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Published on: July 27, 2021
Palivizumab prophylaxis, respiratory syncytial virus and subsequent development of asthma
Mahir Igde1, Hilal Kabasakal2, Onur Ozturk3
1Division of Allergy and Immunology, Department of Pediatrics, Samsun Education and Research Hospital, Samsun, Turkey.
Insights
Palivizumab prophylaxis in premature infants may reduce the risk of developing asthma. This study found lower asthma predictive index scores in infants treated with palivizumab, suggesting a protective effect against childhood asthma.
Area of Science:
- Pediatric Respiratory Medicine
- Immunology
- Public Health
Background:
- Respiratory syncytial virus (RSV) infection in early childhood is linked to future asthma development.
- Palivizumab is a proven prophylaxis for RSV, potentially preventing subsequent asthma.
- The modified Asthma Predictive Index (mAPI) is used to assess asthma risk.
Purpose of the Study:
- To evaluate the protective effect of palivizumab on asthma development in children.
- To compare asthma risk using the mAPI in different infant groups.
Main Methods:
- A cohort study of 339 children aged 2-5 years.
- Three groups were analyzed: palivizumab-treated preterm infants, untreated preterm infants, and term newborns.
- Wheezing frequency and mAPI positivity were key evaluation metrics.
Main Results:
- Significant differences in wheezing frequency and asthma diagnosis were observed between groups (P=0.003 and P=0.045, respectively).
- mAPI positivity varied significantly among the groups (P=0.001), with the palivizumab-treated preterm group showing the lowest positivity.
- Palivizumab-treated preterm infants had significantly lower mAPI positivity compared to term newborns.
Conclusions:
- Administration of palivizumab to premature infants is supported as a strategy to reduce asthma development risk.
- Palivizumab prophylaxis may offer long-term benefits beyond RSV prevention.
Background:
Respiratory syncytial virus (RSV) infection is a disease commonly encountered during childhood and it may relapse. An experience in the early childhood would induce asthma development in the future. Palivizumab has a proven efficacy for the RSV prophylaxis so it may prevent asthma. Our aim was to evaluate the possible protective effect of palivizumab on the development of asthma by using the modified Asthma Predictive Index (mAPI).
Methods:
This study's data consist of 339 children between 2 to 5 years of age followed up in healthy children unit from 2008 to 2011. Cases were evaluated in terms of wheezing frequency and characteristic features. Evaluations were performed among three groups; palivizumab-treated children born preterm (group 1), palivizumab-untreated children born preterm (group 2) and term newborn children (group 3) with equal number of patients in each group (N.=113).
Results:
Frequency of the answers about children's experienced wheezing times was significant between groups (P=0.003). A significant difference was found between the groups in terms of the clinician who diagnosed asthma (P=0.045). The groups were compared in terms of the mAPI positivity and a significant difference was found among the groups (P=0.001). Group 1 had lowest and group 3 had highest positivity. Group 1 and group 3 were different (P=0.000), group 2 was found higher than group 1, but was similar to group 3 (P=0.628).
Conclusions:
This study supports the benefit of administration of palivizumab to premature children to reduce the risk of asthma development.
Related Concept Videos
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Asthma-III: Symptoms and Complications
Classification of Asthma
Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
What are Viruses?

