Reviews and feature article
The role of viruses in acute exacerbations of asthma

https://doi.org/10.1016/j.jaci.2010.04.021Get rights and content

Viral respiratory infections are the most common cause of an acute asthma exacerbation in both children and adults and represent a significant global health burden. An increasing body of evidence supports the hypothesis that these infections cause a greater degree of morbidity in asthmatic subjects than in the healthy population, emphasizing a discrepancy in the antiviral response of asthmatics. In this review we discuss why such a discrepancy might exist, examining the role of the bronchial epithelium as well as the main inflammatory cells, mediators, and molecular pathways that are involved in the immune response. In addition, the potential impact of virus-induced asthma exacerbations on airway remodelling is reviewed and we explore which therapeutic options might be of benefit in preventing the deterioration of asthma control seen following viral infection.

Key words

Asthma
acute exacerbation
virus

Abbreviations used

BAL
Bronchoalveolar lavage
BEC
Bronchial epithelial cell
FGF
Fibroblast growth factor
HRV
Human rhinovirus
ICAM-1
Intercellular adhesion molecule 1
IP-10
Interferon-inducible protein 10
IRF
Interferon regulatory factor
NF-κB
Nuclear factor kappa B
PRR
Pattern-recognition receptor
SOCS1
Suppressor of cytokine signaling 1
TLR
Toll-like receptor
VEGF
Vascular endothelial growth factor

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Series editors: Donald Y. M. Leung, MD, PhD, and Dennis K. Ledford, MD

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