Mechanisms of asthma and allergic inflammationRhinovirus illnesses during infancy predict subsequent childhood wheezing
Section snippets
Study subjects
A total of 289 newborns were enrolled from November 1998 through May 2000 in the Childhood Origins of ASThma (COAST) study as previously described.7, 8, 9 Of these children, 285 were followed prospectively for at least 1 year, and 275 were followed for 3 years.7 To qualify, at least 1 parent was required to have respiratory allergies (defined as 1 or more positive aeroallergen skin tests) and/or a history of physician-diagnosed asthma. The Human Subjects Committee of the University of Wisconsin
Viral isolates
A total of 1668 nasopharyngeal wash specimens were obtained during infancy. The likelihood of viral identification was related to the severity of illness, as measured by the symptom score (Fig 1; P < .0001). Viral identification occurred in 78% (95/122) of the severe (score ≥ 10), 70% (312/444) of the moderate (score = 5-9), and 63% (136/216) of the mild illnesses (score = 1-4; Fig 1). Virus was recovered from 66% (118/179) of the wheezing illnesses. Viral recovery from scheduled well (score = 0)
Discussion
We have used a birth cohort at high risk of developing allergic diseases and/or asthma to define more comprehensively the relationships between specific viral respiratory infections during infancy and the subsequent development of early childhood wheezing. A major advance of our findings is the documentation throughout early childhood of the specific viral pathogens involved in both asymptomatic (ie, at scheduled protocol visits) and symptomatic infections. By using this approach, we
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Supported by National Institutes of Health grants #1R01HL61879-01 and #1P01HL70831-01.