Common cold virus leads to death in lung transplant patients

December 15, 2006

Human rhinovirus (HRV), the leading cause of most common colds, struck two immunosuppressed lung transplant patients, leading to progressive respiratory failure, graft dysfunction and death. The two were part of a group of 11 transplant patients who suffered clinically significant respiratory infection from HRV in both the upper and lower airways, overturning the long-held belief that HRV affects only upper airway tissue.

The research appears in the second issue for December 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Laurent Kaiser, M.D., of the Central Laboratory of Virology at the University Hospital of Geneva, Switzerland, and 13 associates assessed the incidence of chronic rhinovirus infection and its potential clinical impact on 69 lung transplant recipients at two centers. Over a 19-month period, they screened all lung transplant patients using molecular analysis to detect 13 different respiratory viruses.

Human rhinovirus is a leading cause of respiratory infections in adults and children. Adults, on average, get infected with the virus once per year. Lung transplant patients, with impaired immune systems due to drugs to halt rejection, are at potentially higher risk from the virus.

"Our evidence demonstrates that rhinoviral disease is not exclusively limited to the upper respiratory tract," said Dr. Kaiser. "It can also lead to lower respiratory complications, which immunosuppressed patients can be at higher risk of developing."

Although eight lung transplant patients had transient rhinoviral infections, three showed a persistent infection. The others were able to clear the virus from their system.

"We confirmed the persistence of a single strain in each of three lung transplant recipients clinically infected by rhinovirus," said Dr. Kaiser. "Two of the three had chronic upper respiratory tract infections. All three had relapsing lower respiratory infections, and two subsequently died with graft dysfunction."

Dr. Kaiser noted that the persistent infection suggests that certain cases can act as viral reservoirs to sustain transmission of rhinovirus.

"Therefore, in lung transplant recipients with severe immunosuppression, clinical rhinovirus infection needs to be considered," said Dr. Kaiser. "This point might have substantial implications in terms of diagnostic procedures, clinical management, and anti-viral use, if available."

In an editorial on the research in the same issue of the journal, Marc B. Hershenson, M.D., of the University of Michigan, Ann Arbor, and Sebastian L. Johnston, M.D., Ph.D., of the National Heart and Lung Institute at Imperial College in London, wrote: "The report by Drs. Kaiser and colleagues ends once and for all the argument that rhinovirus cannot infect the lower airways. Although interesting new data suggest that rhinoviruses may induce proinflammatory responses in lung cells independent of viral replication, replication is almost certainly required for a maximal response. However, until the present report, which includes positive bronchoalveolar cultures and lung immunochemistry, incontrovertible evidence of rhinoviral replication in the lung in the setting of spontaneous infection has been lacking. This report informs our understanding of the mechanisms underlying rhinovirus-induced exacerbations of asthma and COPD."

They continued: "These exciting new data raise the possibility that patients with asthma and other patients with chronic airway disease are unusually susceptible to rhinovirus infection leading to increased rates of exacerbation. These results may also help explained the increased susceptibility of children to rhinovirus infections. Further studies on susceptibility to rhinovirus infection in the population are now required."
-end-
Contact for article: Laurent Kaiser, M.D., Central Laboratory of Virology, Division of Infectious Diseases, University Hospital of Geneva, Rue Michel-du-Crest 24, 1211 Geneva 14, Switzerland
Phone: +41 22 372 4992
E-mail: laurent.kaiser@hcuge.ch

Contact for editorial: Marc B. Hershenson, M.D., University of Michigan, MSRBII, 1150 W. Medical Center Drive, Room 3570B, Ann Arbor, Michigan 48109 Phone: (734) 936-4200
E-mail: mhershen@umich.edu

American Thoracic Society

Related Virus Articles from Brightsurf:

Researchers develop virus live stream to study virus infection
Researchers from the Hubrecht Institute and Utrecht University developed an advanced technique that makes it possible to monitor a virus infection live.

Will the COVID-19 virus become endemic?
A new article in the journal Science by Columbia Mailman School researchers Jeffrey Shaman and Marta Galanti explores the potential for the COVID-19 virus to become endemic, a regular feature producing recurring outbreaks in humans.

Smart virus
HSE University researchers have found microRNA molecules that are potentially capable of repressing the replication of human coronaviruses, including SARS-CoV-2.

COVID-19 - The virus and the vasculature
In severe cases of COVID-19, the infection can lead to obstruction of the blood vessels in the lung, heart and kidneys.

Lab-made virus mimics COVID-19 virus
Researchers at Washington University School of Medicine in St. Louis have created a virus in the lab that infects cells and interacts with antibodies just like the COVID-19 virus, but lacks the ability to cause severe disease.

Virus prevalence associated with habitat
Levels of virus infection in lobsters seem to be related to habitat and other species, new studies of Caribbean marine protected areas have shown.

Herpes virus decoded
The genome of the herpes simplex virus 1 was decoded using new methods.

A new biosensor for the COVID-19 virus
A team of researchers from Empa, ETH Zurich and Zurich University Hospital has succeeded in developing a novel sensor for detecting the new coronavirus.

How at risk are you of getting a virus on an airplane?
New 'CALM' model on passenger movement developed using Frontera supercomputer.

Virus multiplication in 3D
Vaccinia viruses serve as a vaccine against human smallpox and as the basis of new cancer therapies.

Read More: Virus News and Virus Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.