Acute respiratory infections in infancy linked to recurring wheeze

Viral acute respiratory infections within an infant’s first year of life may leave them susceptible to developing recurrent wheeze due to their potential to form oxidative stress, according to research presented at the 2017 American Thoracic Society International Conference.

“While lower respiratory tract infection with respiratory syncytial virus in infancy has long been recognized to be associated with increased risk of recurrent wheeze and childhood asthma, our study shows that both upper and lower respiratory tract infections with RSV in the first year of life are associated with increased risk in early childhood,” Christan Rosas-Salazar, MD, MPH, from the Monroe Carell Jr. Children’s Hospital at Vanderbilt, told Infectious Diseases in Children.

Christan Rosas-Salazar

To determine whether F2-isoprostane concentrations — a result of oxidative stress — in urine during a healthy period or during viral acute respiratory infection (ARI) were associated with recurrent wheeze, the researchers used gas chromatography-mass spectrometry to measure F2-isoprostane concentrations taken near birth and/or when an infant had a viral ARI. Infants from the INSPIRE study (n=476) were included.

The researchers main goal was to assess recurrent wheeze at 2 years of age. To be considered ‘recurrent,’ parents had to report three or more episodes since the infant’s last birthday. The median age of participants at enrollment was 29 (14-66) days, and their median age at the time of viral ARI was 145 (90-190) days.

According to study results, recurrent wheeze was noted in 58 (13.5%) of the 430 infants included in the study. The researchers observed no significant connection between the F2-isoprostane levels of urine samples collected at enrollment and recurrent wheeze; however, F2-isoprostane concentrations in urine during viral ARIs were significantly increased among infants who developed recurrent wheeze (median interquartile=6.9[3.6-12.9]) vs. those who did not (median interquartile =4.7[3.0-7.3]) (P=.004).

When researchers found an interquartile difference of 4.6 ng/mg creatinine in addition to a viral ARI, their risk of developing recurring wheeze increased twofold (OR=1.9; 95% CI=1.1-3.1)

“These results suggest that strategies to prevent RSV acute respiratory infections in infancy could have an important impact in the prevention of recurrent wheeze and possibly asthma in children,” Rosas-Salazar said. —by Katherine Bortz.

Reference:
Rosas-Salazar C, et al. Abstract 9185. Presented at: The 2017 American Thoracic Society International Conference; May 19-24, 2017; Washington, D.C.

Disclosure: This study was supported by a grant from the National Institutes of Health, National Institute of Allergy and Ingectious Diseases Asthma and Allergic Diseases Disease Cooperative Research Center.