Telethon Institute for Child Health Research and Centre for Child Health Research, University of Western Australia, Perth, Australia.
J Allergy Clin Immunol. 2010 Jun;125(6):1202-5. doi: 10.1016/j.jaci.2010.01.024. Epub 2010 Mar 20.
Epidemiologic associations between viral lower respiratory infections (LRIs) and asthma in later childhood are well known. However, the question of whether such infections cause asthma or unmask asthma in a susceptible host has still not been settled. Most early evidence centered on the role of the respiratory syncytial virus; however, recent studies highlight a potential role for human rhinovirus as a risk factor for asthma. The links between early-life viral LRI and subsequent asthma are generally via wheeze; however, the presence of wheeze does not give any information about why the child is wheezing. Wheeze in early life is, at best, a fuzzy phenotype and not specific for subsequent asthma. The risk of asthma after viral LRI is increased in the presence of allergic sensitization in early life and if the infection is more severe. Atopy-associated mechanisms also appear to be involved in viral-induced acute exacerbations of asthma, especially in prolonging symptomatology after the virus has been cleared from the lungs. Breaking the nexus between viral respiratory infections and asthma may be possible with interventions designed to inhibit atopy-related effectors mechanisms from participating in the host response to respiratory viral infections.
病毒下呼吸道感染（LRIs）与儿童后期哮喘之间的流行病学关联已广为人知。然而，此类感染是否会导致哮喘，或者是否会在易感宿主中引发哮喘，仍未得到解决。大多数早期证据集中在呼吸道合胞病毒的作用上；然而，最近的研究强调了人类鼻病毒作为哮喘危险因素的潜在作用。生命早期的病毒 LRIs 与随后的哮喘之间的联系通常是通过喘息；然而，喘息并不能提供任何关于孩子为何喘息的信息。生命早期的喘息充其量只是一种模糊的表型，与随后的哮喘并不特异。生命早期存在过敏致敏和感染更严重时，病毒 LRIs 后发生哮喘的风险会增加。与过敏相关的机制似乎也参与了病毒引起的哮喘急性加重，尤其是在病毒从肺部清除后延长症状持续时间方面。通过设计旨在抑制与过敏相关的效应器机制参与宿主对呼吸道病毒感染的反应的干预措施，可能会打破病毒呼吸道感染与哮喘之间的联系。
