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Editorial
. 2023 Oct;152(4):866-869.
doi: 10.1016/j.jaci.2023.08.009. Epub 2023 Aug 19.

Progress in understanding whether respiratory syncytial virus infection in infancy causes asthma in childhood

Christian Rosas-Salazar  1 , Kohei Hasegawa  2 , Tina V Hartert  3
Affiliations
Editorial

Progress in understanding whether respiratory syncytial virus infection in infancy causes asthma in childhood

Christian Rosas-Salazar et al. J Allergy Clin Immunol. 2023 Oct.
No abstract available

Keywords: Asthma; bronchiolitis; children; infants; respiratory syncytial virus; wheeze.

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Conflict of interest statement

Conflicts of Interests:

CRS serves as a consultant for Amgen and AstraZeneca. TVH has served on vaccine Data Safety Monitoring Boards for Pfizer and as a consultant for Sanofi-Pasteur. KH does not have a commercial or other association that might pose a conflict of interest.

Figures

Figure 1.
Figure 1.
Confounding effect from shared heredity on the association between RSV bronchiolitis and childhood asthma. “A” represents the association in observational studies examining the role of RSV bronchiolitis (*) or some other marker of early life severe RSV disease (such as RSV lower respiratory tract infection requiring hospitalization) on childhood asthma. “B” represents the shared role of host genetics on both RSV bronchiolitis and childhood asthma, an important confounder of the association that cannot be easily controlled. Thus, in observational studies of RSV bronchiolitis and childhood asthma, paths “A” and “B” cannot be differentiated. “C” represents an approach of examining the association between RSV infection in infancy (and not only RSV bronchiolitis) and childhood asthma to overcome several limitations of prior studies, including shared heredity and measuring an exposure rather than a clinical phenotype. Definition of abbreviation: RSV = respiratory syncytial virus.
Figure 2.
Figure 2.
Selected potential mechanistic pathways that could underlie the association between RSV infection in infancy and childhood asthma. The results of recent studies suggest that RSV infection in infancy could lead to childhood asthma though alterations in the human microbiome, airway epithelial cell development, airway hyperresponsiveness, and immune development. Host genetics, viral genetics, and gene-by-virus interactions, among others, can also impact this association. Definition of abbreviation: RSV = respiratory syncytial virus.
See this image and copyright information in PMC

References

    1. Rosas-Salazar C, Chirkova T, Gebretsadik T, Chappell JD, Peebles RS Jr., Dupont WD, et al. Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study. Lancet 2023;401:1669–80. - PMC - PubMed
    1. Wittig HJ, Glaser J. The relationship between bronchiolitis and childhood asthma; a follow-up study of 100 cases of bronchiolitis. J Allergy 1959;30:19–23. - PubMed
    1. Chirkova T, Rosas-Salazar C, Gebretsadik T, Jadhao SJ, Chappell JD, Peebles RS Jr., et al. Effect of Infant RSV Infection on Memory T Cell Responses at Age 2–3 Years. Front Immunol 2022;13:826666. - PMC - PubMed
    1. Wu P, Dupont WD, Griffin MR, Carroll KN, Mitchel EF, Gebretsadik T, et al. Evidence of a causal role of winter virus infection during infancy in early childhood asthma. Am J Respir Crit Care Med 2008;178:1123–9. - PMC - PubMed
    1. Rosas-Salazar C, Shilts MH, Tovchigrechko A, Schobel S, Chappell JD, Larkin EK, et al. Nasopharyngeal Lactobacillus is Associated with Childhood Wheezing Illnesses Following Respiratory Syncytial Virus Infection in Infancy. J Allergy Clin Immunol 2018;142:1447–56. - PMC - PubMed

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