PROJECT SUMMARY/ABSTRACT
Asthma occurs in ~12% of the US population, and rhinovirus (RV) is recognized as the principal virus
producing the common cold syndrome worldwide. Unlike patients without asthma who generally develop upper
respiratory symptoms during colds, asthmatics with an RV infection exhibit severe lower respiratory symptoms
(e.g., cough, wheeze, shortness of breath). In fact, RV, especially species A and C, are associated with 60% to
80% of asthma exacerbations in children requiring treatment in the emergency department. Recent literature
has shown that mutations in cadherin-related family member 3 (CDHR3), the receptor for RVC, increases
susceptibility to RVC infection during exacerbations of asthma. RVA viruses similarly lead to exacerbations of
asthma; however, a genetic link to disease remains unclear. Single nucleotide polymorphisms (SNPs) in
17q21/ORM1-like 3 (ORMDL3) have been associated with both exacerbation and development of asthma.
Strikingly, ~60% of individuals with childhood onset asthma will have risk alleles at this locus. Recently,
ORMDL3 was shown to regulate intercellular adhesion molecule 1 (ICAM1) expression in A549 cells. ICAM1 is
the receptor utilized by RVA to infect epithelial cells. Taken together, this proposal speculates that gain of
function (GOF) SNPs in the 17q21/ORMDL3 locus (risk alleles) modulating ICAM1 expression underlie the
genetic susceptibility to RVA exacerbations in those with asthma. Evaluation of this hypothesis will occur in two
specific aims that maximize research strengths of the Kennedy Laboratory. For Aim 1, the Kennedy Laboratory
will evaluate the effects of risk alleles on ICAM1 expression and downstream effects, including inflammatory
cell infiltrates and mediators in children with asthma exacerbations. Aim 2 will focus on a novel human
precision-cut lung slice (PCLS) platform from donors with asthma and risk alleles. Evaluations of ICAM1
expression and inflammatory mediators, as well as measures of airway hyper-responsiveness (AHR) to
carbachol after RV16 infection in PCLS with and without risk alleles underlie this aim. It is understood that RV
does not replicate well in murine systems and that human cell cultures lack the ability to investigate physiologic
responses of tissue and host immunity during viral infections. With the Kennedy Laboratory’s ability to prepare
and maintain PCLS from human donors that preserve lung architecture and physiologic responses, our
laboratory can examine, within the correct host and target tissue, immunologic mechanisms driving AHR, a
surrogate for asthma exacerbations, in lung tissue from donors with asthma and risk alleles during RVA
infections ex vivo. The project described will generate important data about the immunology of RVA disease in
high-risk asthma populations and will establish a framework on which to conduct further translational
investigations into the relevance of 17q21/ORMDL3 risk alleles, ICAM1, and RVA-induced immune responses
that trigger RVA-induced asthma exacerbations.