The role of early life viral bronchiolitis in the inception of asthma
- PMID: 23385289
- PMCID: PMC3714103
- DOI: 10.1097/ACI.0b013e32835eb6ef
The role of early life viral bronchiolitis in the inception of asthma
Abstract
PROPOSE OF REVIEW: Cumulative evidence suggest that early life bronchiolitis is a major risk factor for subsequent wheezing episodes and asthma. The purpose of this review is to present the recent findings and current perspectives regarding the interplay between bronchiolitis and long-term respiratory outcomes.
Recent findings: Recent studies have supported the long-recognized link between early life severe respiratory syncytial virus bronchiolitis and the physician diagnosis of asthma by school age, and this association appears to continue into early adulthood. Evidence is accumulating regarding the role of early life infection with human rhinovirus as an important antecedent for future asthma. Whether viral bronchiolitis is causal or an early manifestation of future asthma remains uncertain. Vitamin D status has emerged as a potential modifying factor for viral-induced wheeze and could potentially influence the development of asthma.
Summary: Viral bronchiolitis early in life is a major and potential long-term risk factor for subsequent wheezing and asthma. Whether the association between bronchiolitis and subsequent asthma is due to causality or a reflection of predisposition may be dependent on host factors and virus-specific effects.
Conflict of interest statement
Conflict of interest: A.B. none were declared.
References
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Sigurs N, Aljassim F, Kjellman B, Robinson PD, Sigurbergsson F, Bjarnason R, et al. Asthma and allergy patterns over 18 years after severe RSV bronchiolitis in the first year of life. Thorax. 2010 ■■ A study with the longest prospective follow up on the natural history of severe RSV bronchiolitis in infancy; this study reported that the association between early life severe RSV bronchiolitis and asthma might last into early adulthood
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- Stein RT, Sherrill D, Morgan WJ, Holberg CJ, Halonen M, Taussig LM, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet. 1999;354:541–545. - PubMed
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Bacharier LB, Cohen R, Schweiger T, Yin-Declue H, Christie C, Zheng J, et al. Determinants of asthma after severe respiratory syncytial virus bronchiolitis. The Journal of allergy and clinical immunology. 2012;130:91–100. e3. ■■ A recent study that suggests that half of the children hospitalized in early life with RSV bronchiolitis will be diagnosed with asthma over the 6 years following hospitalization and that nasal epithelial CCL5 expression may be an important biomarker for post-RSV asthma.
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