Chairman's Summary

Abstract

The 20th annual Transatlantic Airway Conference (TAC) was aimed at the topic of “Airway Responses to Respiratory Viruses” and was developed with several goals in mind. First, we recognized that, despite the fact that respiratory viral infection is perhaps the most common malady of humankind, there is a great deal more to learn about the pathogenesis of acute and chronic airway disease induced by viral infection. In that regard, discovery on this topic is often left to microbiologists, who focus on the pathogenic determinants of respiratory viruses; infectious disease specialists, who focus on similar issues, often in conjunction with epidemiology; or pathologists, who focus on diagnostic and laboratory medicine issues. We therefore aimed to bring this expertise together with experts in lung disease. Second, there is renewed interest in the subject of emergent diseases with the discovery, just in the past two years, of new and devastating respiratory viral infections. Recent examples include the coronavirus associated with severe acute respiratory syndrome (SARS) and a new strain of avian influenza virus, as well as the newly discovered human metapneumovirus, which can also cause serious disease in the immunocompromised host. Third, there is a new appreciation of the possibility that even transient respiratory viral infections can have long-lasting, if not permanent, effects on the host, resulting in chronic airway disease. In that regard, experimental evidence has been provided to demonstrate a permanent switch to an asthmatic bronchitis phenotype in a susceptible genetic background. Thus, infection with common respiratory viruses may trigger disease itself, not just disease exacerbations. Finally, the world has become more receptive to the possibility of vaccine strategies to combat viral infection. Devastating side effects that developed during the initial application of a killed-virus vaccine to combat respiratory syncytial virus (RSV) in the 1960s are slowly being placed in the context of advances in modern molecular biology. It is now possible to more rapidly and perhaps more intelligently engineer recombinant viruses and corresponding antibodies to those viruses and so facilitate studies aimed at therapeutic development. These approaches are now applicable to acute infections, especially in high-risk populations, and to the occurrence of virus-induced chronic airway disease as well. In view of this background, the TAC was organized to reflect the multidisciplinary approach needed to combat the most common human pathogens. Invited speakers and discussants from North America and Europe (and Australia) had backgrounds in virology, infectious diseases, immunology, genetics, and pathology, as well as in adult and pediatric pulmonary medicine. The articles that accompany this summary were provided by the TAC 2005 speakers and provide detailed examples of these