Open AccessViral Respiratory Pathogens and Lung Injury
Author(s) -
Nicola Clementi,
Sreya Ghosh,
Maria De Santis,
Matteo Castelli,
Elena Criscuolo,
Ivan Zai,
Massimo Clementi,
Nicasio Mancini
Publication year - 2021
Publication title -
clinical microbiology reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 9.177
H-Index - 282
eISSN - 1070-6305
pISSN - 0893-8512
DOI - 10.1128/cmr.00103-20
Subject(s) - ards , respiratory tract , respiratory tract infections , medicine , respiratory distress , respiratory system , immunology , lung , pandemic , diffuse alveolar damage , immune system , airway , intensive care medicine , acute respiratory distress , covid-19 , disease , anesthesia , infectious disease (medical specialty)
Several viruses target the human respiratory tract, causing different clinical manifestations spanning from mild upper airway involvement to life-threatening acute respiratory distress syndrome (ARDS). As dramatically evident in the ongoing SARS-CoV-2 pandemic, the clinical picture is not always easily predictable due to the combined effect of direct viral and indirect patient-specific immune-mediated damage. In this review, we discuss the main RNA (orthomyxoviruses, paramyxoviruses, and coronaviruses) and DNA (adenoviruses, herpesviruses, and bocaviruses) viruses with respiratory tropism and their mechanisms of direct and indirect cell damage. We analyze the thin line existing between a protective immune response, capable of limiting viral replication, and an unbalanced, dysregulated immune activation often leading to the most severe complication. Our comprehension of the molecular mechanisms involved is increasing and this should pave the way for the development and clinical use of new tailored immune-based antiviral strategies.