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2002, Number 3

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Rev Inst Nal Enf Resp Mex 2002; 15 (3)

Pathophysiology and pathogenesis or viral bronchiolitis. Recent advances and perspectives.

Carrada-Bravo T

Language: Spanish
References: 122
Page: 172-191
PDF size: 806.56 Kb.


ABSTRACT

After an incubation period of two to eight days, respiratory syncytial virus (RSV), parainfluenza viruses and rhinoviruses replicate in the nasopharyngeal epithelium and spread to the lower respiratory tract one to three days later. The inflammation response to viral bronchiolitis is characterized by necrosis and sloughing of the small airways epithelium, with edema and increased secretion of mucus, which occludes the flow of terminal airways. The resulting clinical manifestations are the hallmark of bronchiolitis: wheezing, alveolar hyperinflation and atelectasis. About 50 percent of the infants hospitalized with RSV have subsequent wheezing episodes with recruitment of TH-2 cells, eosinophils and release of soluble mediators, such as histamine, kinins, and leukotrienes. Severe wheezing has been correlated with increased IgE antibodies levels and the release of cells and inflammatory mediators that may further affect neural pathways with bronchial hyperreactivity, which are common features of viral bronchiolitis and allergic asthma. Research studies have raised the question of whether the current epidemic of asthma could be diminished by controlling RVS and parainfluenza virus infections.


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