Rhinoviruses revisited: recent advances in pathogenesis and vaccine strategies
10.4168/aard.2026.14.2.69
- Author:
Eun LEE
1
Author Information
1. Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
- Publication Type:REVIEW
- From:Allergy, Asthma & Respiratory Disease
2026;14(2):69-76
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rhinoviruses are the most prevalent respiratory viruses across age groups, responsible for a wide spectrum of illnesses ranging from mild upper respiratory symptoms to lower airway involvement. Moreover, rhinovirus infection is also a major driver of asthma exacerbation and development, imposing a substantial disease burden. Rhinoviruses are classified into three species: Rhinovirus A, Rhinovirus B, and Rhinovirus C, each utilizing distinct host cell receptors and exhibiting different clinical patterns. Rhinovirus A and Rhinovirus C are more frequently associated with clinically significant disease outcomes compared to Rhinovirus B. Rhinovirus C binds to cadherin-related family member 3 (CDHR3), and a missense variant in CDHR3 (rs6967330) increases epithelial expression of the receptor, enhancing susceptibility to infection and severe illness, particularly in early life. Rhinovirus infection induces complex immune responses, characterized by impaired interferon signaling, type 2 inflammation, and epithelial barrier disruption. In individuals with asthma, altered interferon responses and T2-high immune profiles are closely linked to rhinovirus-induced exacerbations.In infants with atopic traits, such as eosinophilia, allergen sensitization, or a family history of allergic diseases, rhinovirus infection is strongly associated with subsequent development of asthma. Rhinovirus vaccine is needed to prevent severe respiratory infections and asthma exacerbations, particularly in vulnerable populations. Rhinovirus vaccine development has been challenging due to extensive antigenic diversity and limited cross-protective immunity. Recent progress in high-valency inactivated vaccines has demonstrated the feasibility of eliciting broad neutralizing responses. Prioritizing rhinovirus types linked to greater clinical severity may enable targeted vaccine strategies for high-risk populations, offering a promising approach to reducing the global burden of rhinovirus-associated illnesses.