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Regina Malveste Ito C, Santos MO, de Oliveira Cunha M, de Araújo KM, de Souza GRL, Rézio GS, de Brito PN, Rezende APC, Fonseca JG, Wastowski IJ, Gonçalves Vieira JD, Gomes Avelino MA, Carneiro LC. Rhinovirus infection and co-infection in children with severe acute respiratory infection during the COVID-19 pandemic period. Virulence 2024; 15:2310873. [PMID: 38384141 PMCID: PMC10885176 DOI: 10.1080/21505594.2024.2310873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Rhinovirus causes respiratory tract infections in children and is found in co-infections. The objective of this research was to study the clinical profile of rhinovirus infection and co-infection in children with severe acute respiratory infection (SARI) during the COVID-19 pandemic period. We included 606 children ranging in age from 0.1 to 144 months of age from March 2020 to December 2021, hospitalized in the Pediatric Intensive Care Unit (PICU). The samples were collected by secretion from the nasopharynx region. A total of 259 children were tested positive for viral infection, 153 (59.07%) of them had a single rhinovirus infection and, 56 (36.6%) were aged between 60.1 and 144 months. Nine types of co-infections were identified and were found coinfection with three or more viruses (22/104, 21.15%). Observing the seasonality, the number of cases was similar between 2020 (49.53%) and 2021 (51.47%). Patients with a single infection (86.88%) and coinfection (67.30%) were more likely to have coughed. Patients with co-infection required the use of O2 for longer than those with a single rhinovirus infection. Hemogram results obtained from individuals with a single infection had higher levels of urea when compared to patients with co-infection with and other respiratory viruses. Multiple correspondence analyses indicated different clinical symptoms and comorbidities in patients with co-infection compared to those with single infection. The results found that the rhinovirus was much prevalent virus during the pandemic period and was found in co-infection with other virus types, what is important to diagnostic for the correct treatment of patients.
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Affiliation(s)
- Célia Regina Malveste Ito
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazil
| | - Mônica Oliveira Santos
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazil
| | - Marcos de Oliveira Cunha
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazil
| | - Kelliane Martins de Araújo
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazil
| | - Guilherme Rocha Lino de Souza
- Biochemistry and Molecular Biology Laboratory, Biologic Science Institute, Federal University of Goiás, Samambaia Camp, Goiânia, Goiás, Brazil
| | - Geovana Sôffa Rézio
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Goiânia, Goiás, Brazil
| | - Pollyanna Neta de Brito
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Goiânia, Goiás, Brazil
| | - Alana Parreira Costa Rezende
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Goiânia, Goiás, Brazil
| | - Jakeline Godinho Fonseca
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Goiânia, Goiás, Brazil
| | - Isabela Jubé Wastowski
- Molecular Immunology Laboratory of Goiás State University, Laranjeiras Unity Prof. Alfredo de Castro neighborhood, Goiânia, Goiás, Brazil
| | - José Daniel Gonçalves Vieira
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazil
| | - Melissa Ameloti Gomes Avelino
- Department of Pediatrics, Federal University of Goiás, Universitaria Avenue, Leste Universitário neighborhood, Goiânia, Goiás, Brazil
| | - Lilian Carla Carneiro
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazil
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Weis A, Hailey C. Bronchiolitis: Safely Doing Less Is the Next Big Thing. Pediatr Ann 2024; 53:e223-e228. [PMID: 38852076 DOI: 10.3928/19382359-20240407-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
Bronchiolitis is a viral lower respiratory tract infection primarily affecting children younger than 2 years; a common cause of health care encounters, including hospitalization; and a considerable economic burden for health care systems in the United States and worldwide. The American Academy of Pediatrics (AAP) most recently updated its bronchiolitis guideline in 2014 and reaffirmed supportive care as the mainstay of treatment. Despite these recommendations, there is still significant variability in care provided for these children, especially in bronchodilator usage, radiography, and high-flow nasal cannula. Since the 2014 AAP guideline, many pediatric hospitalists have undertaken quality initiatives to improve the adherence to published guidelines, yet a large gap remains between what is recommended and what is practiced. This article presents research on the efficacy of common interventions as well as an introduction to diagnostics and treatments potentially on the horizon. [Pediatr Ann. 2024;53(6):e223-e228.].
