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When a common cold becomes life-threatening

Immunology professor Lena Uller.
Immunology professor Lena Uller. Photo: Agata Garpenlind

For risk groups, a common cold can be life-threatening. Researchers in Lund have contributed to the development of a new biological medicinal product to treat severe asthma that is worsened by colds. The hope is that the drug will be approved in Sweden next year.

Young children, the elderly and patients suffering from chronic lung disease such as asthma and COPD run an increased risk of being afflicted by severe colds, which means colds that affect their breathing. Patients on lifelong immunosuppressive medication after an organ transplant are particularly sensitive to cold viruses.
In newborns and children up to two years of age, the RS virus, so feared by parents of young children, can cause serious illness. Young children's immune systems are not sufficiently developed and their airways are narrow, causing mucus to accumulate.

Alarmins produced

The RS virus is an aggressive virus that infects and damages the lung's epithelial cells, a type of protective, barrier cell that builds up the natural mucosal barrier meant to protect the lungs. The barrier cells give a powerful signal when they are infected and damaged by producing proteins called alarmins.
“The alarmins trigger powerful immune reactions in the airways that lead to inflammation. Substances that constrict the airways are formed, making it difficult to breathe. The children often need hospital care,” explains immunology professor Lena Uller at Lund University.
Among other things, she conducts research on how cold viruses affect the immune system of healthy individuals and individuals who suffer from lung disease, and how an active inflammation in the airways of patients with asthma and COPD makes these patients more sensitive to viral infections.

Affected more by colds

Many children who are severely affected by viral disease outgrow their problems by the age of six or seven. But some retain sensitivity in their airways and develop asthma and allergies. The older we get, the harder we are hit by colds, which can sometimes also lead to pneumonia.
“This is in line with what we saw during the COVID-19 pandemic, which is that being older was a risk factor for becoming more ill with hospitalization as a result.”
Lena Uller has taken specific interest in the epithelial cells of the airways, i.e. the cells that are the body's first defence against everything we inhale from the air.
“Just as the conductor in an orchestra starts the music, interacts with the musicians, listens, and increases or softens the notes, the epithelial barrier works to start the body's immune system against viruses, for example. It interacts with the body's surrounding cells, releasing various proteins that can increase or decrease inflammation, which is an important part of the immune system.”
Lena Uller's research has shown that there can be an imbalance in the immune system of patients with lung disease.
“We have identified a protein called TSLP, which is released from the epithelial barrier and is particularly pathogenic. It acts as a conductor in the lungs and starts inflammation. Allergens, viruses and air pollution release this protein, and it is overproduced in lung disease.”

New drug in progress

An area of research where great progress is being made today is in biological medicinal products. Biological medicinal products include preparations whose active substance has a biological origin. An example is using an antibody as treatment against a specific protein that is important for the disease process, which results in selective toxicity with fewer side effects and reduced disease development.
“Our research has contributed to the development of a new biological medicinal product used against TSLP, which reduces virus-induced asthma and inflammation associated with asthma. Hopefully, the new drug will be approved in Sweden next year. It would help many afflicted patients as there is currently no tailored therapy for viral asthma and COPD.”