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Am. J. Respir. Crit. Care Med., Volume 161, Number 5, May 2000, 1501-1507

Respiratory Syncytial Virus Bronchiolitis in Infancy Is an Important Risk Factor for Asthma and Allergy at Age 7 

NELE SIGURS, RAGNAR BJARNASON, FRIDRIK SIGURBERGSSON, and BENGT KJELLMAN

Department of Pediatrics, Borås Central Hospital, Borås, Sweden; Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden; Emergency Department, Reykjavik Hospital, Reykjavik, Iceland; and Department of Pediatrics, Skövde Central Hospital, Skövde, Sweden

We previously reported an increased risk for bronchial obstructive disease and allergic sensitization up to age 3 in 47 children hospitalized with a respiratory syncytial virus (RSV) bronchiolitis in infancy compared with 93 matched control subjects recruited during infancy. The aims of the present study were to evaluate the occurrences of bronchial obstructive disease and allergic sensitization in these children at age 71/ 2. All 140 children reported for the follow-up, which included physical examination, skin prick tests, and serum IgE tests for common food and inhaled allergens. The cumulative prevalence of asthma was 30% in the RSV group and 3% in the control group (p < 0.001), and the cumulative prevalence of "any wheezing" was 68% and 34%, respectively (p < 0.001). Asthma during the year prior to follow-up was seen in 23% of the RSV children and 2% in the control subjects (p < 0.001). Allergic sensitization was found in 41% of the RSV children and 22% of the control subjects (p = 0.039). Multivariate evaluation of possible risk factors for asthma and sensitization using a stepwise logistic statistical procedure for all 140 children showed that RSV bronchiolitis had the highest independent risk ratio for asthma (OR: 12.7, 95% CI 3.4 to 47.1) and a significantly elevated independent risk ratio for allergic sensitization (OR: 2.4, 95% CI 1.1 to 5.5). In conclusion, RSV bronchiolitis in infancy severe enough to cause hospitalization was highly associatied with the development of asthma and allergic sensitization up to age 71/ 2. The results support the theory that the RSV influences the mechanisms involved in the development of asthma and allergy in children.




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Am. J. Respir. Crit. Care Med.Home page
R. F. Lemanske Jr.
Does Respiratory Syncytial Viral-induced Bronchiolitis Result from Helper T Cell Type 1/Type 2 Cytokine Imbalance?
Am. J. Respir. Crit. Care Med., September 15, 2003; 168(6): 625 - 627.
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Am. J. Respir. Crit. Care Med.Home page
J. P. Legg, I. R. Hussain, J. A. Warner, S. L. Johnston, and J. O. Warner
Type 1 and Type 2 Cytokine Imbalance in Acute Respiratory Syncytial Virus Bronchiolitis
Am. J. Respir. Crit. Care Med., September 15, 2003; 168(6): 633 - 639.
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Eur Respir JHome page
S. Ichinohe, I.R. Hussain, and S.L. Johnston
Cytokine production of RSV/PHA-stimulated tonsillar mononuclear cells: influences of age and atopy
Eur. Respir. J., August 1, 2003; 22(2): 317 - 322.
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PediatricsHome page
R. J. Singleton, G. J. Redding, T. C. Lewis, P. Martinez, L. Bulkow, B. Morray, H. Peters, J. Gove, C. Jones, D. Stamey, et al.
Sequelae of Severe Respiratory Syncytial Virus Infection in Infancy and Early Childhood Among Alaska Native Children
Pediatrics, August 1, 2003; 112(2): 285 - 290.
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PediatricsHome page
G. Rachelefsky
Treating Exacerbations of Asthma in Children: The Role of Systemic Corticosteroids
Pediatrics, August 1, 2003; 112(2): 382 - 397.
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J. Immunol.Home page
S.-Z. Wang, C. L. Rosenberger, Y.-X. Bao, J. M. Stark, and K. S. Harrod
Clara Cell Secretory Protein Modulates Lung Inflammatory and Immune Responses to Respiratory Syncytial Virus Infection
J. Immunol., July 15, 2003; 171(2): 1051 - 1060.
[Abstract] [Full Text] [PDF]


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Arch. Dis. Child.Home page
F Nja, W Nystad, O Hetlevik, K C Lodrup Carlsen, and K-H Carlsen
Airway infections in infancy and the presence of allergy and asthma in school age children
Arch. Dis. Child., July 1, 2003; 88(7): 566 - 569.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Cell Mol. Bio.Home page
P. M. Kaan and R. G. Hegele
Interaction between Respiratory Syncytial Virus and Particulate Matter in Guinea Pig Alveolar Macrophages
Am. J. Respir. Cell Mol. Biol., June 1, 2003; 28(6): 697 - 704.
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J. Immunol.Home page
G. Wohlleben, J. Muller, U. Tatsch, C. Hambrecht, U. Herz, H. Renz, E. Schmitt, H. Moll, and K. J. Erb
Influenza A Virus Infection Inhibits the Efficient Recruitment of Th2 Cells into the Airways and the Development of Airway Eosinophilia
J. Immunol., May 1, 2003; 170(9): 4601 - 4611.
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Arch Pediatr Adolesc MedHome page
V. R. G. Bachrach, E. Schwarz, and L. R. Bachrach
Breastfeeding and the Risk of Hospitalization for Respiratory Disease in Infancy: A Meta-analysis
Arch Pediatr Adolesc Med, March 1, 2003; 157(3): 237 - 243.
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ChestHome page
R. F. Lemanske Jr.
Is Asthma an Infectious Disease?: Thomas A. Neff Lecture
Chest, March 1, 2003; 123 (2009): 385S - 390S.
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Am. J. Respir. Crit. Care Med.Home page
H. Bisgaard
A Randomized Trial of Montelukast in Respiratory Syncytial Virus Postbronchiolitis
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 379 - 383.
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JEMHome page
P.G. Holt and P. D. Sly
Interactions between RSV Infection, Asthma, and Atopy: Unraveling the Complexities
J. Exp. Med., November 18, 2002; 196(10): 1271 - 1275.
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JEMHome page
F. J. Culley, J. Pollott, and P. J.M. Openshaw
Age at First Viral Infection Determines the Pattern of T Cell-mediated Disease during Reinfection in Adulthood
J. Exp. Med., November 18, 2002; 196(10): 1381 - 1386.
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Eur Respir JHome page
U. Schauer, S. Hoffjan, J. Bittscheidt, A. Kochling, S. Hemmis, S. Bongartz, and V. Stephan
RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life
Eur. Respir. J., November 1, 2002; 20(5): 1277 - 1283.
[Abstract] [Full Text] [PDF]