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Bernet Sánchez A, Bellés Bellés A, García González M, Minguell Domingo L, Solé Mir E. Clinical relevance of viral codetection in infants with respiratory syncytial virus bronchiolitis. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:308-312. [PMID: 37468350 DOI: 10.1016/j.eimce.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/24/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is the main cause of severe bronchiolitis, especially in infants. The aim of this study is to assess whether codetection of RSV and other respiratory viruses could affect the severity of this infection comparing with unique RSV detection. METHODS A prospective study from 2016 to 2019 including children under 2 years who were admitted in the Emergency Service of the Hospital Universitari Arnau de Vilanova de Lleida (Spain) was performed. Nasopharyngeal samples from all patients were sent to the laboratory for RSV real-time PCR detection (GeneXpert®). A multiplex PCR that detects other respiratory viruses was done in all RSV-positive samples. Patients'medical records were checked to collect clinical data (hospital length of stay, BROSJOD score, ICU admission, need for ventilatory support or transfer to a reference hospital). Patients were divided in two groups: infants with unique RSV detection and infants with viral codetection. Bivariant analyses were performed to analyze the data obtained. RESULTS During the period of study 437 RSV bronchiolitis were diagnosed. In 199 of them (177/437; 45,5%) another respiratory virus was detected concomitantly. Bivariant analyses do not show statistically significant differences between both groups. CONCLUSIONS Viral codetection in infants with RSV bronchiolitis is frequent. However, it does not seems to affect the severity of this infection.
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Affiliation(s)
- Albert Bernet Sánchez
- Sección de Microbiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain.
| | - Alba Bellés Bellés
- Sección de Microbiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Mercè García González
- Sección de Microbiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | | | - Eduard Solé Mir
- Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain; Servicio de Pediatría, Hospital Universitari Arnau de Vilanova, Lleida, Spain
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Kloepfer KM, Kennedy JL. Decoding viral infections and risk for asthma: Biomarkers or clinical histories? Ann Allergy Asthma Immunol 2024; 132:553-554. [PMID: 38702102 DOI: 10.1016/j.anai.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Kirsten M Kloepfer
- Pediatric Pulmonology, Allergy, Immunology and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
| | - Joshua L Kennedy
- Pulmonology, Allergy, and Critical Care Medicine, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Vera JM, McIlwain SJ, Fye S, Palmenberg A, Bochkov Y, Li H, Pinapati R, Tan J, Gern JE, Seroogy C, Ong IM. Assessing Immune Factors in Maternal Milk and Paired Infant Plasma Antibody Binding to Human Rhinoviruses. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.17.565204. [PMID: 38187517 PMCID: PMC10769182 DOI: 10.1101/2023.12.17.565204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Before they can produce their own antibodies, newborns are protected from infections by transplacental transfer of maternal IgG antibodies and after birth through breast milk IgA antibodies. Rhinovirus (RV) infections are extremely common in early childhood, and while RV infections often result in only mild upper respiratory illnesses, they can also cause severe lower respiratory illnesses such as bronchiolitis and pneumonia. We used high-density peptide arrays to profile infant and maternal antibody reactivity to capsid and full proteome sequences of three human RVs - A16, B52, and C11. Numerous plasma IgG and breast milk IgA RV epitopes were identified that localized to regions of the RV capsid surface and interior, and also to several non-structural proteins. While most epitopes were bound by both IgG and IgA, there were several instances where isotype-specific and RV-specific binding were observed. We also profiled 62 unique RV-C dominant protein loop sequences characteristic of this species' capsid VP1 protein. Many of these RV-C sites were highly bound by IgG from one-year-old infants, indicating recent or ongoing active infections, or alternatively, a level of cross-reactivity among homologous RV-C sites.
