title: Creola bodies in infancy with respiratory syncytial virus bronchiolitis predict the development of asthma.
abstract: BACKGROUND
  Creola bodies (CrBs) in the sputum are an indicator of respiratory epithelial damage and appear specifically in bronchial asthma. We studied the presence and clinical significance of CrBs in infants with respiratory syncytial virus (RSV) bronchiolitis contributing to the development of asthma.
  
  
  METHODS
  Aspirated sputum samples were collected from 33 infants admitted with acute RSV bronchiolitis. The samples were then examined for the presence (or absence) of CrBs and classified into the RSV-CrB group and RSV-non-CrB group. Eosinophil cationic protein (ECP) and neutrophil elastase (NE) concentrations in the sputum were compared between the two groups. History of wheeze and asthma was collected at 2 years and 5 years after their discharge from hospital.
  
  
  RESULTS
  CrBs were detected in 23 of the 33 subjects (69.7%). No significant difference in the ECP and the NE concentration were observed between the RSV-CrB group and RSV-non-CrB group. A significant relationship was observed between CrBs detected with RSV bronchiolitis and the development of recurrent wheezing and asthma (after 2 years: relative risk [RR], 3.09; p = 0.002; after 5 years: RR 7.00; p = 0.019).
  
  
  CONCLUSIONS
  These findings suggest that a high rate of CrBs in the sputum is present in infants with RSV bronchiolitis, and notably the CrBs are associated with the progression to recurrent wheezing and asthma.
authors.affiliation: Department of Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan. yu-yama@dokkyomed.ac.jp
authors.forename: Yumi
authors.initials: Y
authors.lastname: Yamada
authors.forename: Shigemi
authors.initials: S
authors.lastname: Yoshihara
mesh_terms: D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D001988:Bronchiolitis; D002648:Child; D002675:Child, Preschool; D047150:Eosinophil Cationic Protein / Q000378:metabolism; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012135:Respiratory Sounds; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D012136:Respiratory Syncytial Viruses / Q000472:pathogenicity*; D013183:Sputum / Q000166:cytology* / Q000378:metabolism
chemical_list: D047150:Eosinophil Cationic Protein; D019272:Leukocyte Elastase