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Arch. Dis. Child.Home page
S W Turner, S Young, L I Landau, and P N Le Souef
Reduced lung function both before bronchiolitis and at 11 years
Arch. Dis. Child., November 1, 2002; 87(5): 417 - 420.
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Eur Respir JHome page
G. Piedimonte and E.A.F. Simoes
Respiratory syncytial virus and subsequent asthma: one step closer to unravelling the Gordian knot?
Eur. Respir. J., September 1, 2002; 20(3): 515 - 517.
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Eur Respir JHome page
P. Pala, R. Bjarnason, F. Sigurbergsson, C. Metcalfe, N. Sigurs, and P.J.M. Openshaw
Enhanced IL-4 responses in children with a history of respiratory syncytial virus bronchiolitis in infancy
Eur. Respir. J., August 1, 2002; 20(2): 376 - 382.
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Eur Respir JHome page
M. Calvani Jr, C. Alessandri, and E. Bonci
Fever episodes in early life and the development of atopy in children with asthma
Eur. Respir. J., August 1, 2002; 20(2): 391 - 396.
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Eur Respir JHome page
W.H. Oddy, N.H. de Klerk, P.D. Sly, and P.G. Holt
The effects of respiratory infections, atopy, and breastfeeding on childhood asthma
Eur. Respir. J., May 1, 2002; 19(5): 899 - 905.
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Eur Respir JHome page
J. Schwarze and E.W. Gelfand
Respiratory viral infections as promoters of allergic sensitization and asthma in animal models
Eur. Respir. J., February 1, 2002; 19(2): 341 - 349.
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J. Biol. Chem.Home page
K. W. Thomas, M. M. Monick, J. M. Staber, T. Yarovinsky, A. B. Carter, and G. W. Hunninghake
Respiratory Syncytial Virus Inhibits Apoptosis and Induces NF-kappa B Activity through a Phosphatidylinositol 3-Kinase-dependent Pathway
J. Biol. Chem., January 4, 2002; 277(1): 492 - 501.
[Abstract] [Full Text]


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Eur Respir JHome page
G. Wennergren and S. Kristjansson
Relationship between respiratory syncytial virus bronchiolitis and future obstructive airway diseases
Eur. Respir. J., December 1, 2001; 18(6): 1044 - 1058.
[Abstract] [Full Text] [PDF]


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Arch. Dis. Child.Home page
A Greenough, S Cox, J Alexander, W Lenney, F Turnbull, S Burgess, P A J Chetcuti, N J Shaw, A Woods, J Boorman, et al.
Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection
Arch. Dis. Child., December 1, 2001; 85(6): 463 - 468.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
K-;H. Carlsen and P.J. Sterk
Infection: friend or foe to the development of asthma?
Eur. Respir. J., November 1, 2001; 18(5): 744 - 747.
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Eur Respir JHome page
E. von Mutius
Infection: friend or foe in the development of atopy and asthma? The epidemiological evidence
Eur. Respir. J., November 1, 2001; 18(5): 872 - 881.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2000
Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1581 - 1594.
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BMJHome page
V. Angelakou, M. Bitsori, E. Galanakis, A.-L. Ponsonby, and A. Kemp
Asthma and early childhood infectious disease
BMJ, July 21, 2001; 323(7305): 164 - 164.
[Full Text]


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Am. J. Respir. Crit. Care Med.Home page
E. A. F. SIMOES
Treatment and Prevention of Respiratory Syncytial Virus Lower Respiratory Tract Infection . Long-Term Effects on Respiratory Outcomes
Am. J. Respir. Crit. Care Med., March 1, 2001; 163(3): S14 - 17.
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Am. J. Respir. Crit. Care Med.Home page
G. PIEDIMONTE
Neural Mechanisms of Respiratory Syncytial Virus-induced Inflammation and Prevention of Respiratory Syncytial Virus Sequelae
Am. J. Respir. Crit. Care Med., March 1, 2001; 163(3): S18 - 21.
[Full Text] [PDF]


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BMJHome page
S. L Johnston and P. J M Openshaw
The protective effect of childhood infections
BMJ, February 17, 2001; 322(7283): 376 - 377.
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