Role of Viral Respiratory Infections in Asthma and Asthma Exacerbations

Overview

Journal Lancet

Publisher Elsevier

Specialty General Medicine

Date 2010 Sep 7

PMID 20816549

Citations 350

Authors

William W Busse

Robert F Lemanske Jr

James E Gern

Affiliations

Soon will be listed here.

Abstract

Viral respiratory tract infections are common and usually selflimited illnesses. For patients at risk of asthma, or with existing asthma, viral respiratory tract infections can have a profound effect on the expression of disease or loss of control. New evidence has shown that wheezing episodes early in life due to human rhinoviruses are a major risk factor for the later diagnosis of asthma at age 6 years. For those with existing asthma, exacerbations are a major cause of morbidity, can need acute care, and can, albeit rarely, result in death. Viral respiratory tract infections, predominantly those caused by human rhinoviruses, are associated with asthma exacerbations. There is also evidence that deficiencies in antiviral activity and the integrity of the airway epithelial barrier could make individuals with asthma more likely to have severe viral respiratory infections of the lower airway, and thus increase the risk of exacerbation. In view of the effect of respiratory viruses on many aspects of asthma, efforts to understand the mechanisms and risk factors by which these airway infections cause changes in airway pathophysiology are a first step towards improved treatment.

Citing Articles

Exploring Asthma as a Protective Factor in COVID-19 Outcomes.

Quinn A, Zhao L, Bell S, Huq M, Fang Y Int J Mol Sci. 2025; 26(4).

PMID: 40004141 PMC: 11855143. DOI: 10.3390/ijms26041678.

Comparative analysis of ambient, in-home, and personal exposures reveals associations between breathing zone pollutant levels and asthma exacerbations in high-risk children.

Moore C, Thornburg J, Secor E, Hamlington K, Schiltz A, Freeman K Respir Res. 2025; 26(1):40.

PMID: 39871239 PMC: 11773965. DOI: 10.1186/s12931-025-03114-y.

Non-Pharmaceutical Interventions May Attenuate Acute Exacerbations of Asthma: Experience During the COVID-19 Pandemic in Taiwan.

Lin C, Lin C, Lo Y, Lo C, Huang H, Hsieh M J Asthma Allergy. 2025; 18:59-67.

PMID: 39867642 PMC: 11760758. DOI: 10.2147/JAA.S488352.

The Role of Inflammation in the Pathogenesis of Viral Respiratory Infections.

Kombe Kombe A, Fotoohabadi L, Gerasimova Y, Nanduri R, Lama Tamang P, Kandala M Microorganisms. 2025; 12(12.

PMID: 39770727 PMC: 11678694. DOI: 10.3390/microorganisms12122526.

A Narrative Review of Key Risk Factors for Severe Illness Following SARS-CoV-2, Influenza Virus, and Respiratory Syncytial Virus Infection.

Branche A, Ramesh M, Francis B Infect Dis Ther. 2024; 14(Suppl 1):39-61.

PMID: 39739198 PMC: 11724830. DOI: 10.1007/s40121-024-01081-3.

References

Sakamoto M, Ida S, Takishima T . Effect of influenza virus infection on allergic sensitization to aerosolized ovalbumin in mice. J Immunol. 1984; 132(5):2614-7. View

Parry D, Busse W, Sukow K, Dick C, Swenson C, Gern J . Rhinovirus-induced PBMC responses and outcome of experimental infection in allergic subjects. J Allergy Clin Immunol. 2000; 105(4):692-8. DOI: 10.1067/mai.2000.104785. View

Ober C, Tan Z, Sun Y, Possick J, Pan L, Nicolae R . Effect of variation in CHI3L1 on serum YKL-40 level, risk of asthma, and lung function. N Engl J Med. 2008; 358(16):1682-91. PMC: 2629486. DOI: 10.1056/NEJMoa0708801. View

von Mutius E, Radon K . Living on a farm: impact on asthma induction and clinical course. Immunol Allergy Clin North Am. 2008; 28(3):631-47, ix-x. DOI: 10.1016/j.iac.2008.03.010. View

Wos M, Sanak M, Soja J, Olechnowicz H, Busse W, Szczeklik A . The presence of rhinovirus in lower airways of patients with bronchial asthma. Am J Respir Crit Care Med. 2008; 177(10):1082-9. PMC: 2383991. DOI: 10.1164/rccm.200607-973OC. View

