a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.
b Département de Médecine Interne et Pneumologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France.
Crit Rev Microbiol. 2017 Nov;43(6):690-708. doi: 10.1080/1040841X.2017.1297763. Epub 2017 Mar 24.
Although bacteria have historically been considered to play a major role in cystic fibrosis (CF) airway damage, a strong impact of respiratory viral infections (RVI) is also now recognized. Emerging evidence confirms that respiratory viruses are associated with deterioration of pulmonary function and exacerbation and facilitation of bacterial colonization in CF patients. The aim of this review is to provide an overview of the current knowledge on respiratory viruses in CF airways, to discuss the resulting inflammation and RVI response, to determine how to detect the viruses, and to assess their clinical consequences, prevalence, and interactions with bacteria. The most predominant are Rhinoviruses (RVs), significantly associated with CF exacerbation. Molecular techniques, and especially multiplex PCR, help to diagnose viral infections, and the coming rise of metagenomics will extend knowledge of viral populations in the complex ecosystem of CF airways. Prophylaxis and vaccination are currently available only for Respiratory syncytial and Influenza virus (IV), but antiviral molecules are being tested to improve CF patients' care. All the points raised in this review highlight the importance of taking account of RVIs and their potential impact on the CF airway ecosystem.
虽然细菌在囊性纤维化 (CF) 气道损伤中一直被认为起着主要作用，但呼吸道病毒感染 (RVI) 的强烈影响现在也得到了认可。新出现的证据证实，呼吸道病毒与 CF 患者肺功能恶化、细菌定植加剧和促进有关。本综述的目的是提供 CF 气道中呼吸道病毒的当前知识概述，讨论由此产生的炎症和 RVI 反应，确定如何检测病毒，并评估其临床后果、流行率以及与细菌的相互作用。最主要的是鼻病毒 (RV)，它与 CF 恶化显著相关。分子技术，尤其是多重 PCR，有助于诊断病毒感染，而宏基因组学的兴起将扩展 CF 气道复杂生态系统中病毒群的知识。目前仅对呼吸道合胞病毒和流感病毒 (IV) 有预防和疫苗接种，但正在测试抗病毒药物来改善 CF 患者的护理。本综述中提出的所有要点都强调了考虑 RVIs 及其对 CF 气道生态系统的潜在影响的重要性。
