Abstract:Objective To investigate the viral etiology and allergen distribution in infants and young children at high risk of asthma during a wheezing episode. Methods A total of 135 infants and young children at high risk of asthma were enrolled who were admitted due to asthmatic bronchitis or asthmatic bronchopneumonia between April 2016 and August 2017. Fluorescent probe PCR was used to measure influenza A (Flu A), respiratory syncytium virus (RSV), adenovirus (ADV), parainfluenza virus (PinF), human rhinovirus (HRV), human partial lung virus (hMPV) and human bocavirus (HBoV) in nasopharyngeal aspirates. ImmunoCAP was used to measure inhaled allergens, food allergens, and total IgE concentration. Results Among the 135 patients, the overall virus detection rate of nasopharyngeal aspirates was 49.6%, and HRV had the highest detection rate of 25.2%, followed by HBoV (9.6%), RSV (8.1%), PinF (5.9%), Flu-A (3.7%), ADV (1.5%) and hMPV (0.7%). The 1-3 years group had a significantly higher detection rate of HRV than the P P P P P P Conclusions Early HRV infection and inhaled allergen sensitization are closely associated with the development of wheezing in infants and young children at high risk of asthma.
WANG Ting,ZHANG Rong,SUN Hui-Ming et al. Detection of viral pathogens and allergens in infants and young children at high risk of asthma during a wheezing episode[J]. CJCP, 2019, 21(6): 505-510.
Tsatsral S, Xiang Z, Fuji N, et al. Molecular epidemiology of the human rhinovirus infection in Mongolia during 2008-2013[J]. Jpn J Infect Dis, 2015, 68(4):280-287.
[8]
Lu QB, Wo Y, Wang LY, et al. Molecular epidemiology of human rhinovirus in children with acute respiratory diseases in Chongqing, China[J]. Sci Rep, 2014, 4:6686.
[9]
Jacobs SE, Lamson DM, St George K, et al. Human rhinoviruses[J]. Clin Microbiol Rev, 2013, 26(1):135-162.
[10]
Fuji N, Suzuki A, Lupisan S, et al. Detection of human rhinovirus C viral genome in blood among children with severe respiratory infections in the Philippines[J]. PLoS One, 2011, 6(11):e27247.
[11]
Feldman AS, He Y, Moore ML, et al. Toward primary prevention of asthma. Reviewing the evidence for early-life respiratory viral infections as modifiable risk factors to prevent childhood asthma[J]. Am J Respir Crit Care Med, 2015, 191(1):34-44.
[12]
Kotaniemi-Syrjanen A, Vainionpaa R, Reijonen TM, et al. Rhinovirus-induced wheezing in infancy - the first sign of childhood asthma?[J]. J Allergy Clin Immunol, 2003, 111(1):66-71.
Henrickson KJ. Advances in the laboratory diagnosis of viral respiratory disease[J]. Pediatr Infect Dis J, 2004, 23(1 Suppl):S6-S10.
[16]
Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections:respective role in inception and persistence of wheezing[J]. Eur Respir J, 2015, 45(3):774-789.
Malmström K, Pitkäranta A, Carpen O, et al. Human rhinovirus in bronchial epithelium of infants with recurrent respiratory symptoms[J]. J Allergy Clin Immunol, 2006, 118(3):591-596.
[19]
Martinez FD. Development of wheezing disorders and asthma in preschool children[J]. Pediatrics, 2002, 109(2 Suppl):362-367.
Djukanović R. Predicting asthmatic responses to inhaled allergen using an unbiased transcriptomics approach[J]. Am J Respir Crit Care Med, 2018, 197(4):415-416.