Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments

Jartti, Tuomas; Smits, Hermelijn H.; Bønnelykke, Klaus; Bircan, Ozlem; Elenius, Varpu; Konradsen, Jon R.; Maggina, Paraskevi; Makrinioti, Heidi; Stokholm, Jakob; Hedlin, Gunilla; Papadopoulos, Nikolaos; Ruszczynski, Marek; Ryczaj, Klaudia; Schaub, Bianca; Schwarze, Jürgen; Skevaki, Chrysanthi; Stenberg-Hammar, Katarina; Feleszko, Wojciech

F I G U R E 5 Major factors influencing asthma risk in young children suffering from bronchiolitis. RV, rhinovirus; RSV, respiratory syncytial virus; n-3 LCPUFA, n-3 (omega-3) long-chain polyunsaturated fatty acids Going forward, it will be important to identify the patients at high risk of asthma and to find the specific primary and secondary prevention strategies for each individual patient ( Figure 5 ), for example, sensitization, eczema, and the first severe wheeze caused by RV appear to predict atopic asthma, while the first severe wheeze before 1-year age, RV/RSV-negative etiology, and/or association with parental smoking appear to predict nonatopic asthma. 7 In conclusion, these new insights into viral virulence, personal risk factors (genetics, allergy, and antiviral immunity), and environmental exposures (farm, urban, microbes, and nutrition) provide hope that in future we might be able to reduce the occurrence of childhood asthma ( Figure 5 ).