Aim: Wheezing bronchitis is a common childhood illness, affecting up to 30% of  children, and is associated with an increased risk of asthma at school age. Human rhinovirus (RV) is one of the most common triggers. The aim of this study is to investigate the specific immune response to RV strains A,B, and C and its role as a prognostic risk factor for persistent disease.

Methods: Using a highly sensitive silicon chip, spec. IgG to VP1 peptides representing RV-A,C and B species were measured in serum from 255 preschool wheezers <6yrs,  93 asthmatics ?6 years and 103 healthy controls from the ALL Age Asthma Cohort (ALLIANCE). In wheezers, a Disease Activity Score was defined at each study visit, based on medication and symptoms.

Results: While RV B sIgG levels did not differ between healthy and diseased subjects, IgG to RV A/C was significantly increased in preschool wheezers compared to age-matched healthy controls (p<0.001), with a distinctly different pattern of IgG A/C compared to RV B over age. Wheezers with a high IgG response to RV A/C were 2.7-times more likely to have a high disease activity score at the respective study visit (95%-CI 1.37-5.27, p=0.004). In children ?3 years of age RV-A/C-sIgG showed a very strong association with disease activity at school age with a predictive validity reflected by an area under the curve of 0.70 (AUC).

Conclusions: The specific pattern of immune response to RV-A/C, but not RV-B, at a young age can discriminate healthy from diseased individuals and has a strong predictive value for persistent disease. Whether this is due to RV-specific characteristics or due to host-specific factors remains to be elucidated.