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The role of early life viral bronchiolitis in the inception of asthma

Beigelman, Avraham; Bacharier, Leonard B.

Current Opinion in Allergy and Clinical Immunology: April 2013 - Volume 13 - Issue 2 - p 211–216
doi: 10.1097/ACI.0b013e32835eb6ef
PEDIATRIC ASTHMA AND DEVELOPMENT OF ATOPYREVIEW: Edited by Carlos E. Baena-Cagnani and Leonard B. Bacharier

Propose of review Cumulative evidence suggest that early life bronchiolitis is a major risk factor for subsequent wheezing episodes and asthma. The purpose of this review is to present the recent findings and current perspectives regarding the interplay between bronchiolitis and long-term respiratory outcomes.

Recent findings Recent studies have supported the long-recognized link between early life severe respiratory syncytial virus bronchiolitis and the physician diagnosis of asthma by school age, and this association appears to continue into early adulthood. Evidence is accumulating regarding the role of early life infection with human rhinovirus as an important antecedent for future asthma. Whether viral bronchiolitis is causal or an early manifestation of future asthma remains uncertain. Vitamin D status has emerged as a potential modifying factor for viral-induced wheeze and could potentially influence the development of asthma.

Summary Viral bronchiolitis early in life is a major and potential long-term risk factor for subsequent wheezing and asthma. Whether the association between bronchiolitis and subsequent asthma is due to causality or a reflection of predisposition may be dependent on host factors and virus-specific effects.

Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, Missouri, USA

Correspondence to Leonard B. Bacharier, MD, Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8116, St. Louis, MO 63110, USA. Tel: +1 314 454 2694; fax: +1 314 454 2515; e-mail:

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