Pediatr Allergy Respir Dis.  2012 Mar;22(1):54-63.

The Relationship between the Time of First Respiratory Syncytial Virus Bronchiolitis and Later Wheezing and Asthma Development

• Kim RR
• Shin MY

Abstract

PURPOSE
Respiratory syncytial virus(RSV) bronchiolitis is believed to be associated with later development of asthma and wheezing. This study was conducted to determine the relationship between the age of the first RSV bronchiolitis episode, the development of later wheezing and asthma, and the related other factors.
METHODS
We studied 255 infants admitted with their first episode of RSV bronchiolitis. Epidemiological and clinical data were collected retrospectively from medical records and through telephone interviews. The patients were divided into < or =3 months, 4 to 12 months, and 13 to 24 months.
RESULTS
Eighty-one infants were < or =3 months, 115 were 4 to 12 months, and 59 were 13 to 24 months old. The gender ratios (Male:Female) were 1:1, 1.6:1, and 3.2:1. Familial and personal history of allergic diseases and disease severity did not significantly differ according to the age of the first RSV bronchiolitis episode. The occurrence of wheezing was associated with the presence of a familial and personal history of allergic diseases, but not with gender (male) or disease severity. The risk for asthma increased when the infants had their first RSV bronchiolitis episode at an older age. A personal history of allergic diseases was associated with an increased risk for asthma.
CONCLUSION
Asthma was more frequently diagnosed in older infants. The most important risk factors for recurrent wheezing and asthma were a familial and personal history of allergic diseases. Therefore, it was thought that RSV bronchiolitis is not the cause of recurrent wheezing and asthma, but that infants with a genetic predisposition to asthma have an increased risk for RSV bronchiolitis.

Keyword

Respiratory syncytial virus; Bronchiolitis; Asthma; Wheezing

MeSH Terms

Asthma
Bronchiolitis
Genetic Predisposition to Disease
Humans
Infant
Interviews as Topic
Medical Records
Respiratory Sounds
Respiratory Syncytial Viruses
Retrospective Studies
Risk Factors

Figure

• 

  Fig. 1 Sex distribution according to the age groups.

Reference

1. Henderson FW, Clyde WA Jr, Collier AM, Denny FW, Senior RJ, Sheaffer CI, et al. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J Pediatr. 1979. 95:183–190.

2. Panitch HB. Bronchiolitis in infants. Curr Opin Pediatr. 2001. 13:256–260.

3. Wennergren G, Hansson S, Engström I, Jodal U, Amark M, Brolin I, et al. Characteristics and prognosis of hospital-treated obstructive bronchitis in children aged less than two years. Acta Paediatr. 1992. 81:40–45.

4. Wennergren G, Kristjánsson S. Relationship between respiratory syncytial virus bronchiolitis and future obstructive airway diseases. Eur Respir J. 2001. 18:1044–1058.

5. Korppi M, Reijonen T, Pöysä L, Juntunen-Backman K. A 2- to 3-year outcome after bronchiolitis. Am J Dis Child. 1993. 147:628–631.

6. 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.

7. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med. 2000. 161:1501–1507.

8. Osundwa VM, Dawod ST, Ehlayel M. Recurrent wheezing in children with respiratory syncytial virus (RSV) bronchiolitis in Qatar. Eur J Pediatr. 1993. 152:1001–1003.

9. Schauer U, Hoffjan S, Bittscheidt J, Köchling A, Hemmis S, Bongartz S, et al. RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life. Eur Respir J. 2002. 20:1277–1283.

10. Culley FJ, Pollott J, Openshaw PJ. Age at first viral infection determines the pattern of T cell-mediated disease during reinfection in adulthood. J Exp Med. 2002. 196:1381–1386.

11. Dakhama A, Park JW, Taube C, Joetham A, Balhorn A, Miyahara N, et al. The enhancement or prevention of airway hyperresponsiveness during reinfection with respiratory syncytial virus is critically dependent on the age at first infection and IL-13 production. J Immunol. 2005. 175:1876–1883.

12. Miller EK, Lu X, Erdman DD, Poehling KA, Zhu Y, Griffin MR, et al. Rhinovirus-associated hospitalizations in young children. J Infect Dis. 2007. 195:773–781.

13. Jartti T, Korppi M. Rhinovirus-induced bronchiolitis and asthma development. Pediatr Allergy Immunol. 2011. 22:350–355.

14. Singh AM, Moore PE, Gern JE, Lemanske RF Jr, Hartert TV. Bronchiolitis to asthma: a review and call for studies of gene-virus interactions in asthma causation. Am J Respir Crit Care Med. 2007. 175:108–119.

