Related Experiment Video
Updated: Sep 10, 2025
A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
Published on: June 4, 2017
Risk factors for recurrent wheezing after infant bronchiolitis: a 6-year single-centre follow up study in China
Sainan Chen1, Xueyun Xu1, Min Wu1
1Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
Insights
Infants hospitalized with respiratory syncytial virus (RSV) bronchiolitis and a history of eczema face a higher risk of developing recurrent wheezing. This study identified key risk factors for post-bronchiolitis wheezing in children.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Epidemiology
Background:
- Infants diagnosed with bronchiolitis are at increased risk for developing recurrent wheezing and asthma.
- Risk factors contributing to recurrent wheezing or asthma post-infant bronchiolitis are not fully understood.
- This prospective observational study aimed to identify these critical risk factors.
Purpose of the Study:
- To identify risk factors for recurrent wheezing and asthma in infants following their first bronchiolitis episode.
- To investigate the long-term outcomes of bronchiolitis in early childhood.
- To correlate early-life factors with later respiratory health.
Main Methods:
- Prospective observational study enrolling 89 infants with first bronchiolitis attack.
- Serum cytokine analysis and follow-up for 6 years to track wheezing episodes.
- Lung function tests, total IgE, and allergen-specific IgE performed at 6-7 years of age.
Main Results:
- 72 infants completed the 6-year follow-up; 31.9% developed recurrent wheezing, and 12.5% developed asthma.
- Infants with bronchiolitis, particularly those with respiratory syncytial virus (RSV) and a history of eczema, showed a significantly higher rate of recurrent preschool wheezing.
- No significant differences in serum cytokine levels were observed between patients with and without current asthma.
Conclusions:
- Hospitalization for bronchiolitis in infancy is linked to a significant risk of developing recurrent wheezing and asthma by age six.
- Respiratory syncytial virus (RSV) bronchiolitis and co-existing eczema are identified as key risk factors for recurrent wheezing in children.
- Early identification of these risk factors can aid in targeted interventions and management strategies.
Background:
Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the risk factors for recurrent wheezing or asthma after infant bronchiolitis remain controversial. The aim of our prospective observational study was to seek the risk factors for recurrent wheezing or asthma.
Methods:
Infants with first bronchiolitis attack at the respiratory department, Children's Hospital of Soochow University were enrolled from November 2016 through March 2017. Serum cytokines, TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF-α and MIP-1α were measured via flow cytometry at enrolment. Patients were followed up with every 3 months for a duration of 6 years by telephone or as outpatients for the number of wheezing episodes. In the sixth year of follow-up, lung function tests, total IgE and allergen specific IgE test were performed in those children at 6-7 years of age.
Results:
We enrolled 89 infants, 72 of whom were successfully followed up for 6 years. In total, 31.9% of the patients developed recurrent wheezing and 12.5% of patients developed asthma after 6 years of follow-up. The Kaplan-Meier curves of the overall analytic cohort (n = 72) revealed that compared with those in the non-eczema group and non-RSV group, the rate of recurrent wheezing preschool was significantly higher in patients with bronchiolitis with eczema and RSV (P < 0.05). There were no significant differences in cytokine levels between patients with and without current asthma (P > 0.05).
Conclusions:
A total of 31.9% of the children with hospitalization for bronchiolitis at an early age developed recurrent wheezing and 12.5% developed asthma at 6-years old. Infants hospitalised with RSV bronchiolitis and/ or with a history of eczema were at increased risk for developing recurrent wheezing.
Related Concept Videos
01:29Asthma-I: Introduction
01:17Pulmonary Cycle: Exhalation
01:26Asthma-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:
01:20Asthma: 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.
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...