Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing

Abstract

There is evidence that respiratory viruses play a key role in the development and exacerbation of obstructive respiratory diseases in children. This review attempts to juxtapose the separate profiles and prototypes of pathogenenetic mechanisms represented by the two most common amongst such viruses: respiratory syncytial virus (RSV) and human rhinovirus (HRV).RSV represents the most common agent of severe airway disease in infants and young children, and is predominant in winter months. Large epidemiological studies have revealed an unequivocal relationship between RSV infection and subsequent wheezing into childhood, thought to be related to long-term changes in neuroimmune control of the airways rather than allergic sensitisation.HRV is a highly diverse group of viruses that affect subjects of all ages, is ubiquitous and occurs yearround. In contrast to RSV, infections with HRV cause minimal cytotoxicity but induce a rapid production of cytokines and chemokines with amplification of the inflammatory response. The susceptibility to HRVinduced bronchiolitis and subsequent wheezing appears to be linked to individual predisposition since it is often associated with a family or personal history of asthma/atopy.Thus, RSV probably serves as an "inducer" rather than a "trigger". Conversely, HRVs seem to serve as a "trigger" rather than an "inducer" in predisposed individuals. @ERSpublications Comprehensive overview of the different roles of RSV and HRV in the pathogenesis of recurrent wheezing in childhood

A Clustering Approach to Identify Severe Bronchiolitis Profiles in Children

“…[11,12] However, whether this association is causal or reflects an underlying susceptibility to both early infection and asthma remains unclear. [11,13,31] It has been suggested that severe rhinovirus-induced infections may be a susceptibility marker for development of childhood asthma in predisposed children, rather than an inducer (causing asthma).…”

“…[11,[14][15][16][17] However, the exact role of early infections in the pathogenesis of asthma remains unclear. [11][12][13] Studies examining subgroups of patients with bronchiolitis generally classify children according to a limited number of characteristics (e.g., RSV-status, wheezing) or to a single dimension (e.g., severity score). Compared to this simple approach, the benefits of multidimensional approaches in addressing a heterogeneous disease (with regards to its etiology, pathobiology or treatments) have been demonstrated for other respiratory/allergic disorders, such as asthma, wheezing illness of childhood, or atopy.…”

“…[10] Importantly, beyond these short-term differences, heterogeneity has also been observed in long-term outcomes, such as the risk of developing recurrent wheezing and asthma. [11][12][13] Studies have suggested that more severe bronchiolitis and rhinovirus infections in early childhood are strongly associated with an increased risk of subsequent recurrent wheezing and asthma. [11,[14][15][16][17] However, the exact role of early infections in the pathogenesis of asthma remains unclear.…”

“…[11][12][13] Studies have suggested that more severe bronchiolitis and rhinovirus infections in early childhood are strongly associated with an increased risk of subsequent recurrent wheezing and asthma. [11,[14][15][16][17] However, the exact role of early infections in the pathogenesis of asthma remains unclear. [11][12][13] Studies examining subgroups of patients with bronchiolitis generally classify children according to a limited number of characteristics (e.g., RSV-status, wheezing) or to a single dimension (e.g., severity score).…”

ReCOMmendations for management of Preschool ASthma for General Practitioners – COMPAS GP

“…Głównymi czynnikami wywołującymi pierwsze epizody świstów oddechowych u niemowląt i małych dzieci są wirusy -zwłaszcza RSV oraz rhinowirusy (RV) [13].…”