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The wheezy legacy of infant bronchiolitis
  1. Fabio Midulla
  1. Department of Pediatrics, Sapienza University of Rome, Rome 00185, Italy
  1. Correspondence to Dr Fabio Midulla, Department of Pediatrics, Sapienza University of Rome, Rome 00185, Italy; midulla{at}uniroma1.it

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The association between bronchiolitis, recurrent wheeze (RW) and asthma is well known. Numerous studies have elucidated that respiratory syncytial virus (RSV) bronchiolitis is associated with RW, whereas disagreement remains regarding its association with asthma. RSV infection and RW may both be consequences of small airways dimensions,1 dysregulation of the innate immune response or they may be the results of post-RSV infection intense inflammation and airways remodelling.2

The Tucson group demonstrated the association between RSV infection and the development of different RW’s phenotypes, but not with asthma.1 On the contrary, Sigur et al demonstrated that RSV bronchiolitis was associated with the development atopy and asthma.3 Regarding the genetic characteristics of infants who developed asthma after bronchiolitis, two Danish studies performed on twins with RSV bronchiolitis, demonstrated that RSV is not responsible for the development of asthma, but that a strong genetic predisposition is crucial for the development of both bronchiolitis and asthma.4 5

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