Virus infection in exacerbations of chronic obstructive pulmonary disease requiring ventilation

Cameron, Robert; Wit, D. de; Welsh, Toni; Ferguson, John; Grissell, Terry V.; Rye, P. J.

doi:10.1007/s00134-006-0202-x

Cited by 86 publications

(94 citation statements)

References 38 publications

(54 reference statements)

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“…Greenberg documented that 27% of exacerbations in 62 prospectively followed patients with COPD were related to a viral etiology (45); picornaviruses, parainfluenza virus, and coronaviruses accounted for the majority of infections in this study. Other investigators have suggested that up to 60% of exacerbations have been associated with viral infections, including picornaviruses, respiratory syncytial virus (RSV), influenza, and human metapneumoviruses (46)(47)(48)(49)(50)(51). One prospective study of hospitalized patients with AE-COPDs found a viral pathogen in more than 48% of episodes (vs. 6.25% in the stable state), with a similar distribution of viral pathogens as previously noted (52).…”

Section: Virusessupporting

confidence: 55%

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Martínez

2007

Proceedings of the American Thoracic Society

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Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the natural history of this chronic lung disorder. These events can be caused by a large number of infectious and noninfectious agents and are associated with an increased local and systemic inflammatory response. Their frequency and severity have been linked to progressive deterioration in lung function and health status. Infectious pathogens ranging from viral to atypical and typical bacteria have been implicated in the majority of episodes. Most therapeutic regimens to date have emphasized broad, nonspecific approaches to bronchoconstriction and pulmonary inflammation. Increasingly, therapy that targets specific etiologic pathogens has been advocated. These include clinical and laboratory-based methods to identify bacterial infections. Further additional investigation has suggested specific pathogens within this broad class. As specific antiviral therapies become available, better diagnostic approaches to identify specific pathogens will be required. Furthermore, prophylactic therapy for at-risk individuals during high-risk times may become a standard therapeutic approach. As such, the future will likely include aggressive diagnostic algorithms based on the combination of clinical syndromes and rapid laboratory modalities to identify specific causative bacteria or viruses.

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Section: Virusessupporting

confidence: 55%

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Martínez

2007

Proceedings of the American Thoracic Society

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“…Previous studies have shown inconsistent patterns of viral infection in COPD exacerbations. In an Australian study of the patients with COPD exacerbations requiring ventilation, most exacerbation episodes occurred in winter and spring season suggesting high seasonal variation (Cameron et al 2006). Contrary to this, the positive rate of virus identification was highest in summer (July to September) in the results from Hong Kong (Ko et al 2007a).…”

Section: Discussionmentioning

confidence: 82%

Prevalence and Risk Factors of Respiratory Viral Infections in Exacerbations of Chronic Obstructive Pulmonary Disease

Kwak

Park

Kim

et al. 2016

Tohoku J. Exp. Med.

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Exacerbations of chronic obstructive pulmonary disease (COPD) lead to high morbidity and mortality. Respiratory virus infection is considered as one of the important causes of COPD exacerbations. The aim of this study was to assess the prevalence of respiratory virus infection in COPD exacerbations and to find the factors associated with susceptibility to viral infections. Furthermore, we tried to examine if COPD exacerbations caused by viral infections have more severe clinical outcomes in comparison with those with non-viral causes. We enrolled the patients with acute exacerbations of COPD who were hospitalized in a university hospital, over a 2-year period. Nasopharyngeal swabs were taken and viruses were identified by multiplex polymerase chain reaction. A total of 278 episodes of COPD exacerbations were recorded in 213 patients with COPD (number of females = 73). Among the COPD exacerbations, viral infection was detected in 78 episodes (28.1%) from 67 subjects. The most common virus was rhinovirus (38.8%), followed by respiratory syncytial virus, coronavirus, influenza A, parainfluenza, adenovirus and metapneumovirus. In multivariate regression analysis adjusting for sex, age, BMI, lung function and history of exacerbations, female subjects were found to be significantly associated with viral infections in COPD exacerbations (Odds ratio 2.58, 95%CI 1.25-5.31, P = 0.010). The severity of COPD exacerbations were not different between positive and negative viral detections. In conclusion, the prevalence of viral infection was 28.1% in the hospitalized patients with COPD exacerbations. Moreover, female subjects are at significantly higher risk for viral infections in COPD exacerbations.

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“…This paradigm may apply particularly to the chronic airway disease found in chronic obstructive pulmonary disease (COPD) (1). In this case, bacterial infection of the lower airways is often associated with COPD exacerbation and progression (2), but more sensitive PCR-based technology detects respiratory viruses in the airway with high frequency as well (3)(4)(5)(6)(7). Moreover, viral challenge shows that viral infection alone is sufficient to induce COPD exacerbation and to lead to secondary bacterial infection with exacerbation (8,9).…”

Section: Introductionmentioning

confidence: 99%

Long-term IL-33–producing epithelial progenitor cells in chronic obstructive lung disease

Byers

Alexander‐Brett²,

Patel³

et al. 2013

J. Clin. Invest.

275

255

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Chronic obstructive lung disease is characterized by persistent abnormalities in epithelial and immune cell function that are driven, at least in part, by infection. Analysis of parainfluenza virus infection in mice revealed an unexpected role for innate immune cells in IL-13-dependent chronic lung disease, but the upstream driver for the immune axis in this model and in humans with similar disease was undefined. We demonstrate here that lung levels of IL-33 are selectively increased in postviral mice with chronic obstructive lung disease and in humans with very severe chronic obstructive pulmonary disease (COPD). In the mouse model, IL-33/IL-33 receptor signaling was required for Il13 and mucin gene expression, and Il33 gene expression was localized to a virus-induced subset of airway serous cells and a constitutive subset of alveolar type 2 cells that are both linked conventionally to progenitor function. In humans with COPD, IL33 gene expression was also associated with IL13 and mucin gene expression, and IL33 induction was traceable to a subset of airway basal cells with increased capacities for pluripotency and ATP-regulated release of IL-33. Together, these findings provide a paradigm for the role of the innate immune system in chronic disease based on the influence of long-term epithelial progenitor cells programmed for excess IL-33 production.

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Virus infection in exacerbations of chronic obstructive pulmonary disease requiring ventilation

Abstract: Forty-six (43%) of the patients with COPD exacerbation requiring mechanical ventilation had a probable viral pathogen. Prodromal, clinical and outcome parameters did not distinguish virus from non-virus illness. PCR was the most sensitive whilst virus culture was the least of virus assays.

Cited by 86 publications

References 38 publications

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Prevalence and Risk Factors of Respiratory Viral Infections in Exacerbations of Chronic Obstructive Pulmonary Disease

Long-term IL-33–producing epithelial progenitor cells in chronic obstructive lung disease

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