How Infections and Immune Development Relate to Preschool Recurrent Wheezing and Asthma.

IF 6.6 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-08-27 DOI:10.1016/j.jaip.2025.08.017

Kirsten M Kloepfer, Daniel J Jackson, Tuomas Jartti, Andrew H Liu, James E Gern

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引用次数: 0

Abstract

The relationship between infections, immune development, and preschool recurrent wheezing and asthma is complex and multifaceted. Respiratory syncytial virus (RSV) and rhinovirus (RV) are significant early-life triggers for wheezing, with differing immunologic and genetic associations. RV, especially RV-C, has been closely linked to asthma development, particularly allergic asthma. RSV wheezing illnesses can identify susceptible children and are linked to nonallergic asthma. Ongoing studies using broader RSV prevention (vaccines, mAbs) in full-term infants may further clarify these relationships. Both RSV and RV infections are associated with changes in