Rhinovirus Infection and Familial Atopy Predict Persistent Asthma and Sensitisation 7 Years after a First Episode of Acute Bronchiolitis in Infancy
Julie Magnier,
Valérie Julian,
Aurélien Mulliez,
Alexandra Usclade,
Emmanuelle Rochette,
Bertrand Evrard,
Flore Amat,
Carole Egron
Affiliations
Julie Magnier
CHU Clermont-Ferrand, Pôle Pédiatrique, Unité d’allergologie de l’enfant, CHU Estaing, 1 Place Lucie et Raymond Aubrac, F-63003 Clermont-Ferrand, France
Valérie Julian
Department of Sport Medicine and Functional Explorations, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, F-63003 Clermont-Ferrand, France
Aurélien Mulliez
CHU Clermont-Ferrand, Unité de Biostatistiques, Direction de la Recherche Clinique et Innovation (DRCI), 58 Rue Montalembert, F-63003 Clermont-Ferrand, France
Alexandra Usclade
CHU Clermont-Ferrand, INSERM CIC 1405, F-63003 Clermont-Ferrand, France
Emmanuelle Rochette
CHU Clermont-Ferrand, Pôle Pédiatrique, Unité d’allergologie de l’enfant, CHU Estaing, 1 Place Lucie et Raymond Aubrac, F-63003 Clermont-Ferrand, France
Bertrand Evrard
CHU Clermont-Ferrand, Service d’Immunologie, CHU Gabriel-Montpied, 58 Rue Montalembert, F63003 Clermont-Ferrand, France
Flore Amat
Unité Fonctionnelle de Pneumologie et Allergologie Pédiatrique, Hôpital Robert Debré, 48 Boulevard Sérurier, F-75019 Paris, France
Carole Egron
CHU Clermont-Ferrand, Pôle Pédiatrique, Unité d’allergologie de l’enfant, CHU Estaing, 1 Place Lucie et Raymond Aubrac, F-63003 Clermont-Ferrand, France
Background: We set out to assess the risk factors for asthma outcome in a cohort of infants who experienced their first episode of acute bronchiolitis. Methods: A cohort of 222 infants who were included during a first episode of acute bronchiolitis was prospectively followed. Herein, we present the results of their assessments (symptom history, skin prick tests, specific IgE assay, respiratory function tests) at age seven. Results: Of the 68/222 (30.6%) children assessed at age seven, 15 (22.05%) presented with asthma and were mainly males (p = 0.033), 14 (20%) had respiratory allergies, 17 (25%) presented atopic dermatitis and none had a food allergy. Family history of atopy was associated with asthma and sensitisation to aeroallergens at age seven (p = 0.003, p = 0.007). Rhinovirus (hRV) infection and rhinovirus/respiratory syncytial virus (RSV) co-infection were significantly associated with asthma at age seven (p = 0.035, p = 0.04), but not with the initial severity of bronchiolitis. Eosinophil counts at ages three and seven were significantly higher in the asthmatics (p = 0.01, p = 0.046). Conclusion: Any infant, especially male, presenting a first episode of acute bronchiolitis due to hRV with a family history of atopy should be closely monitored via follow-up due to a higher risk for asthma at school age.
