Exacerbation of asthma and airway infection: is the virus the villain?
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Data
2014
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Resumo
Objective: To review the available literature on the association between acute viral respiratory
tract infection and the onset of asthma exacerbations, identifying the most prevalent viruses,
detection methods, as well as preventive and therapeutic aspects.
Sources: A search was conducted in PubMed, Lilacs, and SciELO databases, between the years
2002 and 2013, using the following descriptors: asthma exacerbation, virus, child, and acute
respiratory infection.
Summary of the findings: A total of 42 original articles addressing the identification of respi-
ratory viruses during episodes of asthma exacerbation were selected, mostly cross-sectional
studies. There was a wide variation in the methodology of the assessed studies, particularly in
relation to the children’s age and methods of collection and viral detection. The results indicate
that, in up to 92.2% of exacerbations, a viral agent was potentially the main triggering factor,
and human rhinovirus was the most frequently identified factor. The pattern of viral circulation
may have been responsible for the seasonality of exacerbations. The association between viral
infections and allergic inflammation appears to be crucial for the clinical and functional uncon-
trolled asthma, but few studies have evaluated other triggering factors in association with viral
infection.
Conclusions: Respiratory viruses are present in the majority of asthmatic children during
episodes of exacerbation. The involved physiopathological mechanisms are yet to be fully
established, and the synergism between allergic inflammation and viral infection appears to
determine uncontrolled disease. The role of other triggering and protective agents is yet to be
clearly determined.
Descrição
Palavras-chave
Asthma, Child, Exacerbation, Virus, Respiratory tract infection
Citação
COSTA, Lusmaia D. C.; COSTA, Paulo Sucasas; CAMARGOS, PAULO A. M. Exacerbation of asthma and airway infection: is the virus the villain? Jornal de Pediatria, Rio de Janeiro, v. 90, n. 6, p. 542-555, 2014.