Human respiratory syncytial virus (RSV) is a major cause of severe respiratory illness in children and susceptible adults. RSV blocks the development of the innate antiviral immune response and can grow to high titers in the respiratory tract. Here we demonstrate that immunostimulatory defective viral genomes (iDVGs) that are naturally generated during RSV replication are strong inducers of the innate antiviral response to RSV in mice and humans. In mice, RSV iDVGs stimulated the expression of antiviral genes, restricted viral replication, and prevented weight loss and lung inflammation. In human cells, the antiviral response to RSV iDVGs was dominated by the expression of IFN-λ1 over IFN-β and was driven by rapid intranuclear accumulation of the transcription factor IRF1. RSV iDVGs were detected in respiratory secretions of hospitalized patients, and their amount positively correlated with the level of expression of antiviral genes in the samples. Infection of explanted human lung tissue from different donors revealed that most humans can respond to RSV iDVGs and that the rate of accumulation of iDVGs during infection directly correlates with the quality of the antiviral response. Taken together, our data establish iDVGs as primary triggers of robust antiviral responses to RSV and provide the first evidence for an important biological role for naturally occurring iDVGs during a paramyxovirus infection in humans.

Glucocorticoid (GC) anti-inflammatory effects generally require a prolonged onset of action and involve genomic processes. Because of the rapidity of some of GC effects, however, the concept that non-genomic actions may contribute to GC mechanisms of action has arisen. While the mechanisms have not been completely elucidated, the non-genomic effects may play a role in the management of inflammatory diseases. For instance, we recently reported that GC "rapidly" enhanced the effects of bronchodilators, agents used in the treatment of allergic asthma. In this review, we will discuss i) the non-genomic effects of GCs on pathways relevant to the pathogenesis of inflammatory diseases and ii) the putative role of membrane GC receptor. Since GC side effects are often considered to be generated through its genomic actions, understanding GC non-genomic effects will help design GCs with a better therapeutic index.

Asthma is defined by airway inflammation and hyperresponsiveness, and contributes to morbidity and mortality worldwide. Although bronchodilation is a cornerstone of treatment, current bronchodilators become ineffective with worsening asthma severity. We investigated an alternative pathway that involves activating the airway smooth muscle enzyme, soluble guanylate cyclase (sGC). Activating sGC by its natural stimulant nitric oxide (NO), or by pharmacologic sGC agonists BAY 41-2272 and BAY 60-2770, triggered bronchodilation in normal human lung slices and in mouse airways. Both BAY 41-2272 and BAY 60-2770 reversed airway hyperresponsiveness in mice with allergic asthma and restored normal lung function. The sGC from mouse asthmatic lungs displayed three hallmarks of oxidative damage that render it NO-insensitive, and identical changes to sGC occurred in human lung slices or in human airway smooth muscle cells when given chronic NO exposure to mimic the high NO in asthmatic lung. Our findings show how allergic inflammation in asthma may impede NO-based bronchodilation, and reveal that pharmacologic sGC agonists can achieve bronchodilation despite this loss.A sthma is an inflammatory disease that causes airway hyperreactivity (AHR) and bronchoconstriction, which impedes daily life activities and, when severe, can cause death. It is the most common chronic disease of childhood, accounts for one in three emergency department visits daily, and asthma diagnoses are increasing worldwide (1). The leading treatment for relief and acute care is bronchodilation, which relies heavily on the β-adrenergic receptor-cAMP pathway. Nearly 70% of patients, however, develop resistance or tachyphylaxis to the existing β-agonist therapy (2), underscoring a need for new bronchodilators that can act through a different pharmacologic principle.The nitric oxide-soluble guanylate cyclase-cGMP pathway (NO-sGC-cGMP) is the primary signal transduction pathway for relaxing vascular smooth muscle (3). In contrast, a role for the NO-sGC-cGMP pathway in relaxing airway smooth muscle is less clear (4, 5), and bronchodilation was instead suggested to depend on glutathione nitrosothiol levels in the lung (6, 7). However, recent studies have shown that inflammation can desensitize sGC toward its natural activator, NO (8), and new drugs have become available that directly activate sGC, independent of NO (9). These developments encouraged us to re-examine the NO-sGC-cGMP pathway regarding its role in bronchodilation, its becoming damaged in inflammatory asthma, and its potential for alternative bronchodilator development under this circumstance. ResultsThe NO-sGC-cGMP Pathway Bronchodilates Human Lung. We first tested if stimulating the NO-sGC-cGMP pathway would dilate preconstricted small airways in human precision-cut lung slices (PCLS) obtained from healthy donor lungs (Fig. 1A and Table S1). Graded doses of the slow-release NO donor DETA/NO [3,3-Bis(aminoethyl)-1-hydroxy-2-oxo-1-triazene] produced bronchodilation in human PCLS similar to what was ...

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