Benign joint hypermobility syndrome: a cause of childhood asthma?

Benign joint hypermobility syndrome (BJHS) is a hereditable disorder of connective tissue, which is characterized by the occurrence of multiple musculoskeletal problems in hypermobile individuals who do not have a systemic rheumatological disease. Rectal, uterine and mitral prolapses, varicose veins, myopia and recurrent urinary tract infections are more common in patients with BJHS, which indicates a diffuse anomaly in the structure of connective tissue rather than a limited involvement of the musculoskeletal system. Asthma, as a complex trait disease, develops after environmental exposure to innocuous allergens, infectious agents and air pollutants in susceptible individuals on the basis of their genetics. However, genetic factors cannot explain the recent rise in the prevalence, morbidity, or mortality of asthma. Asthma may also be caused by a connective tissue defect. Changes in the mechanical properties of the bronchial airways and lung parenchyma may underlie the increased tendency of the airways to collapse in asthmatic children. In this paper, we postulate that BJHS may lead to persistent childhood wheezing by causing airway collapse through a connective tissue defect that affects the structure of the airways.