Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Video Abstracts
  • Reviews
    • View all reviews ...
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • Substance Use Disorders (Oct 2024)
    • Clonal Hematopoiesis (Oct 2024)
    • Sex Differences in Medicine (Sep 2024)
    • Vascular Malformations (Apr 2024)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Video Abstracts
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Asthma as a chronic disease of the innate and adaptive immune systems responding to viruses and allergens
Michael J. Holtzman
Michael J. Holtzman
Published August 1, 2012
Citation Information: J Clin Invest. 2012;122(8):2741-2748. https://doi.org/10.1172/JCI60325.
View: Text | PDF
Review Series

Asthma as a chronic disease of the innate and adaptive immune systems responding to viruses and allergens

  • Text
  • PDF
Abstract

Research on the pathogenesis of asthma has traditionally concentrated on environmental stimuli, genetic susceptibilities, adaptive immune responses, and end-organ alterations (particularly in airway mucous cells and smooth muscle) as critical steps leading to disease. The focus of this cascade has been the response to allergic stimuli. An alternative scheme suggests that respiratory viruses and the consequent response of the innate immune system also drives the development of asthma as well as related inflammatory diseases. This conceptual shift raises the possibility that sentinel cells such as airway epithelial cells, DCs, NKT cells, innate lymphoid cells, and macrophages also represent critical components of asthma pathogenesis as well as new targets for therapeutic discovery. A particular challenge will be to understand and balance the innate as well as the adaptive immune responses to defend the host against acute infection as well as chronic inflammatory disease.

Authors

Michael J. Holtzman

×

Figure 2

Immune pathways leading to postviral lung disease.

Options: View larger image (or click on image) Download as PowerPoint
Immune pathways leading to postviral lung disease.
(i) Early viral illne...
(i) Early viral illness is characterized by the induction of IFN-α/β/λ and ISG expression to control viral replication and promote cell death and subsequent phagocytosis by CCL5-protected macrophages. (ii) Late viral illness includes lung DC migration to regional lymph nodes for MHC class I–dependent generation of CD8+ T cells and MHC class II–dependent generation of CD4+ Th2 cells and consequent B cell (and, in turn, plasma cell) production of antiviral antibodies (including IgE). (iii) Acute postviral disease is marked by IFN-α/β– and CD49+ polymorphonuclear (PMN) cell–dependent upregulation of FcεRI expression on resident lung DCs. In turn, FcεRI activation by viral antigen and antiviral IgE leads to the production of CCL28 and the recruitment of CCR10-expressing IL-13–producing Th2 cells to the lung. (iv) For chronic postviral disease, virus-activated APCs orchestrate CD1d-dependent glycolipid antigen presentation and consequent activation of iNKT cells. These iNKT cells then interact directly with lung macrophages via IL-13–IL-13R and invariant Vα14 TCR–CD1d interactions. These signals lead to increased expression of IL-13R and production of IL-13 that drives a positive feedback loop to amplify IL-13 production and activation of M2 macrophages, marked by chitinase 1 and arachidonate 15-LOX expression. In this immune axis, the airway epithelial cells may also release cytokines (e.g., IL-25, TSLP, and IL-33) that contribute to immune cell activation and chronic inflammatory disease in the form of asthma and COPD. Modified with permission from the American Journal of Respiratory Cell and Molecular Biology (140).

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts