Mechanisms underlying the increased risk of recurrent wheeze after respiratory syncytial virus lower respiratory tract infection (RSV LRTI) are unclear. Specifically, information about genetic determinants of recurrent wheeze after RSV LRTI is limited. We performed a candidate gene association study to identify genetic determinants of recurrent wheeze after RSV LRTI. We investigated 346 single nucleotide polymorphisms (SNPs) in 220 candidate genes in 166 Dutch infants hospitalized for RSV LRTI. Logistic regression analysis was used to study associations between genotypes and haplotypes and recurrent wheeze after RSV LRTI. We found associations with recurrent wheeze for SNPs in IL19, IL20, MUC5AC, TNFRSF1B, C3, CTLA4, CXCL9, IL4R, and IL7 genes. Haplotype analysis of the combined IL19/IL20 genotyped polymorphisms demonstrated an inverse association between the TGG haplotype and recurrent wheeze after RSV LRTI. IL19 and IL20 genes were notably associated with recurrent wheeze in infants without asthmatic parents. The association of IL20 SNP rs2981573 with recurrent wheeze was confirmed in a healthy birth cohort. We concluded that genetic variation in adaptive immunity genes and particularly in IL19/IL20 genes associates with the development of recurrent wheeze after RSV LRTI, suggesting a role for these IL10 family members in the etiology of airway disease during infancy. (Pediatr Res 70: 518-523, 2011) R espiratory syncytial virus lower respiratory tract infection (RSV LRTI) during infancy is an independent risk factor for subsequent recurrent wheeze, at least within the first years of childhood (1). Mechanisms underlying the increased incidence of wheeze during the first years after RSV LRTI are unclear. Recurrent wheeze after RSV LRTI was related to signs of airflow limitation during RSV LRTI (2), eosinophilia during RSV LRTI (3), and monocyte IL10-production during the convalescent phase of RSV LRTI (4).To date, only two studies aimed to identify genetic determinants of recurrent wheeze after RSV LRTI. In one association study of 134 RSV hospitalized infants, a variant of the IL8 gene was related to the development of subsequent wheeze (5). We previously demonstrated an association between a functional IL13 polymorphism and wheeze at age 6, whereas no association was found between the IL13 polymorphism and recurrent wheeze during the first year after RSV LRTI (6).The availability of analytic tools to study larger numbers of genes and a larger cohort of RSV LRTI-hospitalized infants in whom recurrent wheeze was evaluated enabled us to extend our previous studies. Herein, we describe the results of 346 genotyped single nucleotide polymorphisms (SNPs) on 210 genes, including IL10 family genes.
METHODS
Subjects and design.The infants included in this study participated in previous studies (4,6 -8). In brief, they were hospitalized for RSV LRTI during the winter seasons of 1995-1996 or 2004 -2006. Infants included in the winter season of 1995-1996 participated in an observational study investigating the ...