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© 2005 The American Thoracic Society
Overview of Virus-induced Airway Disease
Department of Respiratory Medicine, National Heart and Lung Institute and Wright Fleming Institute of Infection and Immunity, Imperial College London, London, United Kingdom
Correspondence and requests for reprints should be addressed to Sebastian L. Johnston, M.D., Ph.D., Professor of Respiratory Medicine, Department of Respiratory Medicine, National Heart & Lung Institute and Wright Fleming Institute of Infection & Immunity, Imperial College London, Norfolk Place, London W2 1PG, UK. E-mail: s.johnston{at}imperial.ac.uk
Acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD) are the major cause of morbidity, mortality, and health costs of both diseases. Currently available treatments are poorly effective in both acute treatment of and prevention of acute exacerbations. New treatments for intervention and prophylaxis are therefore required; to facilitate their development, we must understand the causes and mechanisms of exacerbations. Respiratory viral infections (2/3 rhinoviruses) precipitate 80% or more of asthma exacerbations in children, and the majority of exacerbations of asthma and COPD in adults, but mechanisms of virus-induced lower airway inflammation and of host resistance against respiratory viruses are poorly understood. Development of in vitro experimental models of virus infection has identified interferon-ß and nitric oxide as possible therapeutic targets to augment antiviral immunity, and nuclear factor-
B as a target for development of anti-inflammatory therapies. In vivo models could also serve to identify and validate targets and as an experimental system to test candidate molecules as they emerge into clinical studies. Studies in asthma have paved the way for development of an asthma model; a similar experimental model in COPD would accelerate development of new therapies for these common diseases with enormous burdens of illness.
Key Words: acute exacerbations • asthma • chronic obstructive pulmonary disease • virus infections
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