Deficient Immune Response to Viral Infections in Children Predicts Later Asthma Persistence

Baraldo, Simonetta; Contoli, Marco; Bonato, Matteo; Snijders, Deborah; Biondini, Davide; Bazzan, Erica; Cosio, Manuel G.; Barbato, Angelo; Papi, Alberto; Saetta, Marina

doi:10.1164/rccm.201706-1249le

Cited by 16 publications

(13 citation statements)

References 10 publications

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“…Children who developed asthma also tended to have higher IgE levels than those who did not develop asthma. This confirms the role of atopy as a predictor of asthma persistence throughout childhood and adolescence (3,29), directly through early allergen sensitization and indirectly by impairing the immune response to viral infections (30,31).…”

Section: Discussionsupporting

confidence: 75%

Clinical and Pathologic Factors Predicting Future Asthma in Wheezing Children. A Longitudinal Study

Bonato

Bazzan

Snijders

et al. 2018

Am J Respir Cell Mol Biol

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Wheeze is a common symptom in infants, but not all wheezers develop asthma. Indeed, up to 50% of wheezing children outgrow their symptoms by school age. How to predict if early wheeze will become asthma is still a matter of vivid debate. In this work, we sought to assess the clinical and pathological factors that might predict the future development of asthma in children. Eighty children (mean age 3.8 ± 1 yr) who underwent a clinically indicated bronchoscopy were followed prospectively for a median of 5 years. At baseline, clinical characteristics with a particular focus on wheezing and its presentation (episodic or multitrigger) were collected, and structural and inflammatory changes were quantified in bronchial biopsies. Follow-up data were available for 74 of the 80 children. Children who presented with multitrigger wheeze were more likely to have asthma at follow-up than those with episodic wheeze (P = 0.04) or without wheeze (P < 0.0001). Children with asthma also had lower birth weights (P = 0.02), a lower prevalence of breastfeeding (P = 0.02), and a trend for increased IgE (P = 0.07) at baseline than those with no asthma. Basement membrane thickness and airway eosinophils at baseline were increased in children who developed asthma at follow-up (P = 0.001 and P = 0.026, respectively). Multivariate analysis showed that among all clinical and pathological factors, multitrigger wheezing, basement membrane thickening, and reduced birth weight were predictive of future asthma development. We conclude that multitrigger wheeze and reduced birth weight are clinical predictors of asthma development. Basement membrane thickening in early childhood is closely associated with asthma development, highlighting the importance of airway remodeling in early life as a risk factor for future asthma.

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Section: Discussionsupporting

confidence: 75%

Clinical and Pathologic Factors Predicting Future Asthma in Wheezing Children. A Longitudinal Study

Bonato

Bazzan

Snijders

et al. 2018

Am J Respir Cell Mol Biol

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“…Other studies indicate that a deficient immune response to viral infections may predict persistence of asthma 9. These and many other studies indicate the substantial complexity of asthma even when limited to that associated with viral infections.…”

mentioning

confidence: 87%

Lower respiratory infections in early life are linked to later asthma

Moraes

Sears

2017

Thorax

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“…The asthmatic virome was characterised by increased occurrence, richness and diversity of eukaryotic viruses. Since there is no reason to assume that exposure of children with asthma to viruses is governed by different epidemiological characteristics than healthy individuals, this could reflect differential levels of viral control through immune competence [65][66][67] ; it is possible that asthmatics fail to clear eukaryotic viruses as efficiently as healthy children, allowing viruses to persist in the airways at low levels during asymptomatic periods. This may also explain a differential threshold for susceptibility to viral infection in asthma 68 .…”

Section: Dysbiotic Structure Of the Asthmatic Viromementioning

confidence: 99%

Bacteriophage deficiency characterizes respiratory virome dysbiosis in childhood asthma

Megremis

Constantinides

Xepapadaki

et al. 2020

Preprint

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Asthma development and persistence is tightly linked to respiratory viruses. Viral presence is usually interrogated with targeted approaches during periods of disease activity and/or infections, thus neglecting viral occurrence during steady states. We investigate the virome in the upper respiratory system of healthy and asthmatic preschool children during asymptomatic/non-infection periods using metagenomics. Children with asthma have a characteristically dysbiotic virome that correlates to disease severity and control. The major component of dysbiosis is bacteriophage deficiency, while eukaryotic viral presence is increased. At the metacommunity level, differential virus species co-occurrence patterns suggest a decrease of the microbiota community resilience in asthma. Viral dysbiosis is therefore a key characteristic of asthma pathophysiology.

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Deficient Immune Response to Viral Infections in Children Predicts Later Asthma Persistence

Abstract: Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification: a study of the general population.

Cited by 16 publications

References 10 publications

Clinical and Pathologic Factors Predicting Future Asthma in Wheezing Children. A Longitudinal Study

Clinical and Pathologic Factors Predicting Future Asthma in Wheezing Children. A Longitudinal Study

Lower respiratory infections in early life are linked to later asthma

Bacteriophage deficiency characterizes respiratory virome dysbiosis in childhood asthma

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