SELECTED ARTICLES FROM THE RECENT LITERATURE 2006

10/12/06

Rhinoviruses and asthma

Summary
Background - Human rhinoviruses (HRV) are the most common causes of the common cold (URI), preferentially infecting nasal epithelial cells. They are commonly detected in the airways epithelial cells of children with virus infection-associated wheezing

Findings - In an excellent recent editorial, Holgate discussed the likely complex relationship between HRV respiratory infection and wheezing episodes in infants. The relationship of these episodes to the future respiratory course of such children later in childhood was also discussed. It appears that: 1) In a study by Malmstrom et al in the same issue of this journal (the JACI), HRV was detected in the bronchial epithelium in 45% of infants (ages 3-26 months) with repeated wheezing episodes Pulmonary function was worse in cases where HRV was detected. Predictors of appearance of asthma in later childhood were the presence of atopic dermatitis, inhalant allergies and specific IgE at the time of infantile wheezing. 2) In a study by Lemanske et al the occurrence of HRV-associated wheezing in the first 2 years of life was associated with an increased risk of asthma in later childhood in children at genetic risk for asthma (parental asthma).

Reference
J Allergy Clin Immunol 2006;118:587-90

Editor's Comments
These comments and others made by a leading investigator of asthma are well worth reading in entirety. It is still not completely clear (to me at least) why a minority of children with infection-associated wheezing in infancy subsequently have persistent asthma during school age other than the predisposition in those with atopy in themselves and a history of parental asthma. This is a subject of continued, active investigation.

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