Yamaya Mutsuo
Department of Advanced Preventive, Medicine for Infectious Disease, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
Pulm Med. 2012;2012:834826. doi: 10.1155/2012/834826. Epub 2012 Aug 23.
Infection with respiratory viruses, including rhinoviruses, influenza virus, and respiratory syncytial virus, exacerbates asthma, which is associated with processes such as airway inflammation, airway hyperresponsiveness, and mucus hypersecretion. In patients with viral infections and with infection-induced asthma exacerbation, inflammatory mediators and substances, including interleukins (ILs), leukotrienes and histamine, have been identified in the airway secretions, serum, plasma, and urine. Viral infections induce an accumulation of inflammatory cells in the airway mucosa and submucosa, including neutrophils, lymphocytes and eosinophils. Viral infections also enhance the production of inflammatory mediators and substances in airway epithelial cells, mast cells, and other inflammatory cells, such as IL-1, IL-6, IL-8, GM-CSF, RANTES, histamine, and intercellular adhesion molecule-1. Viral infections affect the barrier function of the airway epithelial cells and vascular endothelial cells. Recent reports have demonstrated augmented viral production mediated by an impaired interferon response in the airway epithelial cells of asthma patients. Several drugs used for the treatment of bronchial asthma reduce viral and pro-inflammatory cytokine release from airway epithelial cells infected with viruses. Here, I review the literature on the pathogenesis of the viral infection-induced exacerbation of asthma and on the modulation of viral infection-induced airway inflammation.
感染呼吸道病毒,包括鼻病毒、流感病毒和呼吸道合胞病毒,会加重哮喘,这与气道炎症、气道高反应性和黏液高分泌等过程相关。在病毒感染以及感染诱发哮喘加重的患者中,已在气道分泌物、血清、血浆和尿液中鉴定出炎症介质和物质,包括白细胞介素(ILs)、白三烯和组胺。病毒感染会导致气道黏膜和黏膜下层炎症细胞积聚,包括中性粒细胞、淋巴细胞和嗜酸性粒细胞。病毒感染还会增强气道上皮细胞、肥大细胞和其他炎症细胞中炎症介质和物质的产生,如IL-1、IL-6、IL-8、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、调节激活正常T细胞表达和分泌因子(RANTES)、组胺和细胞间黏附分子-1。病毒感染会影响气道上皮细胞和血管内皮细胞的屏障功能。最近的报告表明,哮喘患者气道上皮细胞中干扰素反应受损介导病毒产生增加。几种用于治疗支气管哮喘的药物可减少感染病毒的气道上皮细胞中病毒和促炎细胞因子的释放。在此,我综述了关于病毒感染诱发哮喘加重的发病机制以及病毒感染诱发气道炎症调节的文献。