15. Ho L, Collis G, Landau LI, Le Souef PN. Effect of salbutamol on oxygen saturation in bronchiolitis. Arch Dis Child. 1991. 66:1061–1064.

16. Bertrand P, Araníbar H, Castro E, Sánchez I. Efficacy of nebulized epinephrine versus salbutamol in hospitalized infants with bronchiolitis. Pediatr Pulmonol. 2001. 31:284–288.

17. Stensballe LG, Kristensen K, Simoes EA, Jensen H, Nielsen J, Benn CS, et al. Atopic disposition, wheezing, and subsequent respiratory syncytial virus hospitalization in Danish children younger than 18 months: a nested case-control study. Pediatrics. 2006. 118:e1360–e1368.

18. Boyce TG, Mellen BG, Mitchel EF Jr, Wright PF, Griffin MR. Rates of hospitalization for respiratory syncytial virus infection among children in medicaid. J Pediatr. 2000. 137:865–870.

19. Fryzek JP, Martone WJ, Groothuis JR. Trends in chronologic age and infant respiratory syncytial virus hospitalization: an 8-year cohort study. Adv Ther. 2011. 28:195–201.

20. Welliver RC. Review of epidemiology and clinical risk factors for severe respiratory syncytial virus (RSV) infection. J Pediatr. 2003. 143:5 Suppl. S112–S117.

21. Thomsen SF, van der Sluis S, Stensballe LG, Posthuma D, Skytthe A, Kyvik KO, et al. Exploring the association between severe respiratory syncytial virus infection and asthma: a registry-based twin study. Am J Respir Crit Care Med. 2009. 179:1091–1097.

22. Sigurs N, Gustafsson PM, Bjarnason R, Lundberg F, Schmidt S, Sigurbergsson F, et al. Severe respiratory syncytial virus bronchiolitis in infancy and asthma and allergy at age 13. Am J Respir Crit Care Med. 2005. 171:137–141.

23. Poorisrisak P, Halkjaer LB, Thomsen SF, Stensballe LG, Kyvik KO, Skytthe A, et al. Causal direction between respiratory syncytial virus bronchiolitis and asthma studied in monozygotic twins. Chest. 2010. 138:338–344.

24. Lehtinen P, Ruohola A, Vanto T, Vuorinen T, Ruuskanen O, Jartti T. Prednisolone reduces recurrent wheezing after a first wheezing episode associated with rhinovirus infection or eczema. J Allergy Clin Immunol. 2007. 119:570–575.

25. Bülow SM, Nir M, Levin E, Friis B, Thomsen LL, Nielsen JE, et al. Prednisolone treatment of respiratory syncytial virus infection: a randomized controlled trial of 147 infants. Pediatrics. 1999. 104:e77.

26. van Woensel JB, Kimpen JL, Sprikkelman AB, Ouwehand A, van Aalderen WM. Long-term effects of prednisolone in the acute phase of bronchiolitis caused by respiratory syncytial virus. Pediatr Pulmonol. 2000. 30:92–96.

27. Bradley JP, Bacharier LB, Bonfiglio J, Schechtman KB, Strunk R, Storch G, et al. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatrics. 2005. 115:e7–e14.

28. Trefny P, Stricker T, Baerlocher C, Sennhauser FH. Family history of atopy and clinical course of RSV infection in ambulatory and hospitalized infants. Pediatr Pulmonol. 2000. 30:302–306.

29. Kneyber MCJ, Steyerberg EW, de Groot R, Moll HA. Long-term effects of respiratory syncytial virus (RSV) bronchiolitis in infants and young children: a quantitative review. Acta Paediatr. 2000. 89:654–660.

30. Murray M, Webb MS, O'Callaghan C, Swarbrick AS, Milner AD. Respiratory status and allergy after bronchiolitis. Arch Dis Child. 1992. 67:482–487.

31. Noble V, Murray M, Webb MS, Alexander J, Swarbrick AS, Milner AD. Respiratory status and allergy nine to 10 years after acute bronchiolitis. Arch Dis Child. 1997. 76:315–319.

32. Park HJ, Kim SY, Lee KH, Lee GH, Choi EJ, Kim JK, et al. Developmental changes in immune responses during respiratory syncytial virus bronchiolitis. Pediatr Allergy Respir Dis. 2007. 17:101–108. (Korea).

33. Ehlenfield DR, Cameron K, Welliver RC. Eosinophilia at the time of respiratory syncytial virus bronchiolitis predicts childhood reactive airway disease. Pediatrics. 2000. 105(1 Pt 1):79–83.

34. Piippo-Savolainen E, Remes S, Korppi M. Does blood eosinophilia in wheezing infants predict later asthma? A prospective 18-20-year follow-up. Allergy Asthma Proc. 2007. 28:163–169.