Mechanisms of allergy and adult asthmaThe relationship between respiratory syncytial virus infections and the development of wheezing and asthma in childrenEverard, Mark LAuthor Information Department of Respiratory Medicine, Sheffield Children's Hospital, Sheffield, UK Correspondence to Dr Mark L. Everard, MB, ChB, FRCP, DM, Department of Respiratory Medicine, Sheffield Children's Hospital, Western Bank, Sheffield, UK Tel: +44 114 271 7400; fax: +44 114 273 0522; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: February 2006 - Volume 6 - Issue 1 - p 56-61 doi: 10.1097/01.all.0000200506.62048.06 Buy Metrics Abstract Purpose of review The relationship between respiratory syncytial virus lower-respiratory-tract infections in early childhood and asthma has been the subject of much debate. Most, but not all, previous cohort studies have failed to identify a link between early respiratory syncytial virus infection and atopic asthma. Recent studies have helped clarify some apparently contradictory findings. Recent findings Cohort studies focusing on wheezing in early childhood have indicated that this is associated with an increased incidence of atopic asthma but that this risk is not increased by respiratory syncytial virus infection. Indeed, wheeze associated with rhinovirus infection may be a better marker for possible asthma. In contrast, there is no increased risk of atopic disease in infants with respiratory syncytial virus ‘acute bronchiolitis’, a phenotype characterized by widespread crepitation. Post-bronchiolitic symptoms are associated with intercurrent viral infections in particular and the incidence of symptoms falls rapidly during infancy. Summary These studies confirm earlier suggestions that the phenotype of respiratory illness and hence the host response rather than the infecting organism is the best predictor of the future pattern of respiratory illness. Such considerations must be central to the design of any future intervention or cohort studies. © 2006 Lippincott Williams & Wilkins, Inc.