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Evolving concepts in how viruses impact asthma: A Work Group Report of the Microbes in Allergy Committee of the American Academy of Allergy, Asthma & Immunology.

  • Altman, Matthew C1
  • Beigelman, Avraham2
  • Ciaccio, Christina3
  • Gern, James E4
  • Heymann, Peter W5
  • Jackson, Daniel J4
  • Kennedy, Joshua L6
  • Kloepfer, Kirsten7
  • Lemanske, Robert F Jr4
  • McWilliams, Laurie M8
  • Muehling, Lyndsey9
  • Nance, Christy10
  • Peebles, R Stokes Jr11
  • 1 Department of Medicine, University of Washington, Seattle, Wash.
  • 2 Division of Pediatric Allergy, Immunology & Pulmonary Medicine, Washington University School of Medicine, St Louis, Mo; Kipper Institute of Allergy and Immunology, Schneider Children's Medical Center of Israel, Tel Aviv University, Petach Tikvah, Israel. , (Israel)
  • 3 Allergy/Immunology and Pediatric Pulmonology and Sleep Medicine, University of Chicago School of Medicine, Chicago, Ill.
  • 4 Division of Pediatric Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
  • 5 Department of Pediatrics, University of Virginia Medical Center, Charlottesville, Va.
  • 6 Division of Allergy/Immunology, Departments of Pediatrics and Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Ark.
  • 7 Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Ind. , (India)
  • 8 Allergy Partners of the Triangle, Raleigh, NC.
  • 9 Department of Medicine, University of Virginia Medical Center, Charlottesville, Va.
  • 10 Department of Pediatrics, Baylor College of Medicine, Houston, Tex; Department of Immunology/Pathology, Baylor College of Medicine, Houston, Tex.
  • 11 Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tenn. Electronic address: [email protected]
Published Article
The Journal of allergy and clinical immunology
Publication Date
May 01, 2020
DOI: 10.1016/j.jaci.2019.12.904
PMID: 31926183


Over the past decade, there have been substantial advances in our understanding about how viral infections regulate asthma. Important lessons have been learned from birth cohort studies examining viral infections and subsequent asthma and from understanding the relationships between host genetics and viral infections, the contributions of respiratory viral infections to patterns of immune development, the impact of environmental exposure on the severity of viral infections, and how the viral genome influences host immune responses to viral infections. Further, there has been major progress in our knowledge about how bacteria regulate host immune responses in asthma pathogenesis. In this article, we also examine the dynamics of bacterial colonization of the respiratory tract during viral upper respiratory tract infection, in addition to the relationship of the gut and respiratory microbiomes with respiratory viral infections. Finally, we focus on potential interventions that could decrease virus-induced wheezing and asthma. There are emerging therapeutic options to decrease the severity of wheezing exacerbations caused by respiratory viral infections. Primary prevention is a major goal, and a strategy toward this end is considered. Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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