Understanding the Asthmatic Response to an Experimental Rhinovirus Infection: Exploring the Effects of Blocking IgE

Abstract Background Rhinovirus (RV) frequently causes asthma exacerbations among children and young adults who are allergic. The interaction between allergen and RV-induced symptoms and inflammation over time is unclear. Objective To compare the response to an experimental inoculation with RV-16 in allergic asthmatics and healthy controls, and evaluate the effects of administrating omalizumab before and during the infection. Methods Two clinical trials were run in parallel. One compared the response to an experimental inoculation with RV-16 among asthmatics with high levels of total IgE versus healthy controls. The other compared the effects of administering omalizumab versus placebo to asthmatics in a randomized, DBPC-investigation. The primary outcome for both trials compared lower respiratory tract symptoms (LRTS) between study groups over the first 4 days of infection. Results Frequent comparisons of symptoms, lung function and blood eosinophil counts revealed differences that were more pronounced among allergic asthmatics than controls by days 2 and 3 after RV inoculation. Additionally, an augmentation of upper and LRTS scores occurred among the atopic asthmatics versus controls during the resolution of symptoms (p Conclusions Lower respiratory tract symptoms and blood eosinophil counts were augmented and lung function reduced among allergic asthmatics early after RV inoculation and increased late in the infection during symptom resolution. The effect of administering omalizumab on the response to RV was most pronounced during the early/innate phase of the infection.