Letter to the editor
Risk of childhood asthma following infant bronchiolitis during the respiratory syncytial virus season

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  • The azithromycin to prevent wheezing following severe RSV bronchiolitis-II clinical trial: Rationale, study design, methods, and characteristics of study population

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    The APW-RSV II clinical trial is designed to investigate whether azithromycin therapy, an easily implemented intervention during RSV bronchiolitis, can reduce the risk of development of subsequent RW and asthma. This clinical trial has the potential to greatly impact pediatric health as up to 13% of new childhood asthma cases are attributable to RSV bronchiolitis [57]. Previous reviews and meta-analyses have established that early life RSV- lower respiratory tract infection (LRTI) is associated with future RW, asthma, and with impaired respiratory physiologic measurements such as reduced lung function and increased airway reactivity [3–5].

  • Childhood Asthma: Is It All About Bacteria and Not About Viruses? A Pro/Con Debate

    2018, Journal of Allergy and Clinical Immunology: In Practice
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    Specificity: Childhood asthma is a chronic pulmonary disease that arises from complex gene-by-environment interactions, and it is clear that there is no single risk factor that could explain the increasing prevalence of this disease.67 However, RSV ARI is a ubiquitous infection in early childhood with a large effect size, and its population-attributable risk for childhood asthma development has been estimated in approximately 13%, with the phenotype of childhood asthma after RSV ARI accounting for approximately 30% of all early childhood asthma.5,68 Thus, preventing early-life RSV ARI, particularly severe infection, could have a significant impact in the burden of childhood asthma.

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This project was funded by grants from the Agency for Healthcare Research and Quality (Tools to reduce infant RSV morbidity and asthma: Use, adherence and effectiveness, R01 HS018454) and the National Institute of Allergy and Infectious Diseases (NIH, K24 AI77839).

Disclosure of potential conflict of interest: K. M. James is employed by Vanderbilt University. G. J. Escobar has received research support and payment for manuscript preparation from the Agency for Healthcare Research and Quality and MedImmune as well as travel support from MedImmune. P. Wu has received research support from the National Institutes of Health and the Agency for Healthcare Research and Quality. S. X. Li and E. M. Walsh have received research support and payment for manuscript preparation from the Agency for Healthcare Research and Quality and MedImmune. T. Hartert has received research support from the National Institutes of Health, has received consultancy fees from the Merck Scientific Advisory Committee, was on the MedImmune Scientific Advisory Board for the REPORT Study, and is employed by Vanderbilt University. The rest of the authors declare that they have no relevant conflicts of interest.

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