Selected article for: "asthma high risk and atopic asthma"
Author: 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
Title: Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments
  • Document date: 2018_11_25
    • ID: 4svg09dt_52
    Snippet: Clinically and pathophysiologically, three main clusters of patients can be identified among children suffering from severe bronchiolitis/first wheezing episode ( Figure 6 ): 1) RSV-induced bronchiolitis is characterized by young age of the patient and mechanical obstruction of the airways due to mucus and cell debris. For the treatment of RSV-induced bronchiolitis, there is a prophylactic RSV-specific monoclonal antibody available that decreases.....
    Document: Clinically and pathophysiologically, three main clusters of patients can be identified among children suffering from severe bronchiolitis/first wheezing episode ( Figure 6 ): 1) RSV-induced bronchiolitis is characterized by young age of the patient and mechanical obstruction of the airways due to mucus and cell debris. For the treatment of RSV-induced bronchiolitis, there is a prophylactic RSV-specific monoclonal antibody available that decreases the risk of recurrent wheezing. 2) RV-induced wheezing is associated with atopic predisposition and high risk of asthma, which may be reversed with systemic corticosteroid in patients with severe first episode. RV susceptibility, thus, serves as an important early marker for asthma-prone children. 3) Wheeze due to other viruses is likely to be less frequent and severe. Clinically, it is important to distinguish between these three partially overlapping patient groups, as they are likely to respond to different treatments. The first severe episode of bronchiolitis or wheezing in a less than 2-year-old child appears to be a critical event and an important opportunity for designing secondary prevention strategies for asthma. Thus, bronchiolitis cannot simply be diagnosed using a certain cutoff age, but instead, viral etiology should be used as the differentiating factor. For nomenclature, we suggest that there are an RSV-induced bronchiolitis and an RV-induced first wheezing episode to better distinguish these conditions.

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