title: [Impact of respiratory viruses on the course of chronic obstructive pulmonary disease: towards optimizing treatment].
abstract: The paper analyzes the currently available data on the impact of respiratory viruses (RVs) on the exacerbations and clinical phenotype of chronic obstructive pulmonary disease (COPD), as well as on the molecular mechanisms of this impact. It emphasizes the role of acute respiratory viral infections (ARVI), primarily rhinovirus infections (RVI) as the most important triggers of COPD exacerbations and the causes of their severe and long-term course. Particular attention is given to ARVI-induced secondary bacterial infections that worsen COPD exacerbations. The mechanisms of how RVs potentiate chronic inflammation and remodeling of the airway, which are caused by tobacco smoke, are depicted. There are arguments that there is a much greater correlation of the acute episodes showing the more severe respiratory symptoms of COPD with ARVI than can be found by molecular methods for RV verification. The body's genetic and/or acquired excessive response to viral invasion does not reflect the efficacy of antiviral defense and is an endogenous damaging factor in this situation. The role of RVs in the formation of the clinical phenotypes of COPD with frequent exacerbations remains debatable. The need for a search and more active practical introduction of means to prevent virus-induced COPD exacerbations appears obvious. In this regard, the authors identify chemical and mechanical polyvalent bacterial lysates for oral and sublingual administration. In addition to nonspecific stimulation of antiviral defense, these medicines induce antigen-specific mucosal and systemic reactions against bacterial pathogens. The role of ARVI pathogens in COPD exacerbations deserves a greater practical attention focused towards optimizing the treatment of this social disease.
authors.affiliation: Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Kalyuzhin
authors.affiliation: Consulting Department, State Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia.
authors.forename: I N
authors.initials: IN
authors.lastname: Chelenkova
authors.affiliation: Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, Russia.
authors.forename: Zh B
authors.initials: ZB
authors.lastname: Ponezheva
mesh_terms: D018450:Disease Progression; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000517:prevention & control / Q000821:virology*; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology*; D012229:Rhinovirus / Q000276:immunology / Q000302:isolation & purification; D014765:Viral Vaccines
chemical_list: D014765:Viral Vaccines