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Author Chawes, B.L.K.; Poorisrisak, P.; Johnston, S.L.; Bisgaard, H. url  doi
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  Title Neonatal bronchial hyperresponsiveness precedes acute severe viral bronchiolitis in infants Type Journal Article
  Year (down) 2012 Publication The Journal of Allergy and Clinical Immunology Abbreviated Journal J Allergy Clin Immunol  
  Volume 130 Issue 2 Pages 354-61.e3  
  Keywords Acute Disease; Bronchial Hyperreactivity/complications/*immunology/virology; Bronchial Provocation Tests; Bronchiolitis, Viral/complications/*immunology/virology; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Methacholine Chloride/immunology; Prospective Studies; Respiratory Function Tests; Respiratory Syncytial Virus Infections/complications/*immunology/virology; Respiratory Syncytial Viruses/immunology; Severity of Illness Index; Time Factors  
  Abstract BACKGROUND: Respiratory syncytial virus and other respiratory tract viruses lead to common colds in most infants, whereas a minority develop acute severe bronchiolitis often requiring hospitalization. We hypothesized that such an excessive response to respiratory tract viral infection is caused by host factors reflected in pre-existing increased bronchial responsiveness. OBJECTIVE: We sought to compare bronchial responsiveness and lung function in 1-month-old neonates who later develop acute severe bronchiolitis with those who do not. METHODS: We measured infant lung function (n=402) and bronchial responsiveness to methacholine (n=363) using the raised-volume rapid thoracoabdominal compression technique before any respiratory symptoms in 1-month-old neonates from the Copenhagen Prospective Study of Asthma in Childhood birth cohort born to mothers with asthma. The children were prospectively monitored for respiratory symptoms and given a diagnosis of acute severe bronchiolitis according to a fixed algorithm. RESULTS: Thirty-four (8.5%) infants had acute severe bronchiolitis before 2 years of age, 21 (62%) were hospitalized, and 23 (67%) of the cases were associated with respiratory syncytial virus. Children who later had acute severe bronchiolitis irrespective of viral species had a 2.5-fold increased responsiveness to methacholine (provocative dose of methacholine producing a 15% decrease in transcutaneous oxygen pressure [PD(15)]) at age 1 month compared with control subjects (median PD(15) in cases vs control subjects, 0.13 vs 0.33 mumol; P=.01), whereas differences in baseline airflow were not significant for forced expiratory volume at 0.5 seconds (mean z score for cases vs control subjects, -0.18 vs -0.01; P=.36) and forced expiratory flow at 50% of forced vital capacity (mean z score for cases vs control subjects, -0.37 vs -0.09; P=.13). CONCLUSION: Bronchial hyperresponsiveness in at-risk neonates precedes acute severe bronchiolitis in response to infections with respiratory tract virus.  
  Address Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen and Danish Pediatric Asthma Centre, Copenhagen University Hospital, Gentofte, Denmark  
  Corporate Author Thesis  
  Impact Factor 11,476 First Author Chawes, B.L.K. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bisgaard, H.  
  ISSN 0091-6749 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22713595 Approved no  
  Call Number Serial 80  
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