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Novel concepts in virally induced asthma.

Huckabee MM, Peebles RS - Clin Mol Allergy (2009)

Bottom Line: Viruses are the predominant infectious cause of asthma exacerbations in the developed world.In this article, we will briefly describe the general perception of how the link between infections and asthma has changed over the last century, and then focus on very recent developments that have provided new insights into the contribution of viruses to asthma pathogenesis.Highlighted areas include the contribution of severe early life viral infections to asthma inception, genetic determinants of severe viral infections in infancy, the differences in innate and adaptive immune system cytokine responses to viral infection between asthmatic and nonasthmatic subjects, and a potential vaccine strategy to prevent severe early life virally-induced illness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA. stokes.peebles@vanderbilt.edu.

ABSTRACT
Viruses are the predominant infectious cause of asthma exacerbations in the developed world. In addition, recent evidence strongly suggests that viral infections may also have a causal role in the development of childhood asthma. In this article, we will briefly describe the general perception of how the link between infections and asthma has changed over the last century, and then focus on very recent developments that have provided new insights into the contribution of viruses to asthma pathogenesis. Highlighted areas include the contribution of severe early life viral infections to asthma inception, genetic determinants of severe viral infections in infancy, the differences in innate and adaptive immune system cytokine responses to viral infection between asthmatic and nonasthmatic subjects, and a potential vaccine strategy to prevent severe early life virally-induced illness.

No MeSH data available.


Related in: MedlinePlus

Predicted probability and 95% confidence intervals of bronchiolitis requiring a health care visit during infancy (hospitalization, emergency department visit, or outpatient visit) by infant age in months at the winter virus peak ( = 345.52; P < 0·001). Results were obtained from a multivariable logistic regression model. Effect was adjusted for gender, infant race, birth weight, gestational age, number of living siblings, region of residence, maternal smoking, marital status, maternal education, and season. Reprinted with permission from Wu et al, Am J Respir Crit Care Med 178:1123–1129, 2008.
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Figure 1: Predicted probability and 95% confidence intervals of bronchiolitis requiring a health care visit during infancy (hospitalization, emergency department visit, or outpatient visit) by infant age in months at the winter virus peak ( = 345.52; P < 0·001). Results were obtained from a multivariable logistic regression model. Effect was adjusted for gender, infant race, birth weight, gestational age, number of living siblings, region of residence, maternal smoking, marital status, maternal education, and season. Reprinted with permission from Wu et al, Am J Respir Crit Care Med 178:1123–1129, 2008.

Mentions: First, the timing of infant birth in relationship to the winter virus peak, as defined as the first day of the week with the highest number of bronchiolitis hospitalizations for that winter season, predicted the likelihood of developing clinically significant bronchiolitis [21]. Clinically significant bronchiolitis was defined as hospitalization, emergency department visit, or outpatient visit. After adjusting for other factors previously reported to be associated with severe bronchiolitis, infants 122 days (95% CI, 118–126 days) old at the winter virus peak had the greatest risk of developing clinically significant bronchiolitis (Figure 1). Second, the timing of infant birth in relationship to the winter virus peak predicted the likelihood of developing childhood asthma as defined by ICD-9 code or medication use for asthma. Children who were 121 days (95% CI, 108–131 days) old at the winter virus peak had the greatest risk of developing high risk asthma when a comparison was made with children who were either older or younger at the peak of the winter virus season (Figure 2) [22]. High risk asthma was defined as asthma-related hospitalization, emergency department treatment, or rescue corticosteroid prescription. Despite the fact that the winter virus peak shifted as much as six weeks over the 5 viral seasons studied for each child, this relationship of age at peak viral season with the subsequent development of asthma was not affected when subgroup analysis was conducted on children who encountered early or late winter virus peaks. Surprisingly, maternal history of asthma had no effect on this analysis.


Novel concepts in virally induced asthma.

Huckabee MM, Peebles RS - Clin Mol Allergy (2009)

Predicted probability and 95% confidence intervals of bronchiolitis requiring a health care visit during infancy (hospitalization, emergency department visit, or outpatient visit) by infant age in months at the winter virus peak ( = 345.52; P < 0·001). Results were obtained from a multivariable logistic regression model. Effect was adjusted for gender, infant race, birth weight, gestational age, number of living siblings, region of residence, maternal smoking, marital status, maternal education, and season. Reprinted with permission from Wu et al, Am J Respir Crit Care Med 178:1123–1129, 2008.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651109&req=5

Figure 1: Predicted probability and 95% confidence intervals of bronchiolitis requiring a health care visit during infancy (hospitalization, emergency department visit, or outpatient visit) by infant age in months at the winter virus peak ( = 345.52; P < 0·001). Results were obtained from a multivariable logistic regression model. Effect was adjusted for gender, infant race, birth weight, gestational age, number of living siblings, region of residence, maternal smoking, marital status, maternal education, and season. Reprinted with permission from Wu et al, Am J Respir Crit Care Med 178:1123–1129, 2008.
Mentions: First, the timing of infant birth in relationship to the winter virus peak, as defined as the first day of the week with the highest number of bronchiolitis hospitalizations for that winter season, predicted the likelihood of developing clinically significant bronchiolitis [21]. Clinically significant bronchiolitis was defined as hospitalization, emergency department visit, or outpatient visit. After adjusting for other factors previously reported to be associated with severe bronchiolitis, infants 122 days (95% CI, 118–126 days) old at the winter virus peak had the greatest risk of developing clinically significant bronchiolitis (Figure 1). Second, the timing of infant birth in relationship to the winter virus peak predicted the likelihood of developing childhood asthma as defined by ICD-9 code or medication use for asthma. Children who were 121 days (95% CI, 108–131 days) old at the winter virus peak had the greatest risk of developing high risk asthma when a comparison was made with children who were either older or younger at the peak of the winter virus season (Figure 2) [22]. High risk asthma was defined as asthma-related hospitalization, emergency department treatment, or rescue corticosteroid prescription. Despite the fact that the winter virus peak shifted as much as six weeks over the 5 viral seasons studied for each child, this relationship of age at peak viral season with the subsequent development of asthma was not affected when subgroup analysis was conducted on children who encountered early or late winter virus peaks. Surprisingly, maternal history of asthma had no effect on this analysis.

Bottom Line: Viruses are the predominant infectious cause of asthma exacerbations in the developed world.In this article, we will briefly describe the general perception of how the link between infections and asthma has changed over the last century, and then focus on very recent developments that have provided new insights into the contribution of viruses to asthma pathogenesis.Highlighted areas include the contribution of severe early life viral infections to asthma inception, genetic determinants of severe viral infections in infancy, the differences in innate and adaptive immune system cytokine responses to viral infection between asthmatic and nonasthmatic subjects, and a potential vaccine strategy to prevent severe early life virally-induced illness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA. stokes.peebles@vanderbilt.edu.

ABSTRACT
Viruses are the predominant infectious cause of asthma exacerbations in the developed world. In addition, recent evidence strongly suggests that viral infections may also have a causal role in the development of childhood asthma. In this article, we will briefly describe the general perception of how the link between infections and asthma has changed over the last century, and then focus on very recent developments that have provided new insights into the contribution of viruses to asthma pathogenesis. Highlighted areas include the contribution of severe early life viral infections to asthma inception, genetic determinants of severe viral infections in infancy, the differences in innate and adaptive immune system cytokine responses to viral infection between asthmatic and nonasthmatic subjects, and a potential vaccine strategy to prevent severe early life virally-induced illness.

No MeSH data available.


Related in: MedlinePlus