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Respiratory-syncytial virus immunoprophylaxis on asthma symptoms development in prematurity with bronchopulmonary

Li-Ching Fang1, Jen-Yu Wang2, Hsin-Hui Yu3

  • 1Section of Pediatric Allergy and Immunology, Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.

The Journal of Allergy and Clinical Immunology. Global
|October 2, 2023
PubMed

Insights

Respiratory-syncytial virus (RSV) hospitalization in infants with bronchopulmonary dysplasia (BPD) increases asthma risk. Palivizumab prophylaxis may prevent RSV hospitalization, thus reducing asthma development and duration in high-risk children.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Allergy and Immunology

Background:

  • Infants hospitalized with respiratory-syncytial virus (RSV) bronchiolitis face higher risks of wheezing and developing asthma.
  • Palivizumab prophylaxis is recognized for preventing RSV hospitalizations in high-risk infants, including premature infants and those with bronchopulmonary dysplasia (BPD).

Purpose of the Study:

  • To investigate the impact of RSV immunoprophylaxis on the risk of asthma development in premature infants diagnosed with BPD in subtropical regions.

Main Methods:

  • A case-control study was conducted involving preterm children with BPD, born between 1999 and 2015.
  • Medical records of 616 eligible participants were retrospectively analyzed from birth to ages 5-20 years.
  • The primary endpoint assessed was the onset of active asthma.

Main Results:

  • A history of RSV bronchiolitis hospitalization was associated with a significantly higher risk of future asthma development (aOR=3.77, HR=2.56).
  • Palivizumab prophylaxis demonstrated a reduction in future asthma development, primarily by inhibiting RSV bronchiolitis hospitalizations (coefficient=-0.021).
  • Asthmatic children who received palivizumab immunoprophylaxis experienced a shorter duration of active asthma compared to those who did not.

Conclusions:

  • Hospitalization for RSV bronchiolitis in children with BPD elevates the risk of developing asthma.
  • Prophylactic palivizumab administration may mitigate later asthma development by preventing RSV hospitalizations.
  • For children who develop asthma, palivizumab treatment appears to shorten the duration of active disease.
Abstract

Keywords:
AsthmaRSV bronchiolitisbronchopulmonary dysplasiapalivizumabprematurity

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