Impact of Therapeutics on Unified Immunity During Allergic Asthma and Respiratory Infections

Abstract

Graphical AbstractInterplay between infectious agents and allergic milieu. Respiratory infections caused by viruses, bacteria and fungi play an important role in asthma pathogenesis. The immune milieu in allergic asthma may be both defective and protective during respiratory infections. Some bacteria are linked to steroid-resistant neutrophilic asthma and an aberrant immune response. Thermotolerant fungi generally induces a T2 immune response in asthma and are linked to asthma severity and higher corticosteroid requirement. Steroid-resistant neutrophilic asthma is associated with increased airway bacterial burden and reduced bacterial diversity. Corticosteroids and antibiotics induce dysbiosis in asthmatics, which may cause immune system alterations. Biologics and antivirals may be beneficial in some patients. However, the effect of eosinophil depletion on antiviral immunity in asthmatics remains unknown. Influenza and COVID-19 vaccination are recommended in asthmatics, but pneumococcal vaccine benefits are still under debate.

Targeting Common Inflammatory Mediators in Experimental Severe Asthma and Acute Lung Injury

“…Tests (blood leukocyte panel, IgE levels, standard cytokine panel including Th1, Th2 and Th17 cytokines, together with allergen identification) that allow for the diagnosis of asthma endotype have to be carried out as routine care, with the findings documented in medical records. When common airborne infections infect patients with underlying allergic asthma, complex, diverse and context-dependent host-pathogen interactions take place [ 56 ].…”

“…Our results suggest that in addition to dexamethasone, Secukinumab possesses the ability to modulate inflammatory cytokine release and to decrease Th17 response in ALI overlapped on exacerbated asthma in mice. Secukinumab long-term safety profile over five years was recently reviewed in other chronic diseases [ 56 ].…”

The Common Cold and Influenza in Children: To Treat or Not to Treat?

“…When encountering a respiratory virus, the innate immune response can be either adequate or incomplete, slowed or weakened, or delayed-in the form of an excessive response after a delay, which can lead to tissue damage [43]. This is particularly important in children with comorbidities and immunocompromised patients, including asthmatics [44,45]. In children with BA, the immune response is imbalanced and may lead to a mutually reinforcing effect of the allergic component of BA and the ARVI pathogen on the inflammation and exacerbation of respiratory tract lesions [45].…”

“…This is particularly important in children with comorbidities and immunocompromised patients, including asthmatics [44,45]. In children with BA, the immune response is imbalanced and may lead to a mutually reinforcing effect of the allergic component of BA and the ARVI pathogen on the inflammation and exacerbation of respiratory tract lesions [45].…”