MINI-SYMPOSIUM: RESPIRATORY SYNCYTIAL VIRUS
Long-term consequences of respiratory syncytial virus (RSV) bronchiolitis

https://doi.org/10.1053/prrv.2000.0052Get rights and content

Abstract

Despite differences in study design, follow-up studies consistently show that approximately half of the infants with respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) go on to have recurrent wheezing episodes during childhood. Respiratory symptoms are associated with abnormal lung function, including bronchial hyper-responsiveness. Wheezing symptoms following RSV LRTI gradually decrease, and it appears that during school age airway morbidity is no longer related to RSV LRTI during infancy. Mechanisms underlying the association between RSV LRTI and long-term airway morbidity are poorly understood. On the one hand, abnormal airway function that is congenitally present or acquired before RSV LRTI occurs could be the cause of both RSV LRTI and subsequent recurrent wheezing. On the other hand, it is possible that RSV LRTI causes changes in the lower airways or the immune system that result in long-term airway morbidity. Animal models suggest that RSV infection can promote the development of allergic sensitization, but most studies in humans do not indicate a role for atopy in the development of recurrent wheezing following RSV LRTI.

References (39)

  • C.R. Pullan et al.

    Wheezing, asthma and pulmonary dysfunction 10 years after infection with respiratory syncytial virus infection in infancy

    BMJ

    (1982)
  • K.M. McConnochie et al.

    Bronchiolitis as a possible cause of wheezing in childhood: new evidence

    Pediatrics

    (1984)
  • P.D. Sly et al.

    Childhood asthma following hospitalization with acute viral bronchiolitis in infancy

    Pediatr Pulmonol

    (1989)
  • N. Sigurs et al.

    Asthma and immunoglobulin E antibodies after respiratory syncytial virus bronchiolitis: a prospective cohort study with matched controls

    Pediatrics

    (1995)
  • T.M. Reijonen et al.

    Nasopharyngeal eosinophil cationic protein in bronchiolitis: relation to viral findings and subsequent wheezing

    Pediatr Pulmonol

    (1997)
  • M. Roman et al.

    respiratory syncytial virus infection in infants is associated with predominant Th-2-like response

    Am J Respir Crit Care Med

    (1997)
  • S.L. Johnston et al.

    Community study of role of viral infections in exacerbations of asthma in 9–11 year old children

    BMJ

    (1995)
  • M. Murray et al.

    Respiratory status and allergy after bronchiolitis

    Arch Dis Child

    (1992)
  • D.G. Sims et al.

    Atopy does not predispose to RSV bronchiolitis or postbronchiolitic wheezing

    BMJ

    (1981)
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    Corresponding author: Dr. J.L.L. Kimpen, University Medical Centre, 3508 AB Utrecht, The Netherlands. Tel: 0031 (0)302504194 Fax: 0031 (0)302505349 e-mail: [email protected]

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