Abbreviations: ALRI = acute lower respiratory tract
infection; ICAM = intercellular adhesion molecule;
IL = interleukin; RSV = respiratory syncytial virus
smoking causes airway and alveolar inflammation in everyone who smokes
and is the major risk factor for developing COPD. However, as only 10
to 15% of heavy smokers develop emphysema and airways
obstruction,1– other risk factors must influence cigarette
smoke-induced lung inflammation to cause the lesions that produce COPD.
Several factors that add risk to cigarette smoking have been
identified,2 but this brief review is designed to
concentrate on lower respiratory tract infections with particular
reference to the hypothesis that latent adenoviral
infection is capable of amplifying cigarette smoke-induced lung
inflammation to produce emphysema.