Asthma and lower airway diseaseDeterminants of asthma after severe respiratory syncytial virus bronchiolitis
Section snippets
Study population
From 1998 to 2001, we enrolled 206 infants 12 months of age or less in the RSV Bronchiolitis in Early Life (RBEL) prospective cohort study. Selection of the study population and characteristics of the cohort at study entry are described in detail elsewhere.17 Included infants were required to have bronchiolitis severe enough to require emergency department care or hospitalization, a positive nasopharyngeal swab result confirming infection with RSV, and physician-documented wheezing during the
Results
Of 206 children enrolled in the RBEL cohort, 201 (98%) had at least 1 follow-up contact during the study period. Fig 1 and the Results section in this article’s Online Repository at www.jacionline.org show recruitment and retention over the course of the study. One hundred fifty-nine (77%) subjects provided data between ages 3 and 6 years. Children who did not provide data between ages 3 and 6 years did not differ from those with data in terms of age, sex, race, bronchiolitis severity, smoke
Discussion
We have demonstrated that severe RSV bronchiolitis in the first year of life is followed by a diagnosis of childhood asthma by the seventh birthday in nearly half of children. Factors assessed around the time of bronchiolitis that were associated with increased risk of physician-diagnosed asthma in our cohort included maternal asthma, exposure to high levels of dog allergen, and increased upper airway expression of CCL5, whereas white race and longer birth length decreased the risk. The
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Supported by National Institutes of Health grant HL 61895.
Disclosure of potential conflict of interest: L. B. Bacharier is on the advisory board for AstraZeneca, has received honoraria from GlaxoSmithKline, and is on the advisory board and has received honoraria from Merck. M. Castro is a consultant and speaker for Asthmatx; is on the advisory board and is a speaker for Genentech; is a speaker for AstraZeneca, Merck, and GlaxoSmithKline; has received research support from Asthmatx, Amgen, Ception/Cephalon, Genentech, MedImmune, Merck, the National Institutes of Health, Novartis, and GlaxoSmithKline; and has received royalties from Elsevier. The rest of the authors declare that they have no relevant conflicts of interest.