The Syndrome We Agreed to Call Bronchiolitis

Polack, Fernando P.; Stein, Renato T.; Čustović, Adnan

doi:10.1093/infdis/jiz082

Cited by 34 publications

(25 citation statements)

References 15 publications

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“…In addition, the recent understanding of asthma not as a disease with a single mechanism of illness but as a syndrome [ 23 , 24 ], reformulates our interpretation of causality previously ascribed to RSV, demanding a recategorization of the specific relationship between “RSV bronchiolitis” and the several different “asthmas” experienced during childhood [ 25 ]. In this review, we summarize the literature exploring the association between RSV LRTI in infancy and subsequent recurrent wheezing and pediatric asthma.…”

Section: Introductionmentioning

confidence: 99%

A Durable Relationship: Respiratory Syncytial Virus Bronchiolitis and Asthma past Their Golden Anniversary

2020

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Numerous preventive strategies against respiratory syncytial virus (RSV) are undergoing late stage evaluation in humans and, in addition to their intended benefit for acute illness, may impact long term consequences of infection in infants. Severe RSV infection has been repeatedly associated in the literature with long term complications, including impaired lung function, recurrent wheezing, and asthma. However, whether RSV lower respiratory tract infection (LRTI) causally affects the odds for developing wheezing and/or asthma during childhood requires further study, and the biological mechanisms underlying this hypothetical progression from viral illness to chronic lung disease are poorly characterized. In this review, we summarize the literature exploring the association between RSV LRTI in infancy and subsequent recurrent wheezing and pediatric asthma.

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Section: Introductionmentioning

confidence: 99%

A Durable Relationship: Respiratory Syncytial Virus Bronchiolitis and Asthma past Their Golden Anniversary

2020

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“…In this study, we defined bronchiolitis as first respiratory distress with or without wheezing associated with a lower respiratory tract infection at the age under 12 months. Unfortunately, there is not a universally accepted consensus of the diagnosis of bronchiolitis, which means that bronchiolitis includes a heterogeneous group of diseases . Earlier, a large multicentre study from the United States and Finland has observed four profiles of bronchiolitis patient at the age under 24 months, which indicates the heterogeneity of bronchiolitis diagnosis .…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, there is not a universally accepted consensus of the diagnosis of bronchiolitis, which means that bronchiolitis includes a heterogeneous group of diseases. 23 Earlier, a large multicentre study from the United States and Finland has observed four profiles of bronchiolitis patient at the age under 24 months, which indicates the heterogeneity of bronchiolitis diagnosis. 24 Those profiles differ by causative virus, earlier history of wheezing and eczema, current wheezing, age on admission and the severity of the disease.…”

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confidence: 97%

Nursing intensity scores did not correlate well with reimbursement claims for infant bronchiolitis

et al. 2019

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Aim We retrospectively evaluated the hospital reimbursement rates for inpatient bronchiolitis treatment and then compared them to the RAFAELA® nursing intensity scores. Methods We selected all 44 bronchiolitis patients treated in the paediatric intensive care unit (PICU) and then for each PICU‐treated patient two patients treated on the ward (n = 88) under 12 months of age in 2010‐2015. The data included medical histories, hospital reimbursement rates using the Nordic Diagnosis Related Groups (NordDRG) or expense categories and the RAFAELA® scores. Results Reimbursement claims were mostly based on expense categories for PICU admissions and NordDRG categories for ward admissions. The median (range) was €6352 (€1330‐30 554) and €2009 (€768‐6027) per episode for the PICU and ward cases, respectively. The median lengths of hospital stay were 8.5 days (3‐18) and 3 days (1‐8), respectively. Higher RAFAELA® scores were associated with nasal continuous positive airway pressure therapy and mechanical ventilation in the PICU and oxygen supplementation and nasogastric tube feeding on the ward. The correlation coefficients between RAFAELA® scores and hospital reimbursement claims ranged from 0.121‐0.450. Conclusion Hospital reimbursement claim for a PICU admission was three times as much as a ward admission and reimbursement claims for bronchiolitis did not match with nursing intensity scores.

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“…A candidate from NIAID-Sanofi with an NS2 non-structural protein deletion that reduces viral suppression of the interferon response and increases the innate immune response has advanced in parallel with a second NIAID-Sanofi candidate with a deletion in the RSV M2-2 protein attenuating viral replication while upregulating gene transcription and antigen expression (NCT02237209 and NCT02040831) 57– 62 . These candidates appear mildly over- and under-attenuated, respectively 61 . Vectored approaches for children include Ad26.RSV.preF using a human adenovirus 26 now in phase 2 trials in adults and 12- to 24-month-old RSV seropositive toddlers (NCT03303625) 63, 64 and ChAd155-RSV (NCT02927873) 65 , a replication-incompetent chimpanzee adenovirus 155 now in phase 2 in seropositive children.…”

Section: Surge Of Approaches To Prevent Respiratory Syncytial Virus Lmentioning

confidence: 97%

The long road to protect infants against severe RSV lower respiratory tract illness

Baglivo

Polack

2019

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Severe respiratory syncytial virus (RSV) lower respiratory tract illness (LRTI) in infants has proven challenging to prevent. In the last 50 years, conceptually different approaches failed to evolve into viable preventive alternatives for routine use. Inactivated RSV vaccine (that is, formalin-inactivated RSV) elicited severe LRTI in RSV-infected toddlers pre-immunized as infants; early purified F protein approaches in pregnant women failed to elicit sufficient immunity more than a decade ago; a second-generation monoclonal antibody (mAb) of high potency against the virus (that is, motavizumab) caused severe adverse reactions in the skin, and owing to lack of efficacy against RSV subgroup B, an extended half-life mAb targeting site V in the RSV fusion protein (that is, REG2222) did not meet its primary endpoint. In the meantime, two protein F vaccines failed to prevent medically attended LRTI in the elderly. However, palivizumab and the recent results of the Novavax maternal immunization trial with ResVax demonstrate that severe RSV LRTI can be prevented by mAb and by maternal immunization (at least to a certain extent). In fact, disease prevention may also decrease the rates of recurrent wheezing and all-cause pneumonia for at least 180 days. In this review, we discuss the history of RSV vaccine development, previous and current vaccine strategies undergoing evaluation, and recent information about disease burden and its implications for the effects of successful preventive strategies.

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The Syndrome We Agreed to Call Bronchiolitis

Cited by 34 publications

References 15 publications

A Durable Relationship: Respiratory Syncytial Virus Bronchiolitis and Asthma past Their Golden Anniversary

A Durable Relationship: Respiratory Syncytial Virus Bronchiolitis and Asthma past Their Golden Anniversary

Nursing intensity scores did not correlate well with reimbursement claims for infant bronchiolitis

The long road to protect infants against severe RSV lower respiratory tract illness

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