Toward primary prevention of asthma. Reviewing the evidence for early-life respiratory viral infections as modifiable risk factors to prevent childhood asthma

Am J Respir Crit Care Med. 2015 Jan 1;191(1):34-44. doi: 10.1164/rccm.201405-0901PP.

Abstract

A first step in primary disease prevention is identifying common, modifiable risk factors that contribute to a significant proportion of disease development. Infant respiratory viral infection and childhood asthma are the most common acute and chronic diseases of childhood, respectively. Common clinical features and links between these diseases have long been recognized, with early-life respiratory syncytial virus (RSV) and rhinovirus (RV) lower respiratory tract infections (LRTIs) being strongly associated with increased asthma risk. However, there has long been debate over the role of these respiratory viruses in asthma inception. In this article, we systematically review the evidence linking early-life RSV and RV LRTIs with asthma inception and whether they could therefore be targets for primary prevention efforts.

Keywords: RSV; RV; asthma; respiratory syncytial virus; rhinovirus.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antiviral Agents / therapeutic use
  • Asthma / genetics
  • Asthma / immunology
  • Asthma / prevention & control*
  • Asthma / virology
  • Child, Preschool
  • Diet
  • Environmental Exposure / adverse effects*
  • Epigenesis, Genetic
  • Genetic Predisposition to Disease
  • Humans
  • Infant
  • Microbiota / drug effects
  • Microbiota / genetics
  • Microbiota / immunology
  • Palivizumab
  • Primary Prevention / methods
  • Respiratory Syncytial Virus Infections / complications*
  • Respiratory Syncytial Virus Infections / drug therapy
  • Respiratory Syncytial Virus Infections / genetics
  • Respiratory Syncytial Virus Infections / immunology
  • Respiratory Syncytial Viruses / drug effects
  • Respiratory Syncytial Viruses / genetics
  • Respiratory Syncytial Viruses / immunology
  • Respiratory Tract Infections / complications*
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / immunology
  • Respiratory Tract Infections / virology
  • Rhinovirus / drug effects
  • Rhinovirus / genetics
  • Rhinovirus / immunology
  • Risk Factors
  • Severity of Illness Index
  • Tobacco Smoke Pollution / adverse effects

Substances

  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • Tobacco Smoke Pollution
  • Palivizumab