Abstract
Bronchiolitis is a virus-associated infection of the lower respiratory tract exhibiting signs and symptoms of airway obstruction. Respiratory Syncytial Virus (RSV) is responsible in most cases; however, different rhinoviruses have also been implicated. Specific viruses and time until the first infection, severity of the respiratory condition, and atopic status have a determinant role in the recurrence of wheezing and asthma development. Genetics, lung function, atopic condition, the role of microbiota and environment, pollution, and obesity are considered in the present review. Emergency room visits and hospitalizations because of severe wheezing and smoking during pregnancy among others were identified as risk factors for significant morbidity in our population. Approaching determinant conditions like genetics, allergy, antiviral immunity, and environmental exposures such as farm vs. urban and viral virulence provides an opportunity to minimize morbidity of viral illness and asthma in children.
Highlights
Bronchiolitis is described as the first phase of low respiratory tract infection (LRTI) in children under the age of 2 years with viral etiology and is clinically expressed by peripheral airway obstruction [1]
Data from Argentina reported that Human Respiratory Syncytial Virus (HRSV) accounted for 81.3% in patients hospitalized for lower respiratory infections (LRIs), with a fatality rate of 1.7% [3, 4]
New molecular techniques have amplified the knowledge of human rhinoviruses (HRV) A, B, and C which have joined the list of agents responsible for lower respiratory infection, including bronchiolitis [5] and pneumonia [6] besides their role of inducers of wheezing and asthma in childhood [7]
Summary
Bronchiolitis is a virus-associated infection of the lower respiratory tract exhibiting signs and symptoms of airway obstruction. Respiratory Syncytial Virus (RSV) is responsible in most cases; different rhinoviruses have been implicated. Specific viruses and time until the first infection, severity of the respiratory condition, and atopic status have a determinant role in the recurrence of wheezing and asthma development. Lung function, atopic condition, the role of microbiota and environment, pollution, and obesity are considered in the present review. Emergency room visits and hospitalizations because of severe wheezing and smoking during pregnancy among others were identified as risk factors for significant morbidity in our population. Approaching determinant conditions like genetics, allergy, antiviral immunity, and environmental exposures such as farm vs urban and viral virulence provides an opportunity to minimize morbidity of viral illness and asthma in children
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