Enhanced airway hyperresponsiveness in asthmatic children and mice with
A(H1N1)pdm09 infection
Abstract
Background: Severe asthma exacerbation is an important comorbidity of
the 2009 HIN1 pandemic [A(H1N1)pdm09] in asthmatic patients.
However, the mechanisms underlying severe asthma exacerbation remain
unknown. In this study, airway hyperresponsiveness (AHR) was measured in
paediatric asthma patients infected with A(H1N1)pdm09. We also evaluated
AHR in asthmatic mice with A(H1N1)pdm09 infection and those with
seasonal influenza for comparison. Methods: AHRs in asthmatic children
were defined as the provocative acetylcholine concentration causing a
20% reduction in FEV1.0 (PC20). To
investigate the pathophysiology using animal models, BALB/c mice aged
6-8 weeks were sensitized and challenged with ovalbumin. Either
mouse-adapted A(H1N1)pdm09, seasonal H1N1 virus (1×105
pfu/20 μL), or mock treatment as a control was administered
intranasally. At 3, 7, and 10 days after infection, each group of mice
was evaluated for AHR by methacholine challenge using an animal
ventilator, flexiVent®. Lung samples were resected and observed using
light microscopy to assess the degree of airway inflammation. Results:
AHRs in the children with bronchial asthma were temporarily increased,
and alleviated by 3 months after discharge. AHR was significantly
enhanced in A(H1N1)pdm09-infected asthmatic mice compared to that in
seasonal H1N1-infected mice (p<0.001), peaking at 7 days
post-infection and then becoming similar to control levels by 10 days
post-infection. Histopathological examination of lung tissues showed
more intense infiltration of inflammatory cells and severe tissue
destruction in A(H1N1)pdm09-infected mice at 7 days post-infection than
at 10 days post-infection. Conclusions: Our results suggest that
enhanced AHR could contribute to severe exacerbation in human asthmatic
patients with A(H1N1)pdm09 infection.