Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Clinical risk factors associated with the development of wheezing in children less than 2 years of age who required hospitalization for viral lower respiratory tract infections

  • Kim, Joon Hwan (Department of Pediatrics, CHA Bundang Medical Center) ;
  • Choi, Ji-Yeon (Department of Pediatrics, CHA Bundang Medical Center) ;
  • Kim, Na Yeon (Department of Pediatrics, CHA Bundang Medical Center) ;
  • Kim, Jin Woo (Department of Pediatrics, CHA Bundang Medical Center) ;
  • Baek, Ji Hyeon (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Baek, Hye Sung (Department of Pediatrics, Hallym University Kandong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Yoon, Jung Won (Department of Pediatrics, Myongji Hospital) ;
  • Jee, Hye Mi (Department of Pediatrics, CHA Bundang Medical Center) ;
  • Choi, Sun Hee (Department of Pediatrics, Kyung Hee University School of Medicine) ;
  • Kim, Hyeung Yoon (Department of Pediatrics, Bundang Jesaeng Hospital) ;
  • Kim, Ki Eun (CHA University School of Medicine) ;
  • Shin, Youn Ho (CHA University School of Medicine) ;
  • Han, Man Yong (Department of Pediatrics, CHA Bundang Medical Center)
  • 투고 : 2014.07.22
  • 심사 : 2014.10.07
  • 발행 : 2015.07.10
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초록

Purpose: Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization. Methods: The study included 142 children <2 years of age hospitalized for LRTIs with at least one virus identified as the cause and classified them into children diagnosed with LRTIs with wheezing (n=70) and those diagnosed with LRTIs without wheezing (n=72). Results: There were no significant differences in the viruses detected between the two groups. Multivariate logistic regression analysis showed that, after adjusting for potentially confounding variables including sex and age, the development of wheezing was strongly associated with parental history of allergic diseases (adjusted odds ratio [aOR], 20.19; 95% confidence interval [CI], 3.22-126.48), past history of allergic diseases (aOR, 13.95; 95% CI, 1.34-145.06), past history of hospitalization for respiratory illnesses (aOR, 21.36; 95% CI, 3.77-120.88), exposure to secondhand smoke at home (aOR, 14.45; 95% CI, 4.74-44.07), and total eosinophil count (aOR, 1.01; 95% CI, 1.01-1.02). Conclusion: Past and parental history of allergic diseases, past history of hospitalization for respiratory illnesses, exposure to secondhand smoke at home, and total eosinophil count were closely associated with the development of wheezing in children <2 years of age who required hospitalization for viral LRTIs. Clinicians should take these factors into consideration when treating, counseling, and monitoring young children admitted for viral LRTIs.

