Viral infection and exacerbations of asthma during pregnancy: characteristics, mechanisms and consequences

在澳大利亚，至少有12%的孕妇患有哮喘，其中一半以上的孕妇在怀孕期间会经历急性发作。这使胎儿面临出生体重低或早产等不良后果的风险，这对他们的短期和长期健康都有重大影响。导致妊娠期哮喘加重的机制尚不清楚，但对哮喘孕妇的治疗有意义。在非妊娠成人中，大多数哮喘急性发作是由病毒感染引起的，并且在患有哮喘的妊娠女性中可能存在类似的机制。以前的研究没有确定导致妊娠期间哮喘恶化的病毒。我们目前在这一领域有一个很有希望的领先优势，数据显示，三分之一的哮喘孕妇在怀孕期间哮喘严重加重，需要医疗干预，其中很大一部分可能是由于病毒感染。我们认为，在怀孕期间，患有哮喘的孕妇比没有哮喘的孕妇更容易感染病毒。我们还认为，患有哮喘的妇女在怀孕期间会有更严重的病毒感染，这些病毒感染会导致大多数怀孕期间的急性哮喘发作。该项目将确定患有和未患有哮喘的孕妇的感染率，并确定导致怀孕期间哮喘急性发作的病毒。这项研究还将探讨使妇女易受病毒感染的炎症机制。这些结果将有助于更好地了解导致妊娠期哮喘加重的机制，并将用于为孕妇制定更合适的哮喘监测和治疗策略，这将对母亲和婴儿都有健康益处。

At least 12% of pregnant women in Australia have asthma and more than half of these women will experience an acute attack during pregnancy. This puts the fetus at risk of poor outcomes such as low birth weight or premature birth, which has a significant impact on their health in both the short term and long term. The mechanisms which lead to exacerbations of asthma during pregnancy are unknown, but have implications for the treatment of pregnant women with asthma. In non-pregnant adults, the majority of asthma exacerbations are caused by viral infection and it is likely that a similar mechanism operates in pregnant women with asthma. No previous studies have identified the viruses responsible for exacerbations of asthma during pregnancy. We currently have a promising lead in this area, with data showing that one third of pregnant women with asthma have a severe exacerbation of their asthma requiring medical intervention during pregnancy, and a large proportion of these are likely to be due to viral infection. We propose that during pregnancy, pregnant women with asthma are more susceptible to viral infection than pregnant women without asthma. We also suggest that women with asthma will have more severe viral infections during pregnancy, and that these will contribute to the majority of acute asthma attacks during pregnancy. This project will determine the rate of infection among pregnant women with and without asthma and determine the viruses responsible for acute attacks of asthma during pregnancy. The study will also explore the inflammatory mechanisms which predispose women to viral infection. These results will contribute to a greater understanding of the mechanisms leading to exacerbations of asthma during pregnancy and will be used to develop more appropriate asthma monitoring and treatment strategies for pregnant women, which will have health benefits for both mother and baby.