title: [The interactions between microorganisms and the small airways. A paediatric focus].
abstract: The spectrum of respiratory viruses is expanding and emerging diseases have been described regularly over the last fifteen years. The origin of these emerging respiratory viruses may be zoonotic (by crossing species barrier, after changes to RNA viruses such as avian influenza virus type A or coronaviruses), or related to the use of new identification techniques (metapneumovirus, bocavirus). The relationship between bronchiolitis and asthma is now better understood thanks to prospective follow up of birth cohorts. The role of rhinovirus has become predominant with respect to respiratory syncytial virus. The identification of predisposing factors immunological, functional, atopic and genetic, for the onset of asthma after rhinovirus infection suggests that viral infection reveals a predisposition rather than itself being a cause of asthma. The role of bacteria in the natural history of asthma is also beginning to be better understood. The results of the COPSAC Danish cohort have shown the frequency of bacterial identification during wheezy episodes before 3 years, and the impact of bacterial colonization at the age of one month on the onset of asthma by age 5 years. The role of bacterial infections in severe asthma in young children is also discussed.
authors.affiliation: Service de pneumologie et allergologie pédiatriques, hôpital universitaire Necker-Enfants-Malades, université Paris Descartes, Assistance publique des Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France. Electronic address: j.deblic@nck.aphp.fr.
authors.forename: J
authors.initials: J
authors.lastname: de Blic
authors.affiliation: EA 4655 U2RM, UCBN, service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14032 Caen, France.
authors.forename: J
authors.initials: J
authors.lastname: Brouard
authors.affiliation: EA 4655 U2RM, UCBN, laboratoire de virologie, CHU de Caen, avenue Clémenceau, 14032 Caen, France.
authors.forename: A
authors.initials: A
authors.lastname: Vabret
authors.affiliation: Unité de pneumologie-allergologie pédiatrique, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Deschildre
mesh_terms: D001424:Bacterial Infections / Q000150:complications / Q000821:virology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D056265:Microbial Interactions / Q000502:physiology*; D012128:Respiratory Distress Syndrome / Q000382:microbiology / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000472:pathogenicity / Q000502:physiology; D012137:Respiratory System / Q000382:microbiology* / Q000821:virology*; D012141:Respiratory Tract Infections / Q000382:microbiology* / Q000821:virology*; D014777:Virus Diseases / Q000150:complications / Q000382:microbiology
keywords: Asthma; Asthme; Grippe; Influenza; Respiratory syncytial virus; Rhinovirus; SARS; Syndrome respiratoire aigu sévère; Virus respiratoire syncytial