Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations
Agamemnon Bakakos, Zoi Sotiropoulou, Angelos Vontetsianos, Stavroula Zaneli, Andriana I Papaioannou, Petros Bakakos 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, GreeceCorrespondence: Agamemnon Bakakos, 1st University Department of...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-09-01
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| Series: | Journal of Asthma and Allergy |
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| Online Access: | https://www.dovepress.com/epidemiology-and-immunopathogenesis-of-virus-associated-asthma-exacerb-peer-reviewed-fulltext-article-JAA |
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| author | Bakakos A Sotiropoulou Z Vontetsianos A Zaneli S Papaioannou AI Bakakos P |
| author_facet | Bakakos A Sotiropoulou Z Vontetsianos A Zaneli S Papaioannou AI Bakakos P |
| author_sort | Bakakos A |
| collection | DOAJ |
| description | Agamemnon Bakakos, Zoi Sotiropoulou, Angelos Vontetsianos, Stavroula Zaneli, Andriana I Papaioannou, Petros Bakakos 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, GreeceCorrespondence: Agamemnon Bakakos, 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Kononos 11 Street, Athens, 11634, Greece, Tel +306972455781, Email agabak@hotmail.comAbstract: Asthma is a common airway disease, affecting millions of people worldwide. Although most asthma patients experience mild symptoms, it is characterized by variable airflow limitation, which can occasionally become life threatening in the case of a severe exacerbation. The commonest triggers of asthma exacerbations in both children and adults are viral infections. In this review article, we will try to investigate the most common viruses triggering asthma exacerbations and their role in asthma immunopathogenesis, since viral infections in young adults are thought to trigger the development of asthma either right away after the infection or at a later stage of their life. The commonest viral pathogens associated with asthma include the respiratory syncytial virus, rhinoviruses, influenza and parainfluenza virus, metapneumovirus and coronaviruses. All these viruses exploit different molecular pathways to infiltrate the host. Asthmatics are more prone to severe viral infections due to their unique inflammatory response, which is mostly characterized by T2 cytokines. Unlike the normal T1 high response to viral infection, asthmatics with T2 high inflammation are less potent in containing a viral infection. Inhaled and/or systematic corticosteroids and bronchodilators remain the cornerstone of asthma exacerbation treatment, and although many targeted therapies which block molecules that viruses use to infect the host have been used in a laboratory level, none has been yet approved for clinical use. Nevertheless, further understanding of the unique pathway that each virus follows to infect an individual may be crucial in the development of targeted therapies for the commonest viral pathogens to effectively prevent asthma exacerbations. Finally, biologic therapies resulted in a complete change of scenery in the treatment of severe asthma, especially with a T2 high phenotype. All available data suggest that monoclonal antibodies are safe and able to drastically reduce the rate of viral asthma exacerbations.Keywords: asthma, virus, exacerbation, pathogenesis, lungs |
| first_indexed | 2024-03-11T21:37:46Z |
| format | Article |
| id | doaj.art-6c223bce8b2e4bd89b5b8cf4846e8638 |
| institution | Directory Open Access Journal |
| issn | 1178-6965 |
| language | English |
| last_indexed | 2024-03-11T21:37:46Z |
| publishDate | 2023-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Asthma and Allergy |
| spelling | doaj.art-6c223bce8b2e4bd89b5b8cf4846e86382023-09-26T18:27:38ZengDove Medical PressJournal of Asthma and Allergy1178-69652023-09-01Volume 161025104086951Epidemiology and Immunopathogenesis of Virus Associated Asthma ExacerbationsBakakos ASotiropoulou ZVontetsianos AZaneli SPapaioannou AIBakakos PAgamemnon Bakakos, Zoi Sotiropoulou, Angelos Vontetsianos, Stavroula Zaneli, Andriana I Papaioannou, Petros Bakakos 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, GreeceCorrespondence: Agamemnon Bakakos, 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Kononos 11 Street, Athens, 11634, Greece, Tel +306972455781, Email agabak@hotmail.comAbstract: Asthma is a common airway disease, affecting millions of people worldwide. Although most asthma patients experience mild symptoms, it is characterized by variable airflow limitation, which can occasionally become life threatening in the case of a severe exacerbation. The commonest triggers of asthma exacerbations in both children and adults are viral infections. In this review article, we will try to investigate the most common viruses triggering asthma exacerbations and their role in asthma immunopathogenesis, since viral infections in young adults are thought to trigger the development of asthma either right away after the infection or at a later stage of their life. The commonest viral pathogens associated with asthma include the respiratory syncytial virus, rhinoviruses, influenza and parainfluenza virus, metapneumovirus and coronaviruses. All these viruses exploit different molecular pathways to infiltrate the host. Asthmatics are more prone to severe viral infections due to their unique inflammatory response, which is mostly characterized by T2 cytokines. Unlike the normal T1 high response to viral infection, asthmatics with T2 high inflammation are less potent in containing a viral infection. Inhaled and/or systematic corticosteroids and bronchodilators remain the cornerstone of asthma exacerbation treatment, and although many targeted therapies which block molecules that viruses use to infect the host have been used in a laboratory level, none has been yet approved for clinical use. Nevertheless, further understanding of the unique pathway that each virus follows to infect an individual may be crucial in the development of targeted therapies for the commonest viral pathogens to effectively prevent asthma exacerbations. Finally, biologic therapies resulted in a complete change of scenery in the treatment of severe asthma, especially with a T2 high phenotype. All available data suggest that monoclonal antibodies are safe and able to drastically reduce the rate of viral asthma exacerbations.Keywords: asthma, virus, exacerbation, pathogenesis, lungshttps://www.dovepress.com/epidemiology-and-immunopathogenesis-of-virus-associated-asthma-exacerb-peer-reviewed-fulltext-article-JAAasthmavirusexacerbationpathogenesislungs |
| spellingShingle | Bakakos A Sotiropoulou Z Vontetsianos A Zaneli S Papaioannou AI Bakakos P Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations Journal of Asthma and Allergy asthma virus exacerbation pathogenesis lungs |
| title | Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations |
| title_full | Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations |
| title_fullStr | Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations |
| title_full_unstemmed | Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations |
| title_short | Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations |
| title_sort | epidemiology and immunopathogenesis of virus associated asthma exacerbations |
| topic | asthma virus exacerbation pathogenesis lungs |
| url | https://www.dovepress.com/epidemiology-and-immunopathogenesis-of-virus-associated-asthma-exacerb-peer-reviewed-fulltext-article-JAA |
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