TY - T1的呼吸道合胞体病毒和子sequent asthma: one step closer to unravelling the Gordian knot? JF - European Respiratory Journal JO - Eur Respir J SP - 515 LP - 517 DO - 10.1183/09031936.02.00404602 VL - 20 IS - 3 AU - Piedimonte, G. AU - Simoes, E.A.F. Y1 - 2002/09/01 UR - //www.qdcxjkg.com/content/20/3/515.abstract N2 - Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infancy, infecting nearly all children within the first 2 yrs of life 1. There is growing evidence that severe RSV lower respiratory infection (LRI) early in life is an important risk factor for the development of recurrent wheezing and asthma in later childhood 2 but the field abounds with apparent controversy 3–13. A recent paper from the Tucson Children's Respiratory Study in Arizona, USA has demonstrated that mild-to-moderate RSV LRI in the first 3 yrs of life is an important risk factor for subsequent wheezing 7, 8 up to 11 yrs of age, but this risk is no longer statistically significant by 13 yrs of age 8. In this study, no relationship was found between the infection and development of atopy. In contrast, in Boras, Sweden, subsequent recurrent wheezing in later childhood (up to 7 yrs of follow-up) was observed in children with a history of severe bronchiolitis requiring hospitalisation in infancy 9, 10 and a significant association was found between RSV and atopic sensitisation, which was not explained by a family history of asthma or atopy. How does one reconcile these apparently discrepant observations? Clearly not all children with recurrent wheezing disease have been previously hospitalised with severe RSV bronchiolitis and not all children with RSV LRI go on to wheeze. The explanation for these observations is slowly unravelling. It was initially suggested that RSV-specific immunoglobulin (Ig) E during acute infection and convalescence correlated with both the severity of RSV illness and subsequent wheezing 14. This implied that the immune responses to RSV were implicit in the subsequent development of an asthmatic phenotype, and has in part driven some of the studies examining the relationship between RSV infection and the T-helper (Th) 2-type responses to … ER -