2002, Number 4
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Rev Inst Nal Enf Resp Mex 2002; 15 (4)
Pathogeny of viral respiratory infections.
Rosete ODP, Archundia SFJ, Cabello GC, Manjarrez ZME
Language: Spanish
References: 54
Page: 239-254
PDF size: 412.28 Kb.
ABSTRACT
Acute respiratory infections are among the most frequent human pathologies and 70% of these infections are generated by viruses. Most of them cause acute respiratory infection (ARI) that are local (influenza, syncytial respiratory, parainfluenza, rhinovirus), but some are able to cause systemic infections (measles, rubella, herpes). As with other microorganisms, the virulence of a virus is under polygenic control, but it is also associated with several physiologic and genetic characteristics of the host, which support viral replication and cell damage. These, in turn, are also closely related with the sensitivity of the receptor cell, a factor that is critical to determine virus tropism and its early interactions such as viral adherence or the release of its nuclear acid inside the cell.
The most important viral antigens capable of inducing the immune response are capsid proteins for nude viruses and glycoprotein spikes for enveloped viruses. Systemic viral infections generate a complete immune response, however, most respiratory tract viruses cause local infections, and for this reason the immune response is short and incomplete.
Several viruses cause ARI of the upper airways but they can reach the lower airways where, besides causing necrosis, they cause cell death and generate other inflammatory pathogenic events. Some of the mechanisms by which viruses introduce sibilance and hyper-reactivity have been proposed, and specific IgE production, decrease in b-adrenergic activity, cholinergic stimulation, among others have been implicated.
Thus, the clinical manifestations generated by viruses are the result of a complex array of events, many of them still unknown.
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