PCR detection of viral nucleic acid in fatal asthma: Is the lower respiratory tract a reservoir for common viruses?

Abstract

Background: There is indirect evidence implicating viral respiratory tract infections in the pathogenesis of fatal asthma. However, it is unknown whether viruses are present within the lower respiratory tract in fatal asthma. Objectives: To apply a nine-virus polymerase chain reaction (PCR) panel to postmortem specimens of lower airway secretions and compare the prevalence of viral nucleic acid among patients who died of asthma, asthmatic patients who died of other causes and persons who died without lung disease. Patients and Methods: Postmortem specimens of lower airway secretions from patients who died of asthma (fatal asthma [n = 101), asthmatic patients who died of other causes (n = 4) and nonasthma controls (n = 6) underwent PCR for nine common respiratory viruses. The prevalence of each virus was compared among the three groups. Results: PCR was positive for at least one virus in 19 of 20 cases, and multiple viruses were detected in 14 of 20 cases. The prevalence of each virus was similar in the three groups studied. Conclusions: In fatal asthma, lower airway secretions do not show a specific pattern of viral nucleic acid. Intriguingly, these results suggest that the lower respiratory tract may act as a potential reservoir for common respiratory viruses.