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참고문헌

  1. Kusel MM, de Klerk NH, Kebadze T, Vohma V, Holt PG, Johnston SL, et al. Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma. J Allergy Clin Immunol 2007;119:1105-10. https://doi.org/10.1016/j.jaci.2006.12.669
  2. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med 2000; 161:1501-7. https://doi.org/10.1164/ajrccm.161.5.9906076
  3. Sigurs N, Gustafsson PM, Bjarnason R, Lundberg F, Schmidt S, Sigurbergsson F, et al. Severe respiratory syncytial virus bronchiolitis in infancy and asthma and allergy at age 13. Am J Respir Crit Care Med 2005;171:137-41. https://doi.org/10.1164/rccm.200406-730OC
  4. Lemanske RF Jr, Jackson DJ, Gangnon RE, Evans MD, Li Z, Shult PA, et al. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol 2005;116:571-7. https://doi.org/10.1016/j.jaci.2005.06.024
  5. Jackson DJ, Gangnon RE, Evans MD, Roberg KA, Anderson EL, Pappas TE, et al. Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children. Am J Respir Crit Care Med 2008;178:667-72. https://doi.org/10.1164/rccm.200802-309OC
  6. O'Callaghan-Gordo C, Bassat Q, Diez-Padrisa N, Morais L, Machevo S, Nhampossa T, et al. Lower respiratory tract infections associated with rhinovirus during infancy and increased risk of wheezing during childhood. A cohort study. PLoS One 2013;8: e69370. https://doi.org/10.1371/journal.pone.0069370
  7. Kennedy JL, Shaker M, McMeen V, Gern J, Carper H, Murphy D, et al. Comparison of viral load in individuals with and without asthma during infections with rhinovirus. Am J Respir Crit Care Med 2014;189:532-9. https://doi.org/10.1164/rccm.201310-1767OC
  8. Esposito S, Daleno C, Baggi E, Ciarmoli E, Lavizzari A, Pierro M, et al. Circulation of different rhinovirus groups among children with lower respiratory tract infection in Kiremba, Burundi. Eur J Clin Microbiol Infect Dis 2012;31:3251-6. https://doi.org/10.1007/s10096-012-1692-9
  9. Chung HL, Kim SG, Shin IH. The relationship between serum endothelin (ET)-1 and wheezing status in the children with Mycoplasma pneumoniae pneumonia. Pediatr Allergy Immunol 2006; 17:285-90. https://doi.org/10.1111/j.1399-3038.2006.00393.x
  10. The Global Initiative for Asthma. GINA Report, Global strategy for asthma management and prevention. Updated December. 2011 [Internet]. The Global Initiative for Asthma; c2011 [cited 2014 Sep 8]. Available from: http://www.ginasthma.org/guidelines-gina-report-global-strategy-for-asthma.html.
  11. Herr M, Clarisse B, Nikasinovic L, Foucault C, Le Marec AM, Giordanella JP, et al. Does allergic rhinitis exist in infancy? Findings from the PARIS birth cohort. Allergy 2011;66:214-21. https://doi.org/10.1111/j.1398-9995.2010.02467.x
  12. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 1980;92:44-7.
  13. Bellau-Pujol S, Vabret A, Legrand L, Dina J, Gouarin S, Petitjean-Lecherbonnier J, et al. Development of three multiplex RT-PCR assays for the detection of 12 respiratory RNA viruses. J Virol Methods 2005;126:53-63. https://doi.org/10.1016/j.jviromet.2005.01.020
  14. Vabret A, Mouthon F, Mourez T, Gouarin S, Petitjean J, Freymuth F. Direct diagnosis of human respiratory coronaviruses 229E and OC43 by the polymerase chain reaction. J Virol Methods 2001;97: 59-66. https://doi.org/10.1016/S0166-0934(01)00343-3
  15. Vabret A, Mourez T, Dina J, van der Hoek L, Gouarin S, Petitjean J, et al. Human coronavirus NL63, France. Emerg Infect Dis 2005;11: 1225-9. https://doi.org/10.3201/eid1108.050110
  16. Vabret A, Dina J, Gouarin S, Petitjean J, Corbet S, Freymuth F. Detection of the new human coronavirus HKU1: a report of 6 cases. Clin Infect Dis 2006;42:634-9. https://doi.org/10.1086/500136
  17. Herr M, Just J, Nikasinovic L, Foucault C, Le Marec AM, Giordanella JP, et al. Influence of host and environmental factors on wheezing severity in infants: findings from the PARIS birth cohort. Clin Exp Allergy 2012;42:275-83. https://doi.org/10.1111/j.1365-2222.2011.03933.x