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Kowalczyk T, Sitarek P, Śliwiński T, Hatziantoniou S, Soulintzi N, Pawliczak R, Wieczfinska J. New Data on Anti-Inflammatory and Wound Healing Potential of Transgenic Senna obtusifolia Hairy Roots: In Vitro Studies. Int J Mol Sci 2023; 24:ijms24065906. [PMID: 36982980 PMCID: PMC10056933 DOI: 10.3390/ijms24065906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/11/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Asthma is an inflammatory disease whose etiology remains unclear. Its characteristics encompass a wide range of clinical symptoms, inflammatory processes, and reactions to standard therapies. Plants produce a range of constitutive products and secondary metabolites that may have therapeutic abilities. The aim of this study was to determine the effects of Senna obtusifolia transgenic hairy root extracts on virus-induced airway remodeling conditions. Three cell lines were incubated with extracts from transformed (SOA4) and transgenic (SOPSS2, with overexpression of the gene encoding squalene synthase 1) hairy roots of Senna obtusifolia in cell lines undergoing human rhinovirus-16 (HRV-16) infection. The effects of the extracts on the inflammatory process were determined based on the expression of inflammatory cytokines (IL-8, TNF-α, IL-1α and IFN-γ) and total thiol content. The transgenic Senna obtusifolia root extract reduced virus-induced expression of TNF, IL-8 and IL-1 in WI-38 and NHBE cells. The SOPSS2 extract reduced IL-1 expression only in lung epithelial cells. Both tested extracts significantly increased the concentration of thiol groups in epithelial lung cells. In addition, the SOPPS2 hairy root extract yielded a positive result in the scratch test. SOA4 and SOPPS2 Senna obtusifolia hairy root extracts demonstrated anti-inflammatory effects or wound healing activity. The SOPSS2 extract had stronger biological properties, which may result from a higher content of bioactive secondary metabolites.
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Affiliation(s)
- Tomasz Kowalczyk
- Department of Molecular Biotechnology and Genetics, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland
| | - Przemysław Sitarek
- Department of Biology and Pharmaceutical Botany, Medical University of Lodz, Muszynskiego 1, 90-151 Lodz, Poland
| | - Tomasz Śliwiński
- Laboratory of Medical Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland
| | - Sophia Hatziantoniou
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece
| | - Nikolitsa Soulintzi
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece
| | - Rafal Pawliczak
- Department of Immunopathology, Medical University of Lodz, Zeligowskiego 7/9, Bldg 2, Rm 177, 90-752 Lodz, Poland
| | - Joanna Wieczfinska
- Department of Immunopathology, Medical University of Lodz, Zeligowskiego 7/9, Bldg 2, Rm 177, 90-752 Lodz, Poland
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Biagi C, Betti L, Manieri E, Dondi A, Pierantoni L, Ramanathan R, Zama D, Gennari M, Lanari M. Different Pediatric Acute Care Settings Influence Bronchiolitis Management: A 10-Year Retrospective Study. Life (Basel) 2023; 13:life13030635. [PMID: 36983790 PMCID: PMC10056632 DOI: 10.3390/life13030635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/13/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Bronchiolitis is the main cause of hospitalization in infants. Diagnosis is clinical, and treatment is based on hydration and oxygen therapy. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. This retrospective study aimed to evaluate whether the setting of bronchiolitis care influences diagnostic and therapeutic choices. The management of 3201 infants, referred to our Italian Tertiary Care Center for bronchiolitis between 2010 and 2020, was analyzed by comparing children discharged from the pediatric emergency department (PEDd group) undergoing short-stay observation (SSO group) and hospitalization. Antibiotic use in PEDd, SSO, and ward was 59.3% vs. 51.6% vs. 49.7%, respectively (p < 0.001); inhaled salbutamol was mainly administered in PEDd and during SSO (76.1% and 82.2% vs. 38.3% in ward; p < 0.001); the use of corticosteroids was higher during SSO and hospitalization (59.6% and 49.1% vs. 39.0% in PEDd; p < 0.001); inhaled adrenaline was administered mostly in hospitalized infants (53.5% vs. 2.5% in SSO and 0.2% in PEDd; p < 0.001); chest X-ray use in PEDd, SSO, and ward was 30.3% vs. 49.0% vs. 70.5%, respectively (p < 0.001). In a multivariate analysis, undergoing SSO was found to be an independent risk factor for the use of systemic corticosteroid and salbutamol; being discharged at home was found to be a risk factor for antibiotic prescription; undergoing SSO and hospitalization resulted as independent risk factors for the use of CXR. Our study highlights that different pediatric acute care settings could influence the management of bronchiolitis. Factors influencing practice may include a high turnover of PED medical staff, personal reassurance, and parental pressure.
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Affiliation(s)
- Carlotta Biagi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Correspondence: (C.B.); (L.B.)
| | - Ludovica Betti
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
- Correspondence: (C.B.); (L.B.)
| | - Elisa Manieri
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Arianna Dondi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Ramsiya Ramanathan
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Monia Gennari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Neugebauer F, Bergs S, Liebert UG, Hönemann M. Human Rhinoviruses in Pediatric Patients in a Tertiary Care Hospital in Germany: Molecular Epidemiology and Clinical Significance. Viruses 2022; 14:v14081829. [PMID: 36016451 PMCID: PMC9415293 DOI: 10.3390/v14081829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022] Open
Abstract
Rhinoviruses (RVs) constitute a substantial public health burden. To evaluate their abundance and genetic diversity in pediatric patients, RV RNA in respiratory samples was assessed using real-time RT-PCR and partial nucleic acid sequencing of viral genomes. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of pediatric RV infections. In total, the respiratory specimens of 776 patients (<18 years), collected from 2013 to 2017, were analyzed. Infections occurred throughout the entire year, with peaks occurring in fall and winter, and showed remarkably high intra- and interseasonal diversity for RV genotypes. RV species were detected in the following frequencies: 49.1% RV-A, 5.9% RV-B, and 43.6% RV-C. RV-C was found to be more frequently associated with asthma (p = 0.04) and bronchiolitis (p < 0.001), while RV-A was more frequently associated with fever (p = 0.001) and pneumonia (p = 0.002). Additionally, 35.3% of the patients had co-infections with other pathogens, which were associated with a longer hospital stay (p < 0.001), need for ventilation (p < 0.001), and pneumonia (p < 0.001). Taken together, this study shows pronounced RV genetic diversity in pediatric patients and indicates differences in RV-associated pathologies, as well as an important role for co-infections.
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Association of Nasopharyngeal and Serum Glutathione Metabolism with Bronchiolitis Severity and Asthma Risk: A Prospective Multicenter Cohort Study. Metabolites 2022; 12:metabo12080674. [PMID: 35893241 PMCID: PMC9394245 DOI: 10.3390/metabo12080674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
Infants hospitalized for bronchiolitis are at high risk for asthma. Glutathione-related metabolites may antagonize oxidative stress, which induces airway injuries in respiratory infection and subsequent airway remodeling. However, little is known about the relationship of glutathione-related metabolites with bronchiolitis severity and the risk of asthma. In a multicenter prospective observational cohort study of infants hospitalized for bronchiolitis, we measured nasopharyngeal and serum glutathione-related metabolites by using liquid chromatography−tandem mass spectrometry. We then examined their association with bronchiolitis severity (defined by positive pressure ventilation (PPV) use). We also identified severity-related glutathione-related metabolite signatures and examined their association with asthma at age 6 years. In 1013 infants, we identified 12 nasopharyngeal and 10 serum glutathione-related metabolites. In the multivariable models, lower relative abundances of seven metabolites, e.g., substrates of glutathione, including cysteine (adjOR 0.21, 95%CI 0.06−0.76), glycine (adjOR 0.25, 95%CI 0.07−0.85), and glutamate (adjOR 0.25, 95%CI 0.07−0.88), were significantly associated with PPV use (all FDR < 0.05). These associations were consistent with serum glutathione-related metabolites. The nasopharyngeal glutathione-related metabolite signature was also associated with a significantly higher risk of asthma (adjOR 0.90, 95%CI 0.82−0.99, p = 0.04). In infants hospitalized for bronchiolitis, glutathione-related metabolites were associated with bronchiolitis severity and asthma risk.
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Piralla A, Pariani E. Editorial for the Special Issue "Epidemiology of Enterovirus Disease". Microorganisms 2022; 10:microorganisms10061221. [PMID: 35744739 PMCID: PMC9228421 DOI: 10.3390/microorganisms10061221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022] Open
Abstract
Enteroviruses (Enterovirus genus, Picornaviridae family) are distributed worldwide and are among the most common causes of human disease globally [...].
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Affiliation(s)
- Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Correspondence: ; Tel.: +39-038-250-2420
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy;
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Ruiz S, Calvo C, Pozo F, Casas I, García-García ML. Lung function, allergic sensitization and asthma in school-aged children after viral-coinfection bronchiolitis. Sci Rep 2022; 12:7552. [PMID: 35534518 PMCID: PMC9085835 DOI: 10.1038/s41598-022-11356-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/06/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractOur main objective was to compare the lung function, the rate of allergic sensitization and the prevalence of asthma at 7–9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection. Observational study in children with previous bronchiolitis and current age 7–9 years. Clinical data were collected. Fraction of exhaled nitric oxide (FeNO) determination, spirometry and skin prick test for common aeroallergens were performed. A total of 181 children hospitalized for bronchiolitis (40 coinfections and 141 single infections), with median age of 8.3 years (IQR:7.5–9.1) were included. Single-HRV-infections showed lower basal FEV1(%) than coinfections (p = 0.04) and lower z-score FEV1 than single-RSV-infections (p = 0.04) or coinfections (p = 0.02). Also, single-HRV-infections had lower post-bronchodilator FEV1(%) and z-score FEV1 values than coinfections (p = 0.03 and p = 0.03). Single-HRV-bronchiolitis was an independent risk factor for FEV1 < 80% (p = 0.007). FeNO value > 25 ppb was detected in 21(12.5%) cases, without differences between viral groups (p = 0.768). The prevalence of allergic sensitization was similar in coinfections (31.4%) versus single infections (38.7%), (p = 0.428). The highest frequency of allergic rhinitis was observed in single-HRV patients (p = 0.004). The respiratory morbidity at 7–9 years of coinfected patients was similar to the single-HRV ones. In contrast, the likelihood of current asthma was up to 5 times higher in RSV/HRV coinfections than in the single-RSV-infections ones (p = 0.012). The respiratory morbidity at 7–9 years of age after severe bronchiolitis is significantly higher in single-HRV or viral coinfection patients that in single-RSV ones. Single-HRV-bronchiolitis is independently associated with lower lung function at school-age.
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De Maio F, Buonsenso D, Bianco DM, Giaimo M, Fosso B, Monzo FR, Sali M, Posteraro B, Valentini P, Sanguinetti M. Comparative Fecal Microbiota Analysis of Infants With Acute Bronchiolitis Caused or Not Caused by Respiratory Syncytial Virus. Front Cell Infect Microbiol 2022; 12:815715. [PMID: 35330643 PMCID: PMC8940166 DOI: 10.3389/fcimb.2022.815715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Bronchiolitis due to respiratory syncytial virus (RSV) or non-RSV agents is a health-menacing lower respiratory tract (LRT) disease of infants. Whereas RSV causes more severe disease than other viral agents may, genus-dominant fecal microbiota profiles have been identified in US hospitalized infants with bronchiolitis. We investigated the fecal microbiota composition of infants admitted to an Italian hospital with acute RSV (25/37 [67.6%]; group I) or non-RSV (12/37 [32.4%]; group II) bronchiolitis, and the relationship of fecal microbiota characteristics with the clinical characteristics of infants. Group I and group II infants differed significantly (24/25 [96.0%] versus 5/12 [41.7%]; P = 0.001) regarding 90% oxygen saturation (SpO2), which is an increased respiratory effort hallmark. Accordingly, impaired feeding in infants from group I was significantly more frequent than in infants from group II (19/25 [76.0%] versus 4/12 [33.3%]; P = 0.04). Conversely, the median (IQR) length of stay was not significantly different between the two groups (seven [3–14] for group I versus five [5–10] for group II; P = 0.11). The 16S ribosomal RNA V3–V4 region amplification of infants’ fecal samples resulted in 299 annotated amplicon sequence variants. Based on alpha- and beta-diversity microbiota downstream analyses, group I and group II infants had similar bacterial communities in their samples. Additionally, comparing infants having <90% SpO2 (n = 29) with infants having ≥90% SpO2 (n = 8) showed that well-known dominant genera (Bacteroides, Bifidobacterium, Escherichia/Shigella, and Enterobacter/Veillonella) were differently, but not significantly (P = 0.44, P = 0.71, P = 0.98, and P = 0.41, respectively) abundant between the two subgroups. Overall, we showed that, regardless of RSV or non-RSV bronchiolitis etiology, no fecal microbiota-composing bacteria could be associated with the severity of acute bronchiolitis in infants. Larger and longitudinally conducted studies will be necessary to confirm these findings.
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Affiliation(s)
- Flavio De Maio
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Delia Mercedes Bianco
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Giaimo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bruno Fosso
- Istituto di Biomembrane, Bioenergetica e Biotecnologie Molecolari (IBIOM), Consiglio Nazionale delle Ricerche, Bari, Italy
| | - Francesca Romana Monzo
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Brunella Posteraro
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
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13
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Nanishi M, Fujiogi M, Stevenson M, Liang L, Qi YS, Raita Y, Hasegawa K, Camargo CA. Association of Growth Trajectory Profiles with Asthma Development in Infants Hospitalized with Bronchiolitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:723-731.e5. [PMID: 34788659 PMCID: PMC9239901 DOI: 10.1016/j.jaip.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Little is known about the relationship of longitudinal growth trajectory in early life with asthma development, particularly in infants with bronchiolitis (a high-risk population). OBJECTIVE Among infants with bronchiolitis, we aimed to identify growth trajectory profiles and determine their longitudinal relationship with the risk for developing childhood asthma. METHODS A multicenter prospective study enrolled infants (aged <1 year) hospitalized for bronchiolitis. We identified growth trajectory profiles-derived from body mass index-for-age at ages 0, 6, 12, 15, 18, 24, and 36 months by using a longitudinal clustering method. We examined associations between growth trajectory profiles and asthma development by age 5 years. RESULTS The analytic cohort consists of 880 infants hospitalized for bronchiolitis (median age, 3 months). Overall, 26% developed asthma by age 5 years. The longitudinal clustering identified 5 distinct profiles: persistent low growth (27%), normative growth (33%), transient overweight (21%), late-onset overweight (16%), and persistent obesity (3%) profiles. In multivariable model, compared with children with a normative profile, those with a persistent obesity profile had significantly higher risks of developing asthma (24% vs 38%, odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.07-6.09, P = .03). Among children with a persistent obesity profile, those without allergic predisposition had significantly higher risks of asthma (OR: 3.02, 95% CI: 1.05-8.64, P = .04 in the nonparental allergic history group; OR: 3.18, 95% CI: 1.02-9.92, P = .047 in the non-IgE sensitization group), whereas those with allergic predisposition were not at increased risk. CONCLUSIONS This multicenter cohort study of infants with bronchiolitis demonstrated distinct growth trajectory profiles that have differential risks for developing asthma.
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Affiliation(s)
- Makiko Nanishi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
| | - Michimasa Fujiogi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ying Shelly Qi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Yoshihiko Raita
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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14
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Sallard E, Schult F, Baehren C, Buedding E, Mboma O, Ahmad-Nejad P, Ghebremedhin B, Ehrhardt A, Wirth S, Aydin M. Viral Infection and Respiratory Exacerbation in Children: Results from a Local German Pediatric Exacerbation Cohort. Viruses 2022; 14:v14030491. [PMID: 35336898 PMCID: PMC8955305 DOI: 10.3390/v14030491] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
Respiratory viruses play an important role in asthma exacerbation, and early exposure can be involved in recurrent bronchitis and the development of asthma. The exact mechanism is not fully clarified, and pathogen-to-host interaction studies are warranted to identify biomarkers of exacerbation in the early phase. Only a limited number of international exacerbation cohorts were studied. Here, we have established a local pediatric exacerbation study in Germany consisting of children with asthma or chronic, recurrent bronchitis and analyzed the viriome within the nasopharyngeal swab specimens derived from the entire cohort (n = 141). Interestingly, 41% of exacerbated children had a positive test result for human rhinovirus (HRV)/human enterovirus (HEV), and 14% were positive for respiratory syncytial virus (RSV). HRV was particularly prevalent in asthmatics (56%), wheezers (50%), and atopic (66%) patients. Lymphocytes were decreased in asthmatics and in HRV-infected subjects, and patients allergic to house dust mites were more susceptible to HRV infection. Our study thus confirms HRV infection as a strong ‘biomarker’ of exacerbated asthma. Further longitudinal studies will show the clinical progress of those children with a history of an RSV or HRV infection. Vaccination strategies and novel treatment guidelines against HRV are urgently needed to protect those high-risk children from a serious course of disease.
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Affiliation(s)
- Erwan Sallard
- Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Institute of Virology and Microbiology, Witten/Herdecke University, 58453 Witten, Germany; (E.S.); (A.E.)
| | - Frank Schult
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
| | - Carolin Baehren
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, Faculty of Health, School of Life Sciences (ZBAF), Witten/Herdecke University, 58455 Witten, Germany; (C.B.); (E.B.)
| | - Eleni Buedding
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, Faculty of Health, School of Life Sciences (ZBAF), Witten/Herdecke University, 58455 Witten, Germany; (C.B.); (E.B.)
| | - Olivier Mboma
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
| | - Parviz Ahmad-Nejad
- Institute for Medical Laboratory Diagnostics, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
| | - Beniam Ghebremedhin
- Institute for Medical Laboratory Diagnostics, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
| | - Anja Ehrhardt
- Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Institute of Virology and Microbiology, Witten/Herdecke University, 58453 Witten, Germany; (E.S.); (A.E.)
| | - Stefan Wirth
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
| | - Malik Aydin
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, Faculty of Health, School of Life Sciences (ZBAF), Witten/Herdecke University, 58455 Witten, Germany; (C.B.); (E.B.)
- Correspondence: ; Tel.: +49-(0)-202-896-2384; Fax: +49-(0)-202-896-3834
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15
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Nanishi M, Fujiogi M, Freishtat RJ, Hoptay CE, Bauer CS, Stevenson MD, Camargo CA, Hasegawa K. Serum periostin among infants with severe bronchiolitis and risk of developing asthma: A prospective multicenter cohort study. Allergy 2022; 77:2121-2130. [PMID: 35000210 DOI: 10.1111/all.15216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Infants hospitalized for bronchiolitis (severe bronchiolitis) are at high risk for developing childhood asthma. However, the pathobiological link between these conditions remains unclear. We examined the longitudinal relationship of periostin (an extracellular matrix protein upregulated in response to type 2 inflammation) during bronchiolitis with the subsequent development of asthma. METHODS In a 17-center prospective cohort study of infants (aged <1 year) with severe bronchiolitis, we measured the serum periostin level at hospitalization and grouped infants into 3 groups: low, intermediate, and high levels. We examined their association with asthma development by age 6 years and investigated effect modification by allergic predisposition (eg, infant's IgE sensitization). RESULTS The analytic cohort consists of 847 infants with severe bronchiolitis (median age, 3 months). Overall, 28% developed asthma by age 6 years. In the multivariable model adjusting for nine patient-level factors, compared to the low periostin group, the asthma risk was significantly higher among infants in the intermediate group (23% vs. 32%, OR 1.68, 95%CI 1.12-2.51, p = .01) and non-significantly higher in the high-level group (28%, OR 1.29, 95%CI 0.86-1.95, p = .22). In the stratified analysis, infants with IgE sensitization had a significantly higher risk for developing asthma (intermediate group, OR 4.76, 95%CI 1.70-13.3, p = .002; high group, OR 3.19, 95%CI 1.08-9.36, p = .04). By contrast, infants without IgE sensitization did not have a significantly higher risk (p > .15). CONCLUSIONS In infants with severe bronchiolitis, serum periostin level at bronchiolitis hospitalization was associated with asthma risk by age 6 years, particularly among infants with an allergic predisposition.
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Affiliation(s)
- Makiko Nanishi
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Michimasa Fujiogi
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Robert J. Freishtat
- Department of Genomics and Precision Medicine George Washington University Washington District of Columbia USA
- Division of Emergency Medicine Children’s National Hospital Washington District of Columbia USA
| | - Claire E. Hoptay
- Children's Research Institute Children's National Hospital Washington District of Columbia USA
| | - Cindy S. Bauer
- Division of Allergy and Immunology Phoenix Children’s Hospital Phoenix Arizona USA
| | - Michelle D. Stevenson
- Department of Pediatrics, Emergency Medicine Norton Children’s HospitalUniversity of Louisville School of Medicine Louisville Kentucky USA
| | - Carlos A. Camargo
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Kohei Hasegawa
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
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16
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Ruotsalainen M, Heikkilä P, Backman K, Korppi M. An increased asthma risk continued until young adulthood after early-childhood hospitalisation for wheezing. Acta Paediatr 2022; 111:157-162. [PMID: 34496079 DOI: 10.1111/apa.16099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/19/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this cohort study was to evaluate doctor-diagnosed and self-reported asthma in young adults after early-childhood hospitalisation for wheezing. METHODS In this prospective-controlled follow-up, questionnaires were sent to 95 subjects aged 24-28 years, who had been hospitalised for their first episodes of wheezing under 24 months of age. Fifty-eight cases and 100 controls returned the questionnaires. RESULTS The risk of doctor-diagnosed asthma was 2.14-fold (95% confidence interval 0.61-7.41), and the risk of self-reported asthma 2.39-fold (1.14-4.99) in cases compared to controls. The increased risk of self-reported asthma remained as statistically significant in analyses adjusted for current smoking, overweight and allergic rhinitis. Study subjects presented with wheezing symptoms, use of bronchodilators and inhaled corticosteroids, and with seasonal symptoms presumptive for allergic rhinitis during the last 12 months, more often than controls. The identification of a respiratory syncytial virus or rhinovirus during hospitalisation in early childhood was not anymore associated with asthma risk in adulthood. As expected, previous asthma during early childhood was a strong risk factor for asthma in young adulthood. CONCLUSION In this controlled questionnaire study, early-childhood hospitalisation for lower respiratory infection with wheezing was an independently significant risk factor of asthma in young adults.
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Affiliation(s)
- Marja Ruotsalainen
- Department of Pediatrics Kuopio University Hospital and University of Eastern Finland Kuopio Finland
| | - Paula Heikkilä
- Tampere Center for Child, Adolescent and Maternity Health Research Faculty of Medicine and Health Technology Tampere University and University Hospital Tampere Finland
| | - Katri Backman
- Department of Pediatrics Kuopio University Hospital and University of Eastern Finland Kuopio Finland
| | - Matti Korppi
- Tampere Center for Child, Adolescent and Maternity Health Research Faculty of Medicine and Health Technology Tampere University and University Hospital Tampere Finland
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17
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Biagi C, Scarpini S, Paleari C, Fabi M, Dondi A, Gabrielli L, Gennari M, Lanari M, Pierantoni L. Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy. Microorganisms 2021; 9:2221. [PMID: 34835347 PMCID: PMC8625287 DOI: 10.3390/microorganisms9112221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022] Open
Abstract
Bronchiolitis is the most common lower respiratory tract infection in infants. According to evidence-based guidelines, diagnosis is clinical, there is no need for routine use of laboratory or instrumental tests and therapy is primarily supportive, based on oxygen and adequate fluid supplementation. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. The aim of this retrospective cohort study was to evaluate how the management of bronchiolitis has changed in the last ten years in a Tertiary Care Center in Italy, assessing adherence to national guidelines. Considering the publication of the Italian inter-society consensus document in 2014, we compared patients admitted in the prior four epidemic seasons with patients admitted in the latter six epidemic seasons. The comparison between the two groups showed a significant reduction in the prescription of systemic corticosteroids (58.9% vs. 41.8%, p < 0.001), nebulized epinephrine (73.8% vs. 38.3%, p < 0.001) and antibiotics (59.5% vs. 42.3%, p < 0.001), together with a drastic decrease in the use of chest X-ray (92.2% vs. 54.4%, p < 0.001). On the contrary, the use of inhaled salbutamol remained substantially stable over time (39.4% vs. 37.6%, p = 0.505). Despite the encouraging results, further efforts are needed to limit the prescription of ineffective therapies like antibiotics and inhaled salbutamol.
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Affiliation(s)
- Carlotta Biagi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Sara Scarpini
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Camilla Paleari
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Marianna Fabi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Arianna Dondi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Liliana Gabrielli
- Microbiology Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy;
| | - Monia Gennari
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Marcello Lanari
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
| | - Luca Pierantoni
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant’Orsola Hospital, 40138 Bologna, Italy; (C.B.); (M.F.); (A.D.); (M.G.); (M.L.); (L.P.)
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18
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Teijeiro A, Gómez RM. Wheezing-Related Relevant Factors and the Role of Viral Bronchiolitis. FRONTIERS IN ALLERGY 2021; 2:726972. [PMID: 35387057 PMCID: PMC8974738 DOI: 10.3389/falgy.2021.726972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/01/2021] [Indexed: 12/17/2022] Open
Abstract
Bronchiolitis is a virus-associated infection of the lower respiratory tract exhibiting signs and symptoms of airway obstruction. Respiratory Syncytial Virus (RSV) is responsible in most cases; however, different rhinoviruses have also been implicated. Specific viruses and time until the first infection, severity of the respiratory condition, and atopic status have a determinant role in the recurrence of wheezing and asthma development. Genetics, lung function, atopic condition, the role of microbiota and environment, pollution, and obesity are considered in the present review. Emergency room visits and hospitalizations because of severe wheezing and smoking during pregnancy among others were identified as risk factors for significant morbidity in our population. Approaching determinant conditions like genetics, allergy, antiviral immunity, and environmental exposures such as farm vs. urban and viral virulence provides an opportunity to minimize morbidity of viral illness and asthma in children.
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Affiliation(s)
- Alvaro Teijeiro
- Respiratory Department, Children's Hospital, Córdoba, Argentina
| | - R. Maximiliano Gómez
- School of Health Sciences, Catholic University of Salta, Salta, Argentina
- *Correspondence: R. Maximiliano Gómez ; orcid.org/0000-0001-6898-186X
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