Bronchiolitis in Infancy the Ultimate Cause of Chest Problems in Childhood

Researchers at the University of Liverpool have found that a large proportion of infants who suffer from bronchiolitis have an inherent predisposition to the disease.

Although most infants infected with the disease have only mild symptoms such as a cough and wheeze, some develop potentially life-threatening bronchiolitis. Babies born prematurely are particularly susceptible to the condition but what has puzzled scientists is that the majority of babies admitted to hospital are previously healthy and have not had an obvious reason for becoming so ill.

The study involved nearly 200 infants less than two years old admitted to Alder Hey over a five-year period. On admission to hospital, those with severe disease were taking more than 50 breaths per minute and their blood oxygen levels were dangerously low.

The research team found that those with severe bronchiolitis had lower levels of interferon-gamma and substance P in their airway secretions.

Gamma interferon is an important substance made in the body, which is used to fight viral infections. The role of substance P is less understood but is thought to be involved in the local inflammatory response in many parts of the body.

'This work helps to explain a common observation about children who had bronchiolitis as babies. Parents often tell us that every time their child gets a cold ‘it goes straight to his chest’ and many parents and doctors believe that bronchiolitis in infancy is the cause of these chest problems in childhood,' Dr Calum Semple, Senior Lecturer in Child Health at the University of Liverpool and Consultant Respiratory Paediatrician based at Alder Hey, said.

'This study shows that it is the difference in the child’s ability to fight viruses that predisposes them to bronchiolitis in the first place. That poor ability to fight the condition is an innate feature of their immune system. Bronchiolitis just happens to be the commonest respiratory virus around and therefore the first virus a baby is likely to come across.

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'Because the gamma interferon response is an important feature of the immune system in these children, they won’t handle subsequent respiratory viruses very well either. The association between bronchiolitis in babies and ‘chestiness’ in childhood is not causal or consequential but due to a common immune predisposition and is probably genetic,' Dr Semple added.

Source-ANI
SPH/C