2019
DOI: 10.1183/16000617.0063-2018
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Respiratory viral infection: a potential “missing link” in the pathogenesis of COPD

Abstract: Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of global mortality. Acute exacerbations of COPD frequently necessitate hospital admission to enable more intensive therapy, incurring significant healthcare costs. COPD exacerbations are also associated with accelerated lung function decline and increased risk of mortality. Until recently, bacterial pathogens were believed to be responsible for the majority of disease exacerbations. However, with the advent of cultureindepen… Show more

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Cited by 103 publications
(115 citation statements)
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References 146 publications
(235 reference statements)
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“…This eventually results in the resolution of the inflammatory response and clearance of the viral infection (Vareille et al, 2011;Braciale et al, 2012). However, in a chronically inflamed airway, the responses against the virus may be impaired or aberrant, causing sustained inflammation and erroneous infiltration, resulting in the exacerbation of their symptoms (Mallia and Johnston, 2006;Dougherty and Fahy, 2009;Busse et al, 2010;Britto et al, 2017;Linden et al, 2019). This is usually further compounded by the increased susceptibility of chronic airway inflammatory disease patients toward viral respiratory infections, thereby increasing the frequency of exacerbation as a whole (Dougherty and Fahy, 2009;Busse et al, 2010;Linden et al, 2019).…”
Section: Significance Of Virus Infection In Exacerbation Of Chronic Amentioning
confidence: 99%
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“…This eventually results in the resolution of the inflammatory response and clearance of the viral infection (Vareille et al, 2011;Braciale et al, 2012). However, in a chronically inflamed airway, the responses against the virus may be impaired or aberrant, causing sustained inflammation and erroneous infiltration, resulting in the exacerbation of their symptoms (Mallia and Johnston, 2006;Dougherty and Fahy, 2009;Busse et al, 2010;Britto et al, 2017;Linden et al, 2019). This is usually further compounded by the increased susceptibility of chronic airway inflammatory disease patients toward viral respiratory infections, thereby increasing the frequency of exacerbation as a whole (Dougherty and Fahy, 2009;Busse et al, 2010;Linden et al, 2019).…”
Section: Significance Of Virus Infection In Exacerbation Of Chronic Amentioning
confidence: 99%
“…On the other hand, patients with COPD and patients with CRS without nasal polyp (CRSsNP) are more neutrophilic in nature due to the expression of neutrophil chemoattractants such as CXCL9, CXCL10, and CXCL11 (Cukic et al, 2012;Brightling and Greening, 2019). The pathology of these airway diseases is characterized by airway remodeling due to the presence of remodeling factors such as matrix metalloproteinases (MMPs) released from infiltrating neutrophils (Linden et al, 2019). Viral infections in such conditions will then cause increase neutrophilic activation; worsening the symptoms and airway remodeling in the airway thereby exacerbating COPD, CRSsNP and even CRSwNP in certain cases (Wang et al, 2009;Tacon et al, 2010;Linden et al, 2019).…”
Section: Current Understanding Of Viral Induced Exacerbation Of Chronmentioning
confidence: 99%
See 1 more Smart Citation
“…Collectively, respiratory tract viral infections are responsible for more than 2.5 million deaths/year globally and represent an economic burden on health care systems for all demographics (4). In individuals with underlying chronic airway disease, respiratory tract viral infections increase frequency and severity of disease exacerbations, hospitalizations, and contribute to morbidity and mortality (5)(6)(7)(8)(9). Understanding the mechanisms governing respiratory tract viral infections and host defence is essential for the future development of treatments aimed at minimizing the morbidity and mortality of these pathogens.…”
Section: Introductionmentioning
confidence: 99%
“…Antiviral sensing mechanisms in the respiratory mucosa enable responses to influenza A, respiratory syncytial virus, rhinovirus, and human parainfluenza virus; all single stranded RNA viruses (13). dsDNA viruses are also relevant lung infections, with adenovirus capable of inducing influenza like symptoms in healthy subjects and associated with chronic respiratory disease exacerbations (8,(14)(15)(16). Like RNA viruses, adenovirus is able to infect airway epithelium followed by replication, which leads to a variety of innate immune defences able to sense viral nucleic acids and proteins (14,17,18).…”
Section: Introductionmentioning
confidence: 99%