National Hospital Organization Ureshino Medical Center, 4279-3 Shimojuku Kou, Ureshino 8430393, Japan.
Adv Respir Med. 2022 Jul 21;90(4):246-253. doi: 10.3390/arm90040034.
Lower respiratory tract infections (LRTIs) have been reported to possibly initiate the development of asthma in children. However, the role of LRTIs in infantile asthma remains controversial. The goal of this study is to investigate whether LRTIs in hospitalized infants are involved in the development of asthma.
The subjects were 251 infants under 2 years of age who were admitted to our hospital with an RTI (59 cases of upper RTI (URTIs) with upper respiratory tract inflammation and pharyngeal tonsillitis; 192 cases of LRTIs with bronchitis, pneumonia, and bronchiolitis). Pathogens of viral infections were examined at admission using viral antigen test kits that could be used in ordinary clinical practice in Japan. When the children reached the age of 3 years, a survey was conducted by mailing a questionnaire to determine the symptoms, diagnosis, and treatment of asthma.
The mailed questionnaires were returned by 116 of the 251 subjects. On the questionnaire, the diagnosis of asthma and treatment for asthma were significantly higher in hospitalized infants with LRTIs than in those with URTIs. By diagnosis of LRTIs, infants with pneumonia and bronchiolitis were significantly more likely to develop asthma. However, on pathogen-specific examination, there was no difference in the development of asthma among infants with LRTIs.
LRTI in infancy may be involved in the development of asthma. The severity of LRTI in hospitalized infants, but not the particular viral pathogen causing infection, may be associated with later asthma onset.
下呼吸道感染(LRTIs)已被报道可能引发儿童哮喘的发生。然而,LRTIs 在婴儿哮喘中的作用仍存在争议。本研究旨在探讨住院婴儿的 LRTIs 是否与哮喘的发生有关。
本研究对象为 251 名年龄在 2 岁以下因 RTI(59 例上呼吸道感染(URTIs)伴上呼吸道炎症和扁桃体炎;192 例 LRTIs 伴支气管炎、肺炎和细支气管炎)而住院的婴儿。入院时使用日本常规临床实践中可用的病毒抗原检测试剂盒检测病毒感染的病原体。当儿童达到 3 岁时,通过邮寄问卷进行调查,以确定哮喘的症状、诊断和治疗情况。
在 251 名受试者中,有 116 名寄回了问卷。在问卷中,患有 LRTIs 的住院婴儿的哮喘诊断和哮喘治疗明显高于患有 URTIs 的婴儿。通过 LRTIs 的诊断,患有肺炎和细支气管炎的婴儿更有可能患上哮喘。然而,在针对特定病原体的检查中,LRTIs 婴儿患哮喘的情况并无差异。
婴儿时期的 LRTI 可能与哮喘的发生有关。住院婴儿 LRTIs 的严重程度,而不是引起感染的特定病毒病原体,可能与以后哮喘的发作有关。