Rhinovirus Infection in Asthmatic Adults

The study set‐up (ClinicalTrials.gov: NCT01866306) is represented schematically in Figure 1. Twenty (out of 23) stable adult mild to moderate asthma patients on inhaled corticosteroids (≤500 µg/day fluticasone propionate or equivalent), all RV16‐seronegative (<1:4), were included in this analysis. The three excluded patients were either not infected (n = 1), infected with another virus at the time of inoculation (n = 1) or the sequence reads did not match with the non‐stranded sequenced samples during the stranded library preparation step (n = 1). Nasal lavage and brushed nasal epithelial cells (NECs) were collected 7 days prior to low dose rhinovirus16 (RV16UB) inoculation (100 TICD₅₀) as baseline and at days 3, 6 and 14 after inoculation.18 RV16UB is a GMP RV16 stock prepared under auspices of U‐BIOPRED, where 100 TICD₅₀ was found to be the lowest optimal dose for effective infections in healthy individuals and asthma patients (manuscript in preparation). Blood was obtained 4 days prior, as baseline, and at day 6 post‐RV16 exposure. Viral load was measured in nasal lavage fluid at days 3, 6 and 14. In addition, a PCR screening for respiratory viruses was performed in throat swabs 1 day before RV16 challenge to ensure no other viral infections. Fractional exhaled nitric oxide (FeNO) was measured, at the same days as nasal lavage was obtained. Cold Symptom Scores and FEV₁% predicted (based on morning values) were measured every day from 7 days before until 14 days after RV16 challenge. The study was approved by the internal review boards of the participating centres, and written informed consent was obtained from all participating patients. Patient baseline characteristics are provided in Table 1. The inclusion and exclusion criteria for these patients are provided in the online data supplement.