哮喘联盟

   摘要
   慢性阻塞性肺疾病(COPD) 的特征是慢性气道炎症和/或肺气肿导致的气流受限。慢性支气管炎、肺气肿和支气管哮喘可能都有与气流受限相关；因此，哮喘急性加重可能也与COPD的病理生理学有所关联。此外，近期研究提示，病毒诱发的哮喘急性加重可能与多种呼吸道病毒相关。COPD合并哮喘具有不同的潜在病理生理学进程，因此需要进行个体化治疗。基于临床症状定义和诊断的COPD合并哮喘患者的急性加重，与肺功能快速下降和死亡率增加相关。在哮喘和/或COPD急性加重期也常能检出相似的致病源，包括人鼻病毒、呼吸道合胞病毒、流感病毒、付流感病毒和冠状病毒。COPD或哮喘患者对呼吸道病毒感染的免疫反应可能与急性加重的严重程度相关，但对于COPD合并哮喘的患者则有所不同。就这一点而言，识别和了解与呼吸道病毒感染相关的COPD和/或哮喘患者临床特征的相似点和差异是很重要的，尤其是在急性加重期。本文的目的旨在通过聚焦呼吸道病毒感染相关的临床意义，综述当前对于COPD合并哮喘的急性加重患者的研究进展，包括定义、流行病学和病理生理学。
 

（林江涛 审校）
Front Microbiol. 2013 Oct 1;4:293.


 

Virus-induced exacerbations in asthma and COPD.
 

Kurai D, Saraya T, Ishii H, Takizawa H.
 

ABSTRACT
Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation and/or airflow limitation due to pulmonary emphysema. Chronic bronchitis, pulmonary emphysema, and bronchial asthma may all be associated with airflow limitation; therefore, exacerbation of asthma may be associated with the pathophysiology of COPD. Furthermore, recent studies have suggested that the exacerbation of asthma, namely virus-induced asthma, may be associated with a wide variety of respiratory viruses. COPD and asthma have different underlying pathophysiological processes and thus require individual therapies. Exacerbation of both COPD and asthma, which are basically defined and diagnosed by clinical symptoms, is associated with a rapid decline in lung function and increased mortality. Similar pathogens, including human rhinovirus, respiratory syncytial virus, influenza virus, parainfluenza virus, and coronavirus, are also frequently detected during exacerbation of asthma and/or COPD. Immune response to respiratory viral infections, which may be related to the severity of exacerbation in each disease, varies in patients with both COPD and asthma. In this regard, it is crucial to recognize and understand both the similarities and differences of clinical features in patients with COPD and/or asthma associated with respiratory viral infections, especially in the exacerbative stage. In relation to definition, epidemiology, and pathophysiology, this review aims to summarize current knowledge concerning exacerbation of both COPD and asthma by focusing on the clinical significance of associated respiratory virus infections.
 

Front Microbiol. 2013 Oct 1;4:293.