The Journal of Allergy and Clinical Immunology
Volume 122, Issue 4 , Pages 685-688, October 2008

Etiology of asthma exacerbations

  • Annemarie Sykes, MBBS, MSc

      Affiliations

    • Corresponding Author InformationReprint requests: Annemarie Sykes, MBBS, MSc, Department of Respiratory Medicine, National Heart and Lung Institute, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, Norfolk Place, London W21PG, United Kingdom.
  • ,
  • Sebastian L. Johnston, MBBS, PhD

Department of Respiratory Medicine, National Heart and Lung Institute, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, United Kingdom

Received 24 July 2008; received in revised form 6 August 2008; accepted 7 August 2008.

Asthma exacerbations are common, and the major morbidity, mortality, and health care costs associated with asthma are related to exacerbations. The majority are related to viral infection, and although progress has been made in identifying the mechanisms of virus-induced asthma exacerbations, there is still much to be learned. Allergen exposure causes some exacerbations and can participate in virus-induced exacerbations, as can other environmental exposures. A role for atypical bacterial infection in exacerbations is also increasingly recognized. Exacerbations are characterized by airway inflammation, which can differ in type depending on whether it is primarily infective or allergic in origin. An increased understanding of the inflammatory pathways might lead to identification of targets for the development of novel prevention or treatment strategies.

Key words: Asthma, exacerbations, virus, bacteria, allergen

Abbreviations used: IP-10, IFN-γ–induced protein 10, NF-κB, Nuclear factor κB

 

 Disclosure of potential conflict of interest: A. Sykes has received research support from AstraZeneca. S. L. Johnston has received research support from or consulted for Synairgen, Centocor, AstraZeneca, GlaxoSmithKline, Pfizer, and Sanofi Pasteur.

PII: S0091-6749(08)01513-3

doi:10.1016/j.jaci.2008.08.017

The Journal of Allergy and Clinical Immunology
Volume 122, Issue 4 , Pages 685-688, October 2008