Kelly John T, Busse William W
Section of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Section of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
J Allergy Clin Immunol. 2008 Oct;122(4):671-682. doi: 10.1016/j.jaci.2008.08.013.
Viral respiratory infections can have a profound effect on many aspects of asthma including its inception, exacerbations, and, possibly, severity. Of the many viral respiratory infections that influence asthma, the common cold virus, rhinovirus, has emerged as the most frequent illness associated with exacerbations and other aspects of asthma. The mechanisms by which rhinovirus influences asthma are not fully established, but current evidence indicates that the immune response to this virus is critical in this process. Many airway cell types are involved in the immune response to rhinovirus, but most important are respiratory epithelial cells and possibly macrophages. Infection of epithelial cells generates a variety of proinflammatory mediators to attract inflammatory cells to the airway with a subsequent worsening of underlying disease. Furthermore, there is evidence that the epithelial airway antiviral response to rhinovirus may be defective in asthma. Therefore, understanding the immune response to rhinovirus is a key step in defining mechanisms of asthma, exacerbations, and, perhaps most importantly, improved treatment.
病毒性呼吸道感染可对哮喘的许多方面产生深远影响,包括其发病、加重,以及可能的严重程度。在众多影响哮喘的病毒性呼吸道感染中,普通感冒病毒——鼻病毒,已成为与哮喘加重及其他方面关联最为频繁的疾病。鼻病毒影响哮喘的机制尚未完全明确,但目前的证据表明,针对该病毒的免疫反应在这一过程中至关重要。许多气道细胞类型参与了对鼻病毒的免疫反应,但最为重要的是呼吸道上皮细胞,可能还有巨噬细胞。上皮细胞感染会产生多种促炎介质,吸引炎症细胞至气道,进而使基础疾病恶化。此外,有证据表明,哮喘患者气道上皮对鼻病毒的抗病毒反应可能存在缺陷。因此,了解对鼻病毒的免疫反应是明确哮喘机制、加重因素,或许最为重要的是改进治疗方法的关键一步。