What is it about?

Only 25% of smokers get COPD. There is a missing link between smoking and COPD. The inflammatory changes in COPD include anti-viral responses (CD8 T-lymphocytes). Acute viral infections (Rhinovirus) are common in COPD exacerbations (in the top 3 medical causes for hospitalisation). Chronic virus infections with Adenovirus 5 E1A (an early expressed protein) and RSV have been studied in the past. HSV- 1 is in 20% of exacerbators. It is associated with high dose ICS. Death occurs at 19 m (60 m in HSV negative). Epstein Barr Virus goes from latent (lymph glands) to active shedding in the airway in 60 and 80% of COPD patients.

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Why is it important?

Current treatments for COPD do not prevent deterioration and death.


This review highlights that viral infection may have a role in COPD. There are opportunities to explore antiviral treatment - particularly suppression of Epstein Barr Virus shedding in the airway in COPD

Joe Kidney

Read the Original

This page is a summary of: Respiratory viral infection: a potential “missing link” in the pathogenesis of COPD, European Respiratory Review, March 2019, European Respiratory Society (ERS), DOI: 10.1183/16000617.0063-2018.
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