The role of rhinovirus infections in the development of early childhood asthma

Abstract

Purpose of review: To discuss the role of human rhinoviruses (HRVs) in early childhood wheezing illnesses and how HRVs contribute to the development of childhood asthma.

Recent findings: Advanced molecular diagnostics have identified HRVs as pathogens frequently causing wheezing illnesses in infants and young children. Wheezing during HRV infection in early life identifies children at particularly high-risk of asthma development. Plausible mechanisms by which HRV could cause airway damage, promote airway remodeling, and lead to asthma development have recently been identified.

Summary: HRV is a significant source of morbidity in infants and young children. The present review identifies mechanisms by which HRV lower respiratory tract infection, particularly in a susceptible host, could promote the development of childhood asthma. Further studies are needed to elucidate the mechanisms underlying the link between HRV wheezing in early childhood and subsequent asthma development, with the critical goal of identifying novel therapeutic and prevention strategies for both early childhood wheezing and asthma.

Figure 1. Viral etiology of respiratory illnesses during infancy

This figure shows the rates of detection of respiratory viruses by illness severity during the first year of life in the Childhood Origins of ASThma (COAST) study and is updated from previously published data(4) to include virus identification by respiratory multicode assay(3). HRV infections are associated with a broad range of symptom severity from asymptomatic to severe respiratory infection. HRV, human rhinovirus; RSV, respiratory syncytial virus; NRVP, non-rhinovirus picornavirus.

Figure 2. HRV wheezing illnesses & asthma development

This figure depicts how HRV may be causally involved in asthma pathogenesis in susceptible children.