Enhancement of respiratory virus infection by air pollutants

Ya-Fang Chiu; Chih-Chen Kao; Chi-Yuan Chen; Chia-Ping Su; Chia-Hao Ma; Yamin Kyaw; Jeng-How Yang

doi:10.1016/j.ecoenv.2025.118506

Enhancement of respiratory virus infection by air pollutants

Ecotoxicol Environ Saf. 2025 Jun 18:302:118506. doi: 10.1016/j.ecoenv.2025.118506. Online ahead of print.

Authors

Ya-Fang Chiu¹, Chih-Chen Kao², Chi-Yuan Chen³, Chia-Ping Su⁴, Chia-Hao Ma², Yamin Kyaw², Jeng-How Yang⁵

Affiliations

¹ Department of Microbiology and Immunology, Chang Gung University, Taoyuan City 333323, Taiwan; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan City 333323, Taiwan; Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan City 333323, Taiwan; Division of Infectious Diseases, Department of Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 236017, Taiwan; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City 333423, Taiwan. Electronic address: yfchiu@mail.cgu.edu.tw.
² School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan.
³ Department of Microbiology and Immunology, Chang Gung University, Taoyuan City 333323, Taiwan.
⁴ Division of Infectious Diseases, Department of Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 236017, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu City 300044, Taiwan.
⁵ Division of Infectious Diseases, Department of Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 236017, Taiwan.

PMID: 40554104
DOI: 10.1016/j.ecoenv.2025.118506

Abstract

Viral respiratory infections are a leading cause of morbidity and mortality worldwide, posing significant economic and health burdens. This review examines how air pollutants promote viral respiratory infections and influence disease outcomes. Papers published within the last 15 years regarding interactions between air pollutants and respiratory viruses were systematically identified and reviewed. The current evidence shows that common air pollutants can aggravate viral respiratory infections, either by assisting the spread, entry, and penetration of respiratory viruses to facilitate infection, or by interfering with host immune responses to heighten the risk of worse outcomes after infection. Moreover, air pollutants are known to increase the incidence of chronic obstructive pulmonary disease (COPD), diabetes, and asthma, which may weaken the effectiveness of the immune system against viral infections and increase the risks of excessive inflammation or cytokine storms. In addition, air pollutants can penetrate deep into the lower respiratory tract and various organs through the blood-air exchange system, leading to severe pulmonary and systemic adverse effects. In conclusion, air pollutants can affect a wide range of physiological aspects to exacerbate the impact of viral respiratory infections, and further research is critically needed to understand the underlying dynamics.

Keywords: Air pollutants; Asthma; Chronic obstructive pulmonary disease; Obesity; Type 2 diabetes mellitus; Viral respiratory infections.

Publication types

Review