呼吸道合胞病毒感染对慢性阻塞性肺疾病作用的研究现状

Research Status on the Role of Respiratory Syncytial Virus Infection in Chronic Obstructive Pulmonary Disease

慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)合并病毒感染越来越受到关注,呼吸道合胞病毒(Respiratory Syncytial Virus, RSV)是COPD急性发作中最常见的病毒。在RSV感染的COPD患者中,RSV通过多种TOLL样受体、细胞质视黄酸诱导基因-1样受体和核苷酸结合寡聚化结构域样受体三种模式识别受体参与COPD患者的先天性免疫,获得性免疫损伤反应引起Th1/Th2比例失调,产生细胞因子失衡。RSV的免疫逃逸增强了COPD患者的炎症反应,引起细胞凋亡及组织破坏。支持治疗仍是治疗RSV的主要手段,开发中的RSV疫苗集中在减毒活疫苗、载体疫苗、亚单位疫苗颗粒疫苗和mRNA疫苗。本文对RSV对COPD作用的发病机制、先天免疫、获得性免疫、免疫逃逸、治疗方案和疫苗研究进展等方面进行综述,旨在提高RSV对COPD发病影响的认识。

Chronic obstructive pulmonary disease co-infections with viruses are of increasing concern, and respiratory syncytial virus is the most common virus in acute exacerbations of COPD. In RSV-infected COPD patients, RSV participates in the innate immunity of COPD patients through three modes of receptor recognition: Toll-like receptors, RIG-I like receptors and nucleotide-binding leucine-rich repeat receptors, acquired immune injury response causes a dysregulation of the Th1/Th2 ratio and generates cytokine imbalance. Immune escape of RSV enhances the inflammatory response in COPD patients, causing apoptosis and tissue destruction. Supportive therapy is still the mainstay of treatment for RSV infection, and RSV vaccines in development focus on live attenuated vaccines, vector vaccines, subunit vaccine particulate vaccines, and mRNA vaccines. This article provides a review of the pathogenesis, innate immunity, acquired immunity, immune escape, therapeutic options, and progress in vaccine research with the aim of improving the understanding of the impact of RSV on the pathogenesis of COPD.