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Low eosinophils during bronchiolitis in infancy are associated with lower risk of adulthood asthma

Katri Backman1, Kirsi Nuolivirta2, Hertta Ollikainen3

  • 1Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|July 18, 2015
PubMed

Insights

Infant bronchiolitis can predict adult asthma risk. Low blood eosinophils during infection indicate lower risk, while high eosinophils during recovery suggest higher asthma risk and irreversible airway obstruction.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Infant bronchiolitis is a common viral respiratory infection.
  • Bronchiolitis in infancy may represent an early manifestation of asthma.
  • Long-term respiratory outcomes following infant bronchiolitis require further investigation.

Purpose of the Study:

  • To assess the association between early-childhood risk factors and adult asthma.
  • To evaluate the link between infant bronchiolitis and reduced lung function in adulthood.
  • To identify predictors of asthma and irreversible airway obstruction 30 years post-bronchiolitis.

Main Methods:

  • A cohort of 47 former infant bronchiolitis patients was studied at a median age of 29.5 years.
  • Participants underwent clinical examination and post-bronchodilator lung function testing (spirometry).
  • Early-life data, including blood eosinophil counts during acute illness and convalescence, were analyzed.

Main Results:

  • Low blood eosinophil count (<0.25 × 10E9/l) on admission for bronchiolitis was protective against adult asthma.
  • High blood eosinophil count (>0.45 × 10E9/l) during convalescence predicted adult asthma.
  • Parental asthma and high eosinophils during bronchiolitis were risk factors for irreversible airway obstruction (reduced FEV1/FVC ratio).

Conclusions:

  • Eosinopenia during infant bronchiolitis is associated with lower asthma risk in adulthood.
  • Eosinophilia during the convalescent phase of bronchiolitis predicts higher asthma risk.
  • Parental asthma and eosinophilia during bronchiolitis are risk factors for persistent, irreversible airway obstruction.
Abstract

Keywords:
asthmabronchiolitiseosinophilsrespiratory syncytial virus

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