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Published on: August 7, 2017
'They said it was bronchiolitis; is it going to turn into asthma doctor?'
Dimos Gidaris1, Don Urquhart, Michael B Anthracopoulos
11st Paediatric Department, Aristotle University of Thessaloniki, Hippokrateion General Hospital, Thessaloniki, Greece.
Insights
Acute bronchiolitis in infants is linked to later recurrent wheezing. However, it remains unclear if bronchiolitis causes asthma or signals an existing predisposition, with both viral and host factors playing a role.
Area of Science:
- Pediatrics
- Epidemiology
- Respiratory Medicine
Background:
- Acute bronchiolitis is a frequent infant illness.
- The link between bronchiolitis and later asthma development is a long-standing clinical and epidemiological question.
Purpose of the Study:
- To review current knowledge on the role of acute bronchiolitis in asthma inception.
- To explore the causal relationship between infant bronchiolitis and subsequent asthma.
Main Methods:
- Literature review of existing evidence.
- Analysis of factors influencing the bronchiolitis-asthma relationship.
Main Results:
- Infant acute bronchiolitis is associated with increased risk of recurrent wheezing in childhood.
- The direction of causality is uncertain: bronchiolitis may lead to asthma, or represent an early sign of asthma predisposition.
- Both host factors (e.g., prematurity, atopy) and viral infection characteristics (e.g., virus type, severity) appear to be involved.
Conclusions:
- The relationship between acute bronchiolitis and asthma is complex, involving both host and viral factors.
- Clarifying this relationship is crucial for informing families about long-term prognosis.
- Further research can guide prophylactic and therapeutic strategies for affected children.
Abstract:
Acute bronchiolitis is a common paediatric disease of infancy. Its association with subsequent asthma development has puzzled clinicians and epidemiologists for decades. This article reviews the current state of knowledge regarding the role of acute bronchiolitis in the inception of asthma. There is little doubt that acute bronchiolitis is associated with an increased risk of recurrent wheezing throughout the primary school years although the direction of causality--i.e. whether bronchiolitis in infancy leads to asthma or it merely represents the first clinical presentation of predisposition to asthma--is uncertain. Existing evidence suggests that both host factors (e.g. prematurity, atopic predisposition) and acute viral infection characteristics (e.g. type of virus, severity) are operating in this relationship, perhaps with variable involvement in different individuals. Further clarification of these issues will help paediatricians provide evidence-based information regarding the long-term prognosis of this common disease to the families, and at the same time, it will facilitate prophylactic approaches and therapeutic strategies.
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