Respiratory Viruses and Treatment Failure in Children With Asthma Exacerbation

Merckx, Joanna; Ducharme, Francine M; Martineau, Christine; Zemek, Roger; Gravel, Jocelyn; Chalut, Dominic; Poonai, Naveen; Quach, Caroline

doi:10.1542/peds.2017-4105

Cited by 50 publications

(37 citation statements)

References 32 publications

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“…However, the propensity of neutrophils to exacerbate inflammatory conditions in asthma is neither restricted to bacterial pathogens nor to the airways. Neutrophils isolated from the peripheral blood of asthmatics were found to have enhanced secretion of CXCL8 in response to the viral surrogate and TLR agonist R848 compared to non-asthmatics [134], which may provide an explanation for why patients with viral respiratory tract infections are more likely to experience treatment failures [135]. While most therapies are directed at treating eosinophil-mediated allergic asthma, options for developing neutrophil-directed asthma treatments have been investigated.…”

Section: Asthmamentioning

confidence: 99%

Neutrophil Adaptations upon Recruitment to the Lung: New Concepts and Implications for Homeostasis and Disease

Giacalone

Margaroli

Mall

et al. 2020

IJMS

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Neutrophils have a prominent role in all human immune responses against any type of pathogen or stimulus. The lungs are a major neutrophil reservoir and neutrophilic inflammation is a primary response to both infectious and non-infectious challenges. While neutrophils are well known for their essential role in clearance of bacteria, they are also equipped with specific mechanisms to counter viruses and fungi. When these defense mechanisms become aberrantly activated in the absence of infection, this commonly results in debilitating chronic lung inflammation. Clearance of bacteria by phagocytosis is the hallmark role of neutrophils and has been studied extensively. New studies on neutrophil biology have revealed that this leukocyte subset is highly adaptable and fulfills diverse roles. Of special interest is how these adaptations can impact the outcome of an immune response in the lungs due to their potent capacity for clearing infection and causing damage to host tissue. The adaptability of neutrophils and their propensity to influence the outcome of immune responses implicates them as a much-needed target of future immunomodulatory therapies. This review highlights the recent advances elucidating the mechanisms of neutrophilic inflammation, with a focus on the lung environment due to the immense and growing public health burden of chronic lung diseases such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD), and acute lung inflammatory diseases such as transfusion-related acute lung injury (TRALI).

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Section: Asthmamentioning

confidence: 99%

Neutrophil Adaptations upon Recruitment to the Lung: New Concepts and Implications for Homeostasis and Disease

Giacalone

Margaroli

Mall

et al. 2020

IJMS

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“…For RSV in particular, young age in months has been reported to be a predictive factor for progression to a severe condition [13]. Moreover, RSV infection was reported to be a precipitating factor for bronchial asthma [14] and a risk factor for recurrent wheezing [15]. However, difficulty of the treatment of pediatric patients who have underlying bronchial asthma or who developed RSV infection in summer has been mentioned only in a few reports.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with progression to severe condition and treatment prolongation in respiratory syncytial virus infection: a retrospective study in Japan

Oikawa

Suzuki

Terada

et al. 2019

Preprint

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Overview Background: In recent years, the epidemic of respiratory syncytial virus (RSV) has been seen in the summer. In daily clinical practice, we noted that RSV infection tends to become more severe and its treatment tends to be longer, particularly in patients hospitalized in the summer. Thus, we investigated factors associated with the progression to severe condition and the prolongation of treatment in RSV infection. Methods: Subjects were pediatric patients diagnosed with RSV infection and hospitalized for treatment during the 5 year s from April 2014 to March 2019. Information on age, sex, season of hospitalization, gestational age, and bronchial asthma of each subject was collected from inpatient medical records. Duration of oxygen administration was used as an index for treatment duration and the use of devices for severe cases as an index for severity. Multiple linear regression analysis and logistic regression analysis were performed to examine the variables associated with duration of oxygen administration and use of a device for severe cases. Results: Data from 298 patients were analyzed. Duration of oxygen administration was significantly associated with bronchial asthma (partial regression coefficient: 0.804, p = 0.010). Hospitalization in summer was significantly associated with use of a device for severe condition (adjusted odds ratio: 5.89, 95% confidence interval: 1.72-20.18). Conclusion: The present study showed that bronchial asthma is a risk factor for prolongation of treatment and infection in summer is a risk factor for progression to severe condition in cases of RSV infection. These findings suggested that children with bronchial asthma and infection in summer need to be treated carefully regardless of their age, sex, and gestational age.

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“…Viral respiratory infections remain a leading cause of asthma exacerbations, both in children and adults. The presence of any pathogen is usually associated with a higher risk of treatment failure [86]. Typically management of all asthma exacerbations includes a symptomatic treatment increasing doses of beta 2a g o n i s t s , e n h a n c i n g t h e us e o f i n h a l e d o r or a l glucocorticosteroids [87].…”

Section: Treatment Of Asthma In Regard To Viral Infectionsmentioning

confidence: 99%

Role of viruses in asthma

et al. 2020

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Respiratory viral infections are the most important triggers of asthma exacerbations. Rhinovirus (RV), the common cold virus, is clearly the most prevalent pathogen constantly circulating in the community. This virus also stands out from other viral factors due to its large diversity (about 170 genotypes), very effective replication, a tendency to create Th2-biased inflammatory environment and association with specific risk genes in people predisposed to asthma development (CDHR3). Decreased interferon responses, disrupted airway epithelial barrier, environmental exposures (including biased airway microbiome), and nutritional deficiencies (low in vitamin D and fish oil) increase risk to RV and other virus infections. It is intensively debated whether viral illnesses actually cause asthma. Respiratory syncytial virus (RSV) is the leading causative agent of bronchiolitis, whereas RV starts to dominate after 1 year of age. Breathing difficulty induced by either of these viruses is associated with later asthma, but the risk is higher for those who suffer from severe RV-induced wheezing. The asthma development associated with these viruses has unique mechanisms, but in general, RV is a risk factor for later atopic asthma, whereas RSV is more likely associated with later non-atopic asthma. Treatments that inhibit inflammation (corticosteroids, omalizumab) effectively decrease RV-induced wheezing and asthma exacerbations. The anti-RSV monoclonal antibody, palivizumab, decreases the risk of severe RSV illness and subsequent recurrent wheeze. A better understanding of personal and environmental risk factors and inflammatory mechanisms leading to asthma is crucial in developing new strategies for the prevention and treatment of asthma.

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Respiratory Viruses and Treatment Failure in Children With Asthma Exacerbation

Cited by 50 publications

References 32 publications

Neutrophil Adaptations upon Recruitment to the Lung: New Concepts and Implications for Homeostasis and Disease

Neutrophil Adaptations upon Recruitment to the Lung: New Concepts and Implications for Homeostasis and Disease

Factors associated with progression to severe condition and treatment prolongation in respiratory syncytial virus infection: a retrospective study in Japan

Role of viruses in asthma

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