The usual suspects: Respiratory syncytial virus and rhinovirus drive asthma development and exacerbation

Recurrent wheeze and asthma are major health problems, especially in children. Respiratory viral infections are known to induce recurrent wheeze and asthma. Two respiratory viruses associated with most recurrent wheeze and asthma development are respiratory syncytial virus (RSV) and rhinovirus (RV). This review evaluates the roles these 2 viruses play in the development of wheeze and asthma. RSV tends to drive recurrent wheeze in those infants who have a severe infection in the first 2 to 6 months of life and do not have preexisting atopy. This is in contrast with RV, which tends to drive wheeze and asthma in those with preexisting atopy. In the review, the mechanisms that have been proposed to drive the development of asthma and wheeze are explored. Finally, newer developments, such as vaccines, are discussed. In particular, vaccines and treatment for RSV have the potential to alter the development of recurrent wheezing, although vaccines and treatment for RV remain elusive. Both RSV and RV remain a major source of recurrent wheezing in young children.