Association between respiratory infections in early life and later asthma is independent of virus type

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:136

Article

Bonnelykke, Klaus^1,2  Vissing, Nadja Hawwa^1,2  Sevelsted, Astrid^1,2  Johnston, Sebastian L.^3,4,5  Bisgaard, Hans^1,2 

[1] Univ Copenhagen, Fac Hlth & Med Sci, Copenhagen Prospect Studies Asthma Childhood, DK-2820 Gentofte, Denmark

[2] Univ Copenhagen, Gentofte Hosp, Danish Pediat Asthma Ctr, DK-2820 Gentofte, Denmark

[3] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, MRC, Airway Dis Infect Sect, London SW7 2AZ, England

[4] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, Asthma UK Ctr Allerg Mech Asthma, London SW7 2AZ, England

[5] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, Ctr Resp Infect, London SW7 2AZ, England

关键词: Child;    asthma;    virus;    bacteria;    respiratory tract infection;   

DOI  :  10.1016/j.jaci.2015.02.024

来源: Elsevier

【 摘 要 】

Background: Lower respiratory tract infections in the first years of life are associated with later asthma, and this observation has led to a focus on the potential causal role of specific respiratory viruses, such as rhinoviruses and respiratory syncytial virus, in asthma development. However, many respiratory viruses and bacteria trigger similar respiratory symptoms and it is possible that the important risk factors for asthma are the underlying susceptibility to infection and the exaggerated reaction to such triggers rather than the particular triggering agent. Objective: We sought to study the association between specific infections in early life and development of asthma later in childhood. Methods: Three hundred thirteen children were followed prospectively in the Copenhagen Prospective Studies of Asthma in Childhood2000 high-risk birth cohort. Nine respiratory virus types (respiratory syncytial virus, rhinoviruses, other picornaviruses, coronaviruses 229E and OC43, parainfluenza viruses 1-3, influenza viruses AH1, AH3, and B, human metapneumovirus, adenoviruses, and bocavirus) and 3 pathogenic airway bacteria (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) were identified in airway secretions sampled during episodes of troublesome lung symptoms in the first 3 years of life. Asthma was determined by age 7 years. Results: In unadjusted analyses, all viruses and pathogenic bacteria identified during episodes of troublesome lung symptoms were associated with increased risk of asthma by age 7 years with similar odds ratios for all viruses and pathogenic bacteria. After adjustment for the frequency of respiratory episodes, the particular triggers were no longer associated with asthma. Conclusion: The number of respiratory episodes in the first years of life, but not the particular viral trigger, was associated with later asthma development. This suggests that future research should focus on the susceptibility and exaggerated response to lower respiratory tract infections in general rather than on the specific triggering agent.

【 授权许可】

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