Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine. Department of Medicine. Emory University School of Medicine, Atlanta, Georgia, USA.
Curr Opin Pulm Med. 2024 May 1;30(3):287-293. doi: 10.1097/MCP.0000000000001061. Epub 2024 Feb 26.
Asthma exacerbations are associated with substantial symptom burden and healthcare costs. Viral infections are the most common identified cause of asthma exacerbations. The epidemiology of viral respiratory infections has undergone a significant evolution during the COVID-19 pandemic. The relationship between viruses and asthmatic hosts has long been recognized but it is still incompletely understood. The use of newly approved asthma biologics has helped us understand this interaction better.
We review recent updates on the interaction between asthma and respiratory viruses, and we address how biologics and immunotherapies could affect this relationship by altering the respiratory mucosa cytokine milieu. By exploring the evolving epidemiological landscape of viral infections during the different phases of the COVID-19 pandemic, we emphasize the early post-pandemic stage, where a resurgence of pre-pandemic viruses with atypical seasonality patterns occurred. Finally, we discuss the newly developed RSV and SARS-CoV-2 vaccines and how they reduce respiratory infections.
Characterizing how respiratory viruses interact with asthmatic hosts will allow us to identify tailored therapies to reduce the burden of asthma exacerbations. New vaccination strategies are likely to shape the future viral asthma exacerbation landscape.
哮喘恶化与显著的症状负担和医疗保健成本相关。病毒感染是哮喘恶化最常见的明确病因。在 COVID-19 大流行期间，病毒呼吸道感染的流行病学发生了重大演变。病毒和哮喘宿主之间的关系早已被认识，但仍不完全清楚。新批准的哮喘生物制剂的使用帮助我们更好地理解了这种相互作用。
我们回顾了哮喘与呼吸道病毒相互作用的最新进展，并讨论了生物制剂和免疫疗法如何通过改变呼吸道黏膜细胞因子环境来影响这种关系。通过探索 COVID-19 大流行不同阶段病毒感染的不断变化的流行病学情况，我们强调了大流行后的早期阶段，即出现了具有非典型季节性模式的前流行病毒的复发。最后，我们讨论了新开发的 RSV 和 SARS-CoV-2 疫苗以及它们如何减少呼吸道感染。
描述呼吸道病毒如何与哮喘宿主相互作用，将使我们能够确定针对减少哮喘恶化负担的定制疗法。新的疫苗接种策略可能会塑造未来的病毒性哮喘恶化的情况。
