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Neonatal bronchial hyperresponsiveness precedes acute severe viral bronchiolitis in infants

Bo L K Chawes1, Porntiva Poorisrisak, Sebastian L Johnston

  • 1Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen and Danish Pediatric Asthma Centre, Copenhagen University Hospital, Gentofte, Denmark.

The Journal of Allergy and Clinical Immunology
|June 21, 2012
PubMed

Insights

Infants who later develop severe bronchiolitis show heightened bronchial responsiveness before symptoms appear. This early indicator suggests a host factor contributing to severe respiratory illness in neonates.

Area of Science:

  • Pediatric Respiratory Medicine
  • Neonatal Immunology
  • Pulmonology

Background:

  • Respiratory syncytial virus and other viruses cause common colds in infants.
  • A minority of infants develop severe bronchiolitis, often requiring hospitalization.
  • Pre-existing bronchial hyperresponsiveness may cause excessive responses to viral infections.

Purpose of the Study:

  • Compare bronchial responsiveness and lung function in neonates.
  • Identify predictors of acute severe bronchiolitis in infants.
  • Investigate host factors in infant respiratory infections.

Main Methods:

  • Measured lung function and bronchial responsiveness in 1-month-old neonates.
  • Used methacholine challenge and raised-volume rapid thoracoabdominal compression.
  • Monitored infants prospectively for respiratory symptoms and diagnosis of severe bronchiolitis.

Main Results:

  • 34 infants (8.5%) developed acute severe bronchiolitis before age 2.
  • Infants with later severe bronchiolitis had 2.5-fold increased methacholine responsiveness at 1 month.
  • No significant differences in baseline airflow measures were found between groups.

Conclusions:

  • Bronchial hyperresponsiveness precedes acute severe bronchiolitis in at-risk neonates.
  • Host factors, specifically bronchial hyperresponsiveness, play a role in severe infant respiratory infections.
  • Early identification of bronchial hyperresponsiveness may aid in predicting severe bronchiolitis.
Abstract

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