Viral and bacterial infections in the development and progression of asthma
Viral and bacterial infections in the development and progression of asthma
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DOI：
10.1016/s0091-6749(00)90050-2
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发表时间：
2000-02-01
影响因子：
14.2
通讯作者：
Gern, JE
中科院分区：
文献类型：
--
作者：
Gern, JE
病毒性呼吸道感染可导致所有年龄段的患者出现喘息性疾病。在婴儿期，呼吸道合胞病毒和副流感病毒感染是毛细支气管炎和哮吼的主要原因，而鼻病毒等普通感冒病毒感染是年龄较大的儿童和成人哮喘患者喘息的主要诱因。除了引起哮喘中喘息增加之外，越来越多的证据表明，儿童早期的感染可以影响免疫系统的发育，从而改变随后发生过敏和哮喘的风险。这两种作用似乎都是由病毒诱导的免疫应答介导的。在病毒感染过程的早期，气道中的驻留细胞以抗原非依赖性方式被激活，触发抗病毒反应，但也激活和招募细胞到气道，这可能有助于气道阻塞和呼吸道症状，病毒特异性T细胞和B细胞反应也可能在预先存在的气道炎症的存在下具有双重作用。最后，有证据表明过敏原和病毒诱导的气道炎症之间存在协同作用。病毒诱导炎症机制的进一步明确很可能为过敏和哮喘的治疗和预防提供治疗靶点。
Viral respiratory infections produce wheezing illnesses in patients of all ages, In infancy, infections with respiratory syncytial virus and parainfluenza virus are the major cause of bronchiolitis and croup, whereas infections with common cold viruses such as rhinoviruses are the principal triggers for wheezing in older children and adults with asthma. In addition to causing increased wheezing in asthma, there is mounting evidence that infections early in childhood can affect the development of the immune system and thereby modify the risk for the subsequent development of allergies and asthma, Both of these effects appear to be mediated by virus-induced immune responses, Early during the course of viral infection, resident cells in the airway are activated in an antigen-independent fashion, triggering antiviral responses but also activating and recruiting cells to the airway that could contribute to airway obstruction and respiratory symptoms, Virus-specific T- and B-cell responses may also have dual effects in the presence of preexisting airway inflammation. Finally, there is evidence of synergistic interactions between allergen- and virus-induced airway inflammation. It is Likely that greater definition of mechanisms of virus-induced inflammation will provide therapeutic targets for the treatment and possibly the prevention of allergies and asthma.