Host Inflammatory Response in Viral Lower Respiratory Tract Infections: Friend or Foe?

Abstract

Viral lower respiratory tract infections (LRTI) are a leading cause of hospitalizations and death worldwide, placing significant pressure on healthcare systems. In this article, two pulmonary critical care specialists explored the prevalence and global burden of viral LRTIs, focusing on recent advancements in understanding the role of dysregulated host immune response and hyper-inflammation. Specifically, they focused on the relevance of alarmin cytokines and their association with adverse patient outcomes. This article reviews the presentations delivered during an industry theater session that took place at the American Thoracic Society (ATS) 2023 International Conference, held in person in Washington, D.C., USA, in May 2023. The primary objective of this session was to provide a comprehensive overview of the impact and burden imposed by severe viral LRTIs. Pratik Sinha, an Assistant Professor in Anesthesiology at Washington University in St. Louis, Missouri, USA, provided valuable insights into the drivers behind the progression of viral LRTIs, which result in significant mortality and morbidity, imposing a considerable clinical burden with unmet needs. Nuala Meyer, an Associate Professor of Medicine at the Hospital of the University of Pennsylvania, Philadelphia, USA, shed light on the dysregulated host immune response and hyper-inflammation triggered by viral infections, which serve as key drivers of disease progression and severe patient outcomes. Sinha also discussed the potential role of alarmin cytokines, particularly IL-33, in influencing the severity and progression of respiratory viral infection. These cytokines may also serve as pleiotropic regulators of the host immune response to viral LRTIs.