  18. Kurosaka F, Terada T, Tanaka A, Nakatani Y, Yamada K, Nishikawa J, et al. Risk factors for wheezing, eczema and rhinoconjunctivitis in the previous 12 months among six-year-old children in Himeji City, Japan: food allergy, older siblings, day-care attendance and parental allergy history. Allergol Int 2011;60:317-30. https://doi.org/10.2332/allergolint.10-OA-0246
  19. Brunetti L, Colazzo D, Francavilla R, Tesse R, De Sario V, Lore M, et al. The role of pulmonary infection in pediatric asthma. Allergy Asthma Proc 2007;28:190-3. https://doi.org/10.2500/aap.2007.28.2964
  20. Fujitsuka A, Tsukagoshi H, Arakawa M, Goto-Sugai K, Ryo A, Okayama Y, et al. A molecular epidemiological study of respiratory viruses detected in Japanese children with acute wheezing illness. BMC Infect Dis 2011;11:168. https://doi.org/10.1186/1471-2334-11-168
  21. Bacharier LB, Cohen R, Schweiger T, Yin-Declue H, Christie C, Zheng J, et al. Determinants of asthma after severe respiratory syncytial virus bronchiolitis. J Allergy Clin Immunol 2012;130:91-100.e3. https://doi.org/10.1016/j.jaci.2012.02.010
  22. Regnier SA, Huels J. Association between respiratory syncytial virus hospitalizations in infants and respiratory sequelae: systematic review and meta-analysis. Pediatr Infect Dis J 2013;32:820-6.
  23. Piotrowska Z, Vazquez M, Shapiro ED, Weibel C, Ferguson D, Landry ML, et al. Rhinoviruses are a major cause of wheezing and hospitalization in children less than 2 years of age. Pediatr Infect Dis J 2009;28:25-9. https://doi.org/10.1097/INF.0b013e3181861da0
  24. Kieninger E, Fuchs O, Latzin P, Frey U, Regamey N. Rhinovirus infections in infancy and early childhood. Eur Respir J 2013;41:443-52. https://doi.org/10.1183/09031936.00203511
  25. Garcia-Garcia ML, Calvo C, Falcon A, Pozo F, Perez-Brena P, De Cea JM, et al. Role of emerging respiratory viruses in children with severe acute wheezing. Pediatr Pulmonol 2010;45:585-91.
  26. Saglani S. Viral infections and the development of asthma in children. Ther Adv Infect Dis 2013;1:139-50. https://doi.org/10.1177/2049936113497202
  27. Macaubas C, de Klerk NH, Holt BJ, Wee C, Kendall G, Firth M, et al. Association between antenatal cytokine production and the development of atopy and asthma at age 6 years. Lancet 2003;362: 1192-7. https://doi.org/10.1016/S0140-6736(03)14542-4
  28. Martinez FD, Stern DA, Wright AL, Taussig LM, Halonen M. Differential immune responses to acute lower respiratory illness in early life and subsequent development of persistent wheezing and asthma. J Allergy Clin Immunol 1998;102(6 Pt 1):915-20. https://doi.org/10.1016/S0091-6749(98)70328-8
  29. Malinovschi A, Fonseca JA, Jacinto T, Alving K, Janson C. Exhaled nitric oxide levels and blood eosinophil counts independently associate with wheeze and asthma events in National Health and Nutrition Examination Survey subjects. J Allergy Clin Immunol 2013;132:821-7.e1-5. https://doi.org/10.1016/j.jaci.2013.06.007
  30. Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis. Pediatrics 2012;129:735-44. https://doi.org/10.1542/peds.2011-2196
  31. Kalliola S, Pelkonen AS, Malmberg LP, Sarna S, Hamalainen M, Mononen I, et al. Maternal smoking affects lung function and airway inflammation in young children with multiple-trigger wheeze. J Allergy Clin Immunol 2013;131:730-5. https://doi.org/10.1016/j.jaci.2013.01.005
  32. Tsai CH, Huang JH, Hwang BF, Lee YL. Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan. Respir Res 2010;11:11. https://doi.org/10.1186/1465-9921-11-11
  33. Tanaka K, Miyake Y, Arakawa M, Sasaki S, Ohya Y. Prevalence of asthma and wheeze in relation to passive smoking in Japanese children. Ann Epidemiol 2007;17:1004-10. https://doi.org/10.1016/j.annepidem.2007.07.108
  34. Bradley JP, Bacharier LB, Bonfiglio J, Schechtman KB, Strunk R, Storch G, et al. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatrics 2005;115:e7-14. https://doi.org/10.1542/peds.2004-0059
  35. Lodge CJ, Zaloumis S, Lowe AJ, Gurrin LC, Matheson MC, Axelrad C, et al. Early-life risk factors for childhood wheeze phenotypes in a high-risk birth cohort. J Pediatr 2014;164:289-94.e1-2. https://doi.org/10.1016/j.jpeds.2013.09.056

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