Teenage asthma after severe early childhood wheezing: An 11‐year prospective follow‐up

Hyvärinen, Mari; Kotaniemi‐Syrjänen, Anne; Reijonen, Tiina M.; Korhonen, Kaj; Korppi, Matti

doi:10.1002/ppul.20273

Cited by 103 publications

(152 citation statements)

References 32 publications

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“…For example, a case control study conducted in Finland demonstrated that infants hospitalized with HRV-induced wheezing were found to have a particularly high risk for subsequent asthma, and this relationship persisted at least through the teen years (37,56). This finding is further supported by the results of two birth cohort studies.…”

Section: Hrv As a Lower Airway Pathogensupporting

confidence: 70%

The ABCs of Rhinoviruses, Wheezing, and Asthma

Gern

2010

J Virol

235

226

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Human rhinoviruses (HRVs) were discovered as common cold pathogens over 50 years ago. Recent advances in molecular viral diagnostics have led to an appreciation of their role in more-significant respiratory illnesses, including bronchiolitis in infancy, childhood pneumonia, and acute exacerbations of chronic respiratory diseases such as asthma, chronic obstructive lung disease, and cystic fibrosis. Until a few years ago, only two groups of HRVs (A and B) had been recognized. However, full and partial sequencing of HRVs led to the discovery of a third species of HRV (HRV-C) that has distinct structural and biologic features. Risk factors and pathogenic mechanisms for more-severe HRV infections are being defined, and yet fundamental questions persist about mechanisms relating this common pathogen to allergic diseases and asthma. The close relationship between HRV infections and asthma suggests that antiviral treatments could have a major impact on the morbidity associated with this chronic respiratory disease.Virology and clinical textbooks and virtually all web-based information sources generally describe human rhinoviruses (HRVs) as the most frequent cause of the common cold. In this light, HRVs are important pathogens because common colds are so widespread and annoying, and from an economic perspective, supplying symptomatic-relief medications is a huge industry. A 2003 study estimated that expenditures on common cold medications in the United States exceeded 4 billion dollars, including 1.1 billion dollars spent on inappropriate prescriptions for antibiotics (18). Finding a cure for the common cold has been a much-publicized goal ever since HRVs were first discovered in the 1950s and 1960s. The basic biology of the replication cycle was soon described, and most HRVs were found to replicate best at 33°to 35°C (88, 99), which is consistent with their role as upper airway pathogens. HRVs were found to have tremendous diversity, and approximately 100 serotypes in two groups (A and B) had been identified by 1990, when it was presumed that all, or nearly all, HRVs had been identified. These HRVs were found to bind to one of two main receptors: ICAM-1 (major group) (30) and the low-density-lipoprotein receptor (most of the minor group) (35). Despite advances in understanding HRV genetics and the picornavirus replication cycle, efforts toward developing specific antivirals have fallen short due to modest efficacy, side effects, drug interactions, and economic considerations (16). Consequently, enthusiasm for pursuing a common cold cure has waned, and the pharmaceutical industry has refocused attention on viruses that cause more-significant illnesses. This failure is a bit embarrassing. As summarized by White and Fenner, "In this era of organ transplantation, genetic engineering, and other dramatic demonstrations of the wonders of medical science, the man in the street perceives a certain irony in the inability of modern medicine to make the slightest impact on that most trivial of all human ailments, the common cold" ...

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Section: Hrv As a Lower Airway Pathogensupporting

confidence: 70%

The ABCs of Rhinoviruses, Wheezing, and Asthma

Gern

2010

J Virol

235

226

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“…Unfortunately, objective evaluation of viral infections on swabs was not available in the MAS. Other studies have found direct evidence of respiratory syncytical virus and rhinovirus infection in infancy to be associated with persistence of asthma in teenagers [22,23].…”

Section: Discussionmentioning

confidence: 99%

Wheezing in childhood: incidence, longitudinal patterns and factors predicting persistence

Matricardi¹,

Illi²,

Grüber³

et al. 2008

Eur Respir J

161

138

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Childhood asthma is frequently perceived as a disease with uniform clinical pathways. This perception might be an oversimplification. The aim of the present study was to investigate the incidence and natural course of wheeze over the first 13 yrs of life and analyse the risk factors predicting wheeze at 11-13 yrs of age.The Multicentre Allergy Study, a German birth cohort, recruited 1,314 children in 1990. Physical examinations, interviews on atopic diseases, immunoglobulin (Ig)E and lung function tests were performed up to 13 yrs of age.Complete data on the course of wheeze were available for 441 children. It was found that incidence of wheezing declined with age. The first wheezing episode was reported by 29, 9 and 9% of participants at f3 (early wheezers), 3-6 (late wheezers), and .6 yrs (very late wheezers) of age, respectively. Wheezing at the age of 13 yrs was associated with parental atopy, and with IgE sensitisation to common allergens, elevated total IgE and exposure to high levels of indoor allergens in early life. All these associations were remarkably stronger among early wheezers than among early nonwheezers.In conclusion, the relevance of an early expression of atopy as a predictor of wheezing at age 13 yrs declines with increasing age of wheezing onset.

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“…Factors underlying the frequency and severity of episodes are only partially understood, but the severity of the first episode (which is, in turn, related to pre-existent impaired lung function and younger age), atopy, prematurity and exposure to tobacco smoke have been implicated [29][30][31][32][33][34][35]. Whether or not [36][37][38].…”

Section: Definitionsmentioning

confidence: 99%

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Brand¹,

Baraldi²,

Bisgaard³

et al. 2008

Eur Respir J

750

759

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There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis.Based on the limited evidence available, inhaled short-acting b 2 -agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop.Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit.Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes.

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Teenage asthma after severe early childhood wheezing: An 11‐year prospective follow‐up

Cited by 103 publications

References 32 publications

The ABCs of Rhinoviruses, Wheezing, and Asthma

The ABCs of Rhinoviruses, Wheezing, and Asthma

Wheezing in childhood: incidence, longitudinal patterns and factors predicting persistence

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

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