Rhinovirus in pediatric patients with a history of refractory cough is associated with bronchoalveolitis and ciliary dysfunction, according to new research.

To examine the effect of respiratory pathogens on inflammatory patterns in the lungs, investigators analyzed results from clinically indicated bronchoscopy and bronchoalveolar lavage in children aged 1 to 6 years old with treatment-refractory coughing and wheezing.

Among the 245 children without clinical symptoms of recent or acute respiratory infection, rhinovirus was the most common pathogen identified (40%). In comparing bronchoalveolar lavage samples, those in which rhinovirus was detected were more likely to have a higher total cell count, eosinophils, and neutrophils. Additionally, those samples in which rhinovirus was detected were more likely to have absent ciliary motion.

Researchers concluded that β€œThe presence of [rhinovirus] in the lung fluid of preschool children with a history of refractory cough/wheeze but importantly without symptoms of recent respiratory infection is associated with a mixed eosinophiic/neutrophilic bronchoalveolitis, ciliary dysfunction, elevated blood (high-sensitivity C-reactive protein), and T1/T2/T3 cytokine response.” They added that increased broncoalveolar lavage eosinophils and T2 cytokines may identify children at risk of developing persistent wheeze.

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