PURPOSE OF THE STUDY.
Building on recent studies that have suggested a link between early wheezing caused by rhinovirus and the development of asthma, these researchers sought to characterize the relationship of respiratory viral infections with atopy in hospitalized wheezing children.
The authors studied a subgroup from among a previously described cohort of 293 hospitalized wheezing Finnish children aged 3 months to 16 years who had comprehensive virology performed (N = 247; median age: 1.6 years). Subjects with recent oral corticosteroid use, chronic disease, or ICU treatment were excluded.
Respiratory viral infections were evaluated through a nasopharyngeal aspirate and blood sample at baseline and after 2 to 3 weeks. A combination of viral culture, antigen detection, immunoglobulin G (IgG) and IgM measurement, and polymerase chain reaction was used to evaluate for respiratory syncytial virus, human rhinovirus, enteroviruses, human bocavirus, and a broad panel of additional respiratory viruses. Atopy was assessed through serum-specific IgE testing to several common food allergens, cat, dog, horse, birch, mugwort, timothy grass, mold, and dust mite.
Allergen-specific IgE sensitization was closely related to sole rhinovirus infection (odds ratio: 3.5; P = .0002). In contrast, sole respiratory syncytial virus infection was negatively associated with sensitization (odds ratio: 0.087; P = .027). No significant associations with atopy were found with the remaining viruses or with those with multiple concurrent viral infections.
Acute wheezing in early childhood caused by human rhinovirus is associated with an increased risk of allergic sensitization and, therefore, an increased risk of developing future asthma.
A limitation of this study lies in the fact that all subjects were hospitalized for their wheezing, thereby representing a minority of children with rhinovirus infection. Nevertheless, when considering the asthma predictive index, the evidence presented from this study suggests that a history of rhinovirus infection, especially severe infection, could be considered an additional risk factor for the development of asthma.
- Copyright © 2011 by the American Academy of Pediatrics