Does bronchiolitis caused by RSV predispose to atopic asthma?

Abstract

Based on results from the Tucson Children's Respiratory Study, three different forms of wheezing in children have been proposed: transient infant wheezers, non-atopic wheezers, and atopic wheezers (i.e. children with atopic asthma with IgE antibodies to environmental allergens). All controlled studies of children with RSV bronchiolitis in infancy have revealed that wheezing can continue for varying lengths of time after the infection has subsided. The pathophysiology of this disorder remains to be clarified. Is this wheezing a transient and benign condition, or is it non-atopic, in which case the long-term prognosis is good, or is it a marker for atopic asthma? We have followed prospectively 47 children hospitalised with RSV bronchiolitis and 93 non-bronchiolitis matched controls. The results of follow-up examinations at age 3 and 7 years showed that the incidence of asthma—in children with or without IgE antibodies—was significantly increased in the RSV bronchiolitis group compared to the control group. We observed similar results in a recent follow-up study of these same children at age 13. Our results suggest that infants with RSV bronchiolitis severe enough to cause hospitalisation are at risk for atopic asthma at age 13.