Castro-Rodríguez J A
Neumólogo Pediatra, Facultad de Medicina, Pontificia Universidad Católica, Chile.
An Pediatr (Barc). 2007 Aug;67(2):161-8. doi: 10.1016/s1695-4033(07)70578-7.
Viral respiratory infections are the factor most frequently associated with asthma (independently of phenotype, age, and phase of the natural history of asthma during which the infection occurs) and there is a strong temporal association between viral respiratory infections and acute obstructive/asthmatic episodes. Nevertheless, the role of viral infections in the pathogenesis of asthma remains poorly characterized. The factors that could explain this association are heterogeneous and sometimes contradictory. The four main causative mechanisms implicated in the association between viral respiratory infections and the subsequent development of asthma or wheezing in children are alterations in airway function and size, dysregulation (congenital and acquired) of airway tone, alterations in the immune response to infections, and the genetic variants involved in immune response. These mechanisms should be taken into account in future preventive and therapeutic strategies.
病毒性呼吸道感染是与哮喘最常相关的因素（与表型、年龄以及感染发生时哮喘自然史的阶段无关），并且病毒性呼吸道感染与急性阻塞性/哮喘发作之间存在强烈的时间关联。然而，病毒感染在哮喘发病机制中的作用仍未得到充分阐明。可以解释这种关联的因素多种多样，有时甚至相互矛盾。与儿童病毒性呼吸道感染及随后发生哮喘或喘息相关的四个主要致病机制是气道功能和大小的改变、气道张力的失调（先天性和后天性）、对感染的免疫反应改变以及免疫反应中涉及的基因变异。在未来的预防和治疗策略中应考虑这些机制。