McErlean P, Shackelton L, Andrews E, Webster D, Lambert S, Nissen M . Distinguishing molecular features and clinical characteristics of a putative new rhinovirus species, human rhinovirus C (HRV C). PLoS One. 2008; 3(4):e1847. PMC: 2268738. DOI: 10.1371/journal.pone.0001847. View

Brooks G, Buchta K, Swenson C, Gern J, Busse W . Rhinovirus-induced interferon-gamma and airway responsiveness in asthma. Am J Respir Crit Care Med. 2003; 168(9):1091-4. DOI: 10.1164/rccm.200306-737OC. View

Thomsen S, van der Sluis S, Stensballe L, Posthuma D, Skytthe A, Kyvik K . Exploring the association between severe respiratory syncytial virus infection and asthma: a registry-based twin study. Am J Respir Crit Care Med. 2009; 179(12):1091-7. DOI: 10.1164/rccm.200809-1471OC. View

Hall C, Weinberg G, Iwane M, Blumkin A, Edwards K, Staat M . The burden of respiratory syncytial virus infection in young children. N Engl J Med. 2009; 360(6):588-98. PMC: 4829966. DOI: 10.1056/NEJMoa0804877. View

10.

Thompson E, Pan L, Ostrovnaya I, Weiss L, Gern J, Lemanske Jr R . Integrin beta 3 genotype influences asthma and allergy phenotypes in the first 6 years of life. J Allergy Clin Immunol. 2007; 119(6):1423-9. DOI: 10.1016/j.jaci.2007.03.029. View

11.

Chauhan A, Inskip H, Linaker C, Smith S, Schreiber J, Johnston S . Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children. Lancet. 2003; 361(9373):1939-44. PMC: 7112409. DOI: 10.1016/s0140-6736(03)13582-9. View

12.

Message S, Laza-Stanca V, Mallia P, Parker H, Zhu J, Kebadze T . Rhinovirus-induced lower respiratory illness is increased in asthma and related to virus load and Th1/2 cytokine and IL-10 production. Proc Natl Acad Sci U S A. 2008; 105(36):13562-7. PMC: 2528869. DOI: 10.1073/pnas.0804181105. View

13.

Lee W, Kiesner C, Pappas T, Lee I, Grindle K, Jartti T . A diverse group of previously unrecognized human rhinoviruses are common causes of respiratory illnesses in infants. PLoS One. 2007; 2(10):e966. PMC: 1989136. DOI: 10.1371/journal.pone.0000966. View

14.

Renwick N, Schweiger B, Kapoor V, Liu Z, Villari J, Bullmann R . A recently identified rhinovirus genotype is associated with severe respiratory-tract infection in children in Germany. J Infect Dis. 2008; 196(12):1754-60. PMC: 7109967. DOI: 10.1086/524312. View

15.

Kusel M, de Klerk N, Kebadze T, Vohma V, Holt P, Johnston S . Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma. J Allergy Clin Immunol. 2007; 119(5):1105-10. PMC: 7125611. DOI: 10.1016/j.jaci.2006.12.669. View

16.

Nicholson K, Kent J, Ireland D . Respiratory viruses and exacerbations of asthma in adults. BMJ. 1993; 307(6910):982-6. PMC: 1679193. DOI: 10.1136/bmj.307.6910.982. View

17.

Johnston S, Pattemore P, SANDERSON G, Smith S, Lampe F, Josephs L . Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. BMJ. 1995; 310(6989):1225-9. PMC: 2549614. DOI: 10.1136/bmj.310.6989.1225. View

18.

Shaheen S, Aaby P, Hall A, Barker D, Heyes C, Shiell A . Measles and atopy in Guinea-Bissau. Lancet. 1996; 347(9018):1792-6. DOI: 10.1016/s0140-6736(96)91617-7. View

19.

Bochkov Y, Hanson K, Keles S, Brockman-Schneider R, Jarjour N, Gern J . Rhinovirus-induced modulation of gene expression in bronchial epithelial cells from subjects with asthma. Mucosal Immunol. 2009; 3(1):69-80. PMC: 2884103. DOI: 10.1038/mi.2009.109. View

20.

Kato A, Favoreto Jr S, Avila P, Schleimer R . TLR3- and Th2 cytokine-dependent production of thymic stromal lymphopoietin in human airway epithelial cells. J Immunol. 2007; 179(2):1080-7. PMC: 2220044. DOI: 10.4049/jimmunol.179.2.1080. View