Kurai Daisuke, Saraya Takeshi, Ishii Haruyuki, Takizawa Hajime
Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Tokyo, Japan.
Front Microbiol. 2013 Oct 1;4:293. doi: 10.3389/fmicb.2013.00293.
Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation and/or airflow limitation due to pulmonary emphysema. Chronic bronchitis, pulmonary emphysema, and bronchial asthma may all be associated with airflow limitation; therefore, exacerbation of asthma may be associated with the pathophysiology of COPD. Furthermore, recent studies have suggested that the exacerbation of asthma, namely virus-induced asthma, may be associated with a wide variety of respiratory viruses. COPD and asthma have different underlying pathophysiological processes and thus require individual therapies. Exacerbation of both COPD and asthma, which are basically defined and diagnosed by clinical symptoms, is associated with a rapid decline in lung function and increased mortality. Similar pathogens, including human rhinovirus, respiratory syncytial virus, influenza virus, parainfluenza virus, and coronavirus, are also frequently detected during exacerbation of asthma and/or COPD. Immune response to respiratory viral infections, which may be related to the severity of exacerbation in each disease, varies in patients with both COPD and asthma. In this regard, it is crucial to recognize and understand both the similarities and differences of clinical features in patients with COPD and/or asthma associated with respiratory viral infections, especially in the exacerbative stage. In relation to definition, epidemiology, and pathophysiology, this review aims to summarize current knowledge concerning exacerbation of both COPD and asthma by focusing on the clinical significance of associated respiratory virus infections.
慢性阻塞性肺疾病（COPD）的特征是由于肺气肿导致的慢性气道炎症和/或气流受限。慢性支气管炎、肺气肿和支气管哮喘都可能与气流受限有关；因此，哮喘发作可能与COPD的病理生理学相关。此外，最近的研究表明，哮喘发作，即病毒诱发的哮喘，可能与多种呼吸道病毒有关。COPD和哮喘有不同的潜在病理生理过程，因此需要个体化治疗。COPD和哮喘的发作，基本上是由临床症状定义和诊断的，与肺功能的迅速下降和死亡率增加有关。在哮喘和/或COPD发作期间，也经常检测到类似的病原体，包括人鼻病毒、呼吸道合胞病毒、流感病毒、副流感病毒和冠状病毒。COPD和哮喘患者对呼吸道病毒感染的免疫反应可能与每种疾病发作的严重程度有关，两者各不相同。在这方面，认识和理解与呼吸道病毒感染相关的COPD和/或哮喘患者临床特征的异同至关重要，尤其是在加重期。关于定义、流行病学和病理生理学，本综述旨在通过关注相关呼吸道病毒感染的临床意义，总结目前关于COPD和哮喘发作的知识。
