title: Predictors of asthma following severe respiratory syncytial virus (RSV) bronchiolitis in early childhood.
abstract: We sought to identify predictors of asthma development following severe early childhood RSV bronchiolitis. Different definitions of asthma were also compared.
  
  
  
  This longitudinal, observational study (N = 343) followed patients (<2 years old) from a placebo-controlled trial (N = 979) of montelukast after RSV bronchiolitis to identify clinical, demographic, or biochemical predictors of asthma, atopic disorders, and chronic asthma therapy use at 6 years of age (Clinical Trials Registry Number: NCT01140048). Asthma (primary definition) was based on parental identification of wheeze at 6 AND 12 months before 6 years of age; definitions based on physician diagnosis as well as parental identification of wheeze at 6 OR 12 months (to consider seasonal effect) were also assessed. Post-hoc analyses evaluated agreement among asthma diagnosis criteria.
  
  
  
  Prevalence of asthma (primary definition by parental identification), asthma (physician diagnosis), atopic disorders, and chronic asthma therapy use (parental identification) was 6.1%, 22.4%, 36.2%, and 14.5%, respectively. Predictors for asthma (primary definition) included male gender, a relative with asthma, and RAST positive for dog dander; for physician diagnosis of asthma, high severity score for RSV bronchiolitis, high respiratory rate, and asthma diagnosis before enrollment. Predictors of atopic disorders included allergic rhinitis before enrollment, a relative with asthma, and the plasma biomarkers IL-5, IL-16, and IL-18. Predictors of chronic asthma therapy use included asthma diagnosis before enrollment and geographic region (Europe and Africa). Only 42% of patients with asthma (primary definition) also met the asthma definition by physician diagnosis and chronic asthma therapy use.
  
  
  
  Among children with early RSV bronchiolitis, hereditary factors (i.e., having a relative with asthma) and RSV bronchiolitis severity were predictors of asthma and atopic disorders at 6 years of age. Of interest, there was poor agreement among the asthma definitions evaluated. Pediatr Pulmonol. 2016;51:1382-1392. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Susan
authors.initials: S
authors.lastname: Lu
authors.affiliation: Center for Asthma Research, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Tina V
authors.initials: TV
authors.lastname: Hartert
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Everard
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Hilde
authors.initials: H
authors.lastname: Giezek
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Linda
authors.initials: L
authors.lastname: Nelsen
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Anish
authors.initials: A
authors.lastname: Mehta
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Hima
authors.initials: H
authors.lastname: Patel
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Barbara
authors.initials: B
authors.lastname: Knorr
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Theodore F
authors.initials: TF
authors.lastname: Reiss
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D001990:Bronchiolitis, Viral / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003521:Cyclopropanes; D063607:Dander / Q000276:immunology; D004285:Dogs; D005060:Europe; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000453:epidemiology / Q000276:immunology; D007223:Infant; D019410:Interleukin-16 / Q000276:immunology; D020382:Interleukin-18 / Q000276:immunology; D015848:Interleukin-5 / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D008487:Medical History Taking; D015995:Prevalence; D011446:Prospective Studies; D011804:Quinolines / Q000627:therapeutic use; D056152:Respiratory Rate; D012135:Respiratory Sounds; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D065631:Rhinitis, Allergic / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013440:Sulfides
chemical_list: D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; C508599:IL5 protein, human; D019410:Interleukin-16; D020382:Interleukin-18; D015848:Interleukin-5; D011804:Quinolines; D013440:Sulfides; C093875:montelukast
keywords: RSV bronchiolitis; asthma; asthma diagnosis; respiratory syncytial virus