Respiratory viral infections and asthma exacerbations: new opportunities of omalizumab

The literature review is devoted to the discussion of the role of respiratory viral infections in the development of exacerbations of bronchial asthma. Despite significant advances in the development of new approaches and means of treating bronchial asthma, an insufficient level of control of the disease remains, one of the consequences of which is an exacerbation of asthma, which causes significant damage both to the health of patients and leads to high costs of the healthcare system for treatment. The article provides data on the leading causal role in the development of exacerbations of bronchial asthma in children, as well as adult respiratory viruses, among which rhinoviruses are most often detected during exacerbations, especially rhinovirus C. Based on the research results, the mechanisms of predisposition of patients with bronchial asthma to virus-induced exacerbations are considered in detail., including at the gene level, associated both with the suppression of the production of cytokines suppressing the replication and spread of viruses, in particular alpha-interferon, and the stimulation of the production of T2 cytokines, such as IL5. An important role in the development of asthma exacerbations in viral infections of allergic sensitization is indicated, the role of allergen-specific IgE antibodies in the pathogenesis of asthma exacerbations caused by viruses is discussed. The data on the role of plasmacytoid dendritic cells in the formation of the pathological process in virusinduced exacerbations in patients with atopic bronchial asthma are presented. The results of studies obtained both in real clinical practice and in experimental rhinovirus infection in patients with asthma, testifying to the high therapeutic efficacy of the preparation of monoclonal antibodies against IgE – omalizumab – in the prevention and treatment of exacerbations of bronchial asthma caused by respiratory viruses are presented