Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia.
Nat Med. 2012 May 4;18(5):726-35. doi: 10.1038/nm.2768.
Prospective birth cohort studies tracking asthma initiation and consolidation in community cohorts have identified viral infections occurring against a background of allergic sensitization to aeroallergens as a uniquely potent risk factor for the expression of acute severe asthma-like symptoms and for the ensuing development of asthma that can persist through childhood and into adulthood. A combination of recent experimental and human studies have suggested that underlying this bipartite process are a series of interactions between antiviral and atopic inflammatory pathways that are mediated by local activation of myeloid cell populations in the airway mucosa and the parallel programming and recruitment of their replacements from bone marrow. Targeting key components of these pathways at the appropriate stages of asthma provides new opportunities for the treatment of established asthma but, more crucially, for primary and secondary prevention of asthma during childhood.
前瞻性出生队列研究追踪社区队列中哮喘的起始和巩固情况，发现病毒感染在对气传过敏原过敏致敏的背景下发生，是急性严重哮喘样症状表达和随后发展为哮喘的独特强风险因素，这种哮喘可以持续到儿童期并进入成年期。最近的实验和人体研究的综合结果表明，在这个双重过程的背后，是抗病毒和特应性炎症途径之间的一系列相互作用，这些相互作用是由气道黏膜中髓样细胞群的局部激活以及骨髓中它们的替代物的平行编程和募集所介导的。在哮喘的适当阶段针对这些途径的关键成分进行靶向治疗，为已确立的哮喘治疗提供了新的机会，但更关键的是，为儿童期哮喘的一级和二级预防提供了机会。
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