Sensory-nerves and airway inflammation: interaction with beta-2-adrenoceptor agonists

beta-2-adrenoceptor agonists are used as bronchodilatators in asthma and chronic obstructive pulmonary disease (COPD) treatment. However, regular single use of these molecules may enhance bronchial hyperresponsiveness, a component of asthma and COPD. Indeed, pathophysiologic mechanisms underlying bronchial hyperresponsiveness remain unclear. Sensory nerves have been recently found in the respiratory tract and they play an important role in the regulation of bronchial responsiveness through the release of tachykinins and activation of vanilloid TRPV1 (Transient Receptor Potential Vanilloid 1) receptors. The purpose of this review is to highlight the most recent findings concerning the interactions between beta-2-adrenoceptor agonists and bronchial sensory nerves.     

Bronchiolite sévère à VRS et otite du nourrisson : premiers stigmates de la maladie allergique respiratoire ? À propos d'une observation

The observation of an infant having presented two severe respiratory syncytial virus (RSV) infections in the same winter with associated otitis media led us to consider virus-asthma relations in the child and middle ear place in the airway unit. Viruses (in particular RSV and rhinovirus) are indeed implied in 80% of asthma exacerbations in school-age children. Nevertheless, the role of viral respiratory infections in the genesis of asthma has not been clearly established. Severe RSV bronchiolitis requiring hospitalization seem associated with atopic asthma risk unlike less severe forms. RSV would be thus more revealing a particular susceptibility of the airways than a true etiologic factor. RSV cytopathic effect could indeed be facilitated by an epithelial susceptibility, primum movens of primary asthmatic remodeling. A new entity emerges within the airway unit: the middle ear. IgE sensitisation and wheezing recently seemed independent risk factors of otitis media with effusion. Epithelial infiltrate of the Eustachian tube and effusion located in the middle ear of the atopic patients, have Th2 profile. The "allergic oto-rhino-bronchitis" concept thus impose a total therapeutic approach of the airways of patients presenting with respiratory allergy, in particular otologic.