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Review
. 2021 Nov 29:12:773600.
doi: 10.3389/fimmu.2021.773600. eCollection 2021.

Viral Induced Effects on a Vulnerable Epithelium; Lessons Learned From Paediatric Asthma and Eosinophilic Oesophagitis

Rebecca L Watkinson  1   2 , Kevin Looi  2   3 , Ingrid A Laing  1   2 , Antonella Cianferoni  4 , Anthony Kicic  2   3   5
Affiliations
Review

Viral Induced Effects on a Vulnerable Epithelium; Lessons Learned From Paediatric Asthma and Eosinophilic Oesophagitis

Rebecca L Watkinson et al. Front Immunol. .

Abstract

The epithelium is integral to the protection of many different biological systems and for the maintenance of biochemical homeostasis. Emerging evidence suggests that particular children have epithelial vulnerabilities leading to dysregulated barrier function and integrity, that resultantly contributes to disease pathogenesis. These epithelial vulnerabilities likely develop in utero or in early life due to various genetic, epigenetic and environmental factors. Although various epithelia are uniquely structured with specific function, prevalent allergic-type epithelial diseases in children potentially have common or parallel disease processes. These include inflammation and immune response dysregulation stemming from atypical epithelial barrier function and integrity. Two diseases where aetiology and pathogenesis are potentially linked to epithelial vulnerabilities include Paediatric Asthma and Eosinophilic Oesophagitis (EoE). For example, rhinovirus C (RV-C) is a known risk factor for paediatric asthma development and is known to disrupt respiratory epithelial barrier function causing acute inflammation. In addition, EoE, a prevalent atopic condition of the oesophageal epithelium, is characterised by similar innate immune and epithelial responses to viral injury. This review examines the current literature and identifies the gaps in the field defining viral-induced effects on a vulnerable respiratory epithelium and resulting chronic inflammation, drawing from knowledge generated in acute wheezing illness, paediatric asthma and EoE. Besides highlighting the importance of epithelial structure and barrier function in allergic disease pathogenesis regardless of specific epithelial sub-types, this review focuses on the importance of examining other parallel allergic-type disease processes that may uncover commonalities driving disease pathogenesis. This in turn may be beneficial in the development of common therapeutics for current clinical management and disease prevention in the future.

Keywords: EoE; airway; allergic; asthma; epithelium; paediatric; rhinovirus (RV); wheezing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Structural Morphology and Barrier Functions of the Airway Epithelium. An overview of the structural morphology of the airway epithelium and it’s multifaceted barrier functions including structural, mucociliary and immunomodulatory barrier functions in response to injury. (A) Tight Junction Complex, (B) Adherence Junction Complex, (C) Desmosomes, (D) Mucin Release into Airway Surface Liquid, (E) Structural Mucins, (F) Hemidesmosomes, (G) Disruption of Junctional Complexes due to epithelial vulnerabilities and injury. L, Lumen; ASL, Airway Surface Liquid; Ep, Epithelium; BM, Basement Membrane; ECM, Extracellular Matrix; En, Endothelium; BS, Bloodstream. Created with BioRender.com.
Figure 2
Figure 2
Structural Morphology and Barrier Functions of the Oesophageal Epithelium. An overview of the structural morphology of the oesophageal epithelium and it’s multifaceted barrier functions including structural, mucosal and immunomodulatory barrier functions in response to injury. (A) Tight Junction Complex, (B) Adherence Junction Complex, (C) Desmosomes, (D) Hemidesmosomes. OSL, Oesophageal Surface Liquid; Ep, Epithelium; BM, Basement Membrane; ECM, Extracellular Matrix; En, Endothelium; BS, Bloodstream. Created with BioRender.com.
See this image and copyright information in PMC

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