Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Queens University Belfast, Belfast BT9 7AE, UK.
Department of Respiratory Medicine, Mater Hospital Belfast, Belfast BT14 6AB, UK.
Medicina (Kaunas). 2022 Jan 13;58(1):121. doi: 10.3390/medicina58010121.
COPD is a chronic lung disorder characterized by a progressive and irreversible airflow obstruction, and persistent pulmonary inflammation. It has become a global epidemic affecting 10% of the population, and is the third leading cause of death worldwide. Respiratory viruses are a primary cause of COPD exacerbations, often leading to secondary bacterial infections in the lower respiratory tract. COPD patients are more susceptible to viral infections and associated severe disease, leading to accelerated lung function deterioration, hospitalization, and an increased risk of mortality. The airway epithelium plays an essential role in maintaining immune homeostasis, and orchestrates the innate and adaptive responses of the lung against inhaled and pathogen insults. A healthy airway epithelium acts as the first line of host defense by maintaining barrier integrity and the mucociliary escalator, secreting an array of inflammatory mediators, and initiating an antiviral state through the interferon (IFN) response. The airway epithelium is a major site of viral infection, and the interaction between respiratory viruses and airway epithelial cells activates host defense mechanisms, resulting in rapid virus clearance. As such, the production of IFNs and the activation of IFN signaling cascades directly contributes to host defense against viral infections and subsequent innate and adaptive immunity. However, the COPD airway epithelium exhibits an altered antiviral response, leading to enhanced susceptibility to severe disease and impaired IFN signaling. Despite decades of research, there is no effective antiviral therapy for COPD patients. Herein, we review current insights into understanding the mechanisms of viral evasion and host IFN antiviral defense signaling impairment in COPD airway epithelium. Understanding how antiviral mechanisms operate in COPD exacerbations will facilitate the discovery of potential therapeutic interventions to reduce COPD hospitalization and disease severity.
慢性阻塞性肺疾病(COPD)是一种慢性肺部疾病,其特征为进行性和不可逆转的气流阻塞,以及持续的肺部炎症。它已成为一种全球性的流行疾病,影响了全球 10%的人口,是全球第三大致死原因。呼吸道病毒是 COPD 加重的主要原因,常导致下呼吸道继发性细菌感染。COPD 患者更容易受到病毒感染和相关严重疾病的影响,导致肺功能恶化加速、住院和死亡率增加。气道上皮在维持免疫稳态方面起着至关重要的作用,协调肺对吸入和病原体的先天和适应性反应。健康的气道上皮通过维持屏障完整性和黏液纤毛清除功能,分泌一系列炎症介质,并通过干扰素(IFN)反应启动抗病毒状态,起到宿主防御的第一道防线的作用。气道上皮是病毒感染的主要部位,呼吸道病毒与气道上皮细胞的相互作用激活宿主防御机制,导致病毒迅速清除。因此,IFN 的产生和 IFN 信号级联的激活直接有助于宿主防御病毒感染和随后的先天和适应性免疫。然而,COPD 气道上皮的抗病毒反应发生改变,导致对严重疾病的易感性增加和 IFN 信号受损。尽管已经进行了数十年的研究,但针对 COPD 患者,目前仍没有有效的抗病毒疗法。本文综述了目前对 COPD 气道上皮中病毒逃逸和宿主 IFN 抗病毒防御信号受损机制的理解。了解抗病毒机制在 COPD 加重中的作用将有助于发现潜在的治疗干预措施,以减少 COPD 住院和疾病严重程度。