Determinants of asthma after severe respiratory syncytial virus bronchiolitis
| Journal Title: | Journal of allergy and clinical immunology 2012, Vol.130 (1), p.91-100.e3 |
| Main Author: | Bacharier, Leonard B., MD |
| Other Authors: | Cohen, Rebecca, MD , Schweiger, Toni, RN , Yin-DeClue, Huiquing, PhD , Christie, Chandrika, MA , Zheng, Jie, MS , Schechtman, Kenneth B., PhD , Strunk, Robert C., MD , Castro, Mario, MD, MPH |
| Format: |
 Electronic Article
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| Language: |
English |
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| Quelle: | Alma/SFX Local Collection |
| Publisher: | New York, NY: Mosby, Inc |
| ID: | ISSN: 0091-6749 |
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| recordid: | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3612548 |
| title: | Determinants of asthma after severe respiratory syncytial virus bronchiolitis |
| format: | Article |
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| ispartof: | Journal of allergy and clinical immunology, 2012, Vol.130 (1), p.91-100.e3 |
| description: | Background The development of asthma after respiratory syncytial virus (RSV) bronchiolitis has been demonstrated in case-control studies, although the determinants of post-RSV asthma remain undefined. Objectives We sought to evaluate the potential determinants of physician-diagnosed asthma after severe RSV bronchiolitis during infancy. Methods We enrolled 206 children during an initial episode of severe RSV bronchiolitis at 12 months of age or less in a prospective cohort study and followed these children for up to 6 years. In a subset of 81 children, we analyzed CCL5 (RANTES) mRNA expression in upper airway epithelial cells. Results Forty-eight percent of children had physician-diagnosed asthma before the seventh birthday. Independent determinants significantly associated with increased risk for physician-diagnosed asthma by the seventh birthday included maternal asthma (odds ratio [OR], 5.2; 95% CI, 1.7-15.9; P = .004), exposure to high levels of dog allergen (OR, 3.2; 95% CI, 1.3-7.7; P = .012), aeroallergen sensitivity at age 3 years (OR, 10.7; 95% CI, 2.1-55.0; P = .005), recurrent wheezing during the first 3 years of life (OR, 7.3; 95% CI, 1.2-43.3; P = .028), and CCL5 expression in nasal epithelia during acute RSV infection (OR, 3.8; 95% CI, 1.2-2.4; P < .001). White children (OR, 0.19; 95% CI, 0.04-0.93; P = .041) and children attending day care (OR, 0.18; 95% CI, 0.04-0.84; P = .029) had a decreased risk of physician-diagnosed asthma. Conclusions Approximately 50% of children who experience severe RSV bronchiolitis have a subsequent asthma diagnosis. The presence of increased CCL5 levels in nasal epithelia at the time of bronchiolitis or the development of allergic sensitization by age 3 years are associated with increased likelihood of subsequent asthma. |
| language: | eng |
| source: | Alma/SFX Local Collection |
| identifier: | ISSN: 0091-6749 |
| fulltext: | fulltext |
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