Viral respiratory infections in association with asthma and sinusitis: a review.
OBJECTIVE
Viral respiratory infections (VRIs) commonly precede asthma exacerbations in both children and adults. Likewise, VRIs may affect the paranasal sinuses, predisposing infected individuals to the development of subsequent acute bacterial sinusitis. This article discusses the role that viruses play in both the development of asthma and in acute asthma exacerbations. Mechanisms by which viral infections provoke asthma exacerbations are reviewed, and treatment of such episodes is discussed. The pathogenesis of sinusitis and association with VRIs is reviewed along with treatment recommendations.


METHODS
Relevant articles in the medical literature were reviewed with sources including randomized, controlled clinical trials, review articles, epidemiologic studies, and standard textbooks in allergy and immunology.


CONCLUSIONS
This review highlights the prominent role that viral pathogens (especially rhinovirus) play in exacerbation of asthma and in the development of sinus disease. The specific mechanisms whereby viral infection leads to an acute asthma exacerbation or to subsequent bacterial sinusitis are described. Treatment options are outlined including the potential future application of antiviral compounds.
Osur
Scott L
SL
Albany Medical College. Albany, New York, USA. brassmicroscope@msn.com
D000208:Acute Disease; D000328:Adult; D017668:Age of Onset; D018927:Anti-Asthmatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000453:epidemiology; D001424:Bacterial Infections / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015536:Down-Regulation / Q000187:drug effects; D006801:Humans; D007223:Infant; D009092:Mucous Membrane / Q000473:pathology; D010850:Picornaviridae Infections / Q000150:complications / Q000821:virology; D015995:Prevalence; D011976:Receptors, Muscarinic / Q000096:biosynthesis / Q000187:drug effects; D012135:Respiratory Sounds / Q000209:etiology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications; D012141:Respiratory Tract Infections / Q000150:complications* / Q000821:virology; D012229:Rhinovirus; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D015163:Superinfection / Q000209:etiology / Q000382:microbiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D014481:United States / Q000453:epidemiology; D014777:Virus Diseases / Q000150:complications* / Q000503:physiopathology
D018927:Anti-Asthmatic Agents; D011976:Receptors, Muscarinic; D014028:Tobacco Smoke Pollution