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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2018, Número 2

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Alerg Asma Inmunol Pediatr 2018; 27 (2)


Papel de las infecciones virales en el desarrollo y la exacerbación del asma en los niños

Aguilar PA, Huerta LJG

Idioma: Español
Referencias bibliográficas: 64
Paginas: 49-59
Archivo PDF: 202.93 Kb.


RESUMEN

Las infecciones virales están estrechamente relacionadas con enfermedades sibilantes en niños de todas las edades. El virus sincitial respiratorio (VRS) es el principal agente causal de la bronquiolitis y se ha considerado como el virus que causa más sibilancias en los lactantes, los rinovirus (RV) y los coronavirus, en contraste, son causas bien conocidas de infecciones del tracto respiratorio superior en todas las edades. La enfermedad respiratoria grave inducida por cualquiera de estos virus está asociada con el desarrollo posterior de asma, y el riesgo es mayor para los niños pequeños que tienen sibilancias con infecciones del rinovirus. Si las enfermedades respiratorias realmente causan asma es el tema de un intenso debate. Las enfermedades de sibilancias inducidas por el virus sincitial respiratorio durante la infancia influyen en la salud respiratoria durante años. Hay pruebas definitivas de que la bronquiolitis inducida por el virus sincitial respiratorio puede dañar las vías respiratorias y promover la obstrucción de las vías respiratorias y las sibilancias recurrentes. El rinovirus (RV) probablemente cause menos daño estructural y, sin embargo, es un contribuyente significativo a las enfermedades sibilantes en niños pequeños y en el contexto del asma. Para estos virus, las interacciones entre factores de virulencia virales, factores de riesgo personales (genética) y exposiciones ambientales (microbioma de las vías respiratorias) promueven enfermedades respiratorias y promueven enfermedades sibilantes más graves y el riesgo de progresión del asma. Además, la alergia y el asma son los principales factores de riesgo para las enfermedades más frecuentes y graves relacionadas con el rinovirus, los tratamientos que inhiben la inflamación tienen eficacia para las sibilancias inducidas por rinovirus, mientras que el mAb anti-VSR palivizumab disminuye el riesgo de enfermedad grave inducida por el VSR y las subsecuentes sibilancias recurrentes. Desarrollar una mayor comprensión de los factores personales y ambientales que promueven enfermedades virales más graves podría conducir a nuevas estrategias para la prevención de enfermedades virales sibilantes y quizás reducir el riesgo posterior de asma.


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