Inflammatory and immunological mechanisms of virus induced asthma and chronic obstructive pulmonary disease (COPD) exacerbations

Asthma and chronic obstructive pulmonary disease (COPD) are the two most prevalent chronic airway diseases. Much of the morbidity, mortality and health care costs of the diseases are associated with exacerbations. Exacerbations are acute episodes that punctuated the natural history of the disease characterized by increased symptoms and airflow obstruction determining quality of life impairment and with possible effect on long term history of the disease. Thus, the prevention and the treatment of exacerbations are major tasks in the management of both asthma and COPD. However currently available treatment are only partially effective in reducing the incidence of such events. Over the last decade evidence has emerged implicating virus respiratory tract infections as a major cause of exacerbations both in asthma and in COPD. In particular, rhinovirus (i.e. the etiologic cause of the common cold) is the most frequently identify virus during exacerbations of both asthma and COPD. The comprehension of the inflammatory and immunological mechanisms that pave the way for exacerbation following respiratory tract infection in asthmatic and COPD patients will give the opportunity to highlight novel potential targets for pharmacological intervention. The recent development of in vivo experimental models of rhinovirus induced asthma and COPD exacerbations represents the unique tool to evaluate pathogenetic mechanisms and novel pharmacological pathways for treating and preventing COPD and asthma exacerbations. The aim of the present thesis is to review the data available on inflammatory and immunological mechanisms of virus induced exacerbations of asthma and COPD and to present the results of the studies conducted by the Candidate to enlighten the emerging field of virus induced asthma and COPD exacerbations