Childhood Wheezing With Rhinovirus Can Increase Asthma Odds 10-Fold

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Title: Childhood Wheezing With Rhinovirus Can Increase Asthma Odds 10-Fold
URL: http://www.pslgroup.com/dg/22DF9E.htm
Doctor's Guide
October 1, 2008

NEW YORK -- October 1, 2008 -- Infants who experience rhinovirus (RV) with wheezing are at increased risk for developing asthma later during childhood, according to a study in the October issue of the American Journal of Respiratory and Critical Care Medicine.

"We have found that rhinovirus, the most common cause of colds, contributes a disproportionate amount towards future asthma development in comparison to other viruses that also cause childhood wheezing," said principal investigator, Robert F. Lemanske, Jr., MD, Division of Pediatric Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

From November 1998 to May 2000, researchers at the University of Wisconsin recruited nearly 300 newborns at high risk for asthma to take part in their Childhood Origins of Asthma (COAST) study. The children were followed from birth to age 6 years and evaluated for the presence of specific viruses during wheezing illnesses.

At 6 years, 28% of the kids had asthma and those who had wheezed with RV were disproportionately among them. Children who wheezed with RV during the first year of life were nearly 3 times as likely to have asthma at age 6, whereas children who wheezed with respiratory syncytial virus (RSV) did not have an increased asthma risk.

The older the children were, the greater the effect. Children who had wheezed with RV in their second year of life were more than 6 times as likely to have asthma. Wheezing with RV at age 3 increased asthma odds by more than 30-fold.

The study confirmed previous findings that wheezing with RSV any time during the first 3 years leads to a nearly 3-fold increased asthma risk.

However, the novel finding is that "wheezing RV illnesses occurring at any time during the first 3 years of life were associated with a nearly 10-fold increase in asthma risk at 6 years, making them the most significant predictor of asthma development in the high-risk COAST cohort," said lead author Daniel J. Jackson, MD, University of Wisconsin.

"Indeed, nearly 90% of the children wheezing with RV during year 3 subsequently developed asthma at age 6."

Whether RV causes asthma to develop, or simply reveals children who are already predisposed to the disease remains an open question. Alternatively, "in genetically susceptible children, RV wheezing illnesses could cause airway damage as well as subsequent asthma," stated Dr. Jackson, pointing out that the possibilities are not mutually exclusive and that additional research would be required to resolve the question.

SOURCE: American Thoracic Society

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