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Viral infections in wheezing disorders
1Faculty of Health and Medical Sciences, Dept of Respiratory Medicine, Child and Adolescent Health Service, University of Western Australia, Perth, Australia peter.lesouef@uwa.edu.au.
Abstract:
Over the past year, studies into virus-induced wheeze in children have shifted towards investigations that examine the mechanisms by which respiratory viruses cause wheeze and an increase in studies examining the effects of novel interventions to reduce wheezing exacerbations. Studies on rhinovirus species (RV)-C infection have found that this is associated with a decrease in expression of CDHR3, the cellular receptor specific for this virus, and a decrease in interferon-β expression, both of which are likely to favour RV-C infection. Recent clinical trials in children have found a decrease in wheezing exacerbations with both anti-respiratory syncytial virus antibody and anti-immunoglobulin E antibody therapy, and a clinical trial of prednisolone in children with their first RV-induced wheeze showed that only those with an RV viral count >7000 copies·mL-1 responded. Further studies on the effects of bacterial lysates on immune system function continue to support the potential of this approach to reduce virus-induced wheezing exacerbations in children. These studies and many previous investigations into immunomodulation using bacterial lysates have led to the funding and commencement of a large study in which long-term administration of a bacterial lysate in young children will be assessed for its ability to prevent asthma.
Insights
New research explores how respiratory viruses cause wheezing in children and tests interventions like antibodies and bacterial lysates to prevent asthma. Studies show promise for reducing wheezing exacerbations and potentially preventing childhood asthma.
Area of Science:
- Pediatric Respiratory Medicine
- Immunology
- Virology
Background:
- Virus-induced wheeze is a significant concern in children.
- Rhinovirus-C (RV-C) infection is linked to decreased CDHR3 and interferon-β, favoring viral replication.
- Novel interventions are being investigated to manage wheezing exacerbations.
Purpose of the Study:
- To review recent advancements in understanding virus-induced wheeze mechanisms.
- To summarize findings on novel therapeutic interventions for wheezing in children.
- To highlight the potential of bacterial lysates in preventing childhood asthma.
Main Methods:
- Review of recent studies on respiratory virus mechanisms in children.
- Analysis of clinical trial data for anti-viral antibodies, anti-immunoglobulin E therapy, and prednisolone.
- Examination of research on bacterial lysates for immunomodulation.
Main Results:
- RV-C infection is associated with reduced CDHR3 and interferon-β expression.
- Anti-RSV and anti-IgE therapies decreased wheezing exacerbations.
- Prednisolone efficacy in RV-induced wheeze was dependent on viral load (>7000 copies·mL⁻¹).
- Bacterial lysates show potential for reducing virus-induced wheezing.
Conclusions:
- Understanding virus-induced wheeze mechanisms is advancing.
- Several interventions show promise in reducing wheezing exacerbations.
- Bacterial lysates are a promising avenue for preventing childhood asthma, with a large study now underway.
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