV) and influenza A virus. Methods: Sputum induction was performed in asthmatic patients with acute exacerbations induced by RSV (n = 6), influenza A (n = 7), and non-upper respiratory infection (URI)-related factors (n = 8). Sputum concentrations of cysteinyl leukotrienes (cysLTs), TNF-alpha and IFN-gamma were measured. Results: Sputum cysLTs were significantly higher in RSV-induced exacerbations than in influenza A- and non-URI-induced exacerbations. Sputum TNF-alpha was significantly higher in influenza A-induced exacerbations than in RSV- and non-URI-induced exacerbations. Sputum IFN-gamma was significantly lower in RSV-induced exacerbations than in the others. Conclusions: RSV and influenza A cause acute exacerbations and have different effects on airway inflammation in asthmatic patients. RSV significantly increased cysLTs, while influenza A significantly increased TNF-alpha in the airway. The underlying mechanism in virus-induced asthma might depend on the viral species. Copyright (C) 2013 S. Karger AG, Basel