Pathogenesis

Rhinoviruses attach to specific receptors on respiratory epithelial cells and infect them. After replicating, large numbers of virions are released and infect other cells. Infected cells cease ciliary motion and may slough off. The injury causes the release of inflammatory mediators and stimulates nervous reflexes. The result is an increase in nasal secretions, sneezing, and swelling of the mucosa and nasal erectile tissue. This swelling partially or completely obstructs the airways. Later, in the inflammatory response, dilation of blood vessels, oozing of plasma, and congregation of leukocytes in the infected area occur. Secretions from the area may then contain pus and blood. The infection is eventually halted by the inflammatory response, interferon release, and cellular and humoral immunity, but it can extend into the ears, sinuses, or even the lower respiratory tract before it is stopped. Rhinoviruses can even cause life-threatening pneumonia in individuals with AIDS. ■ interferon, pp. 380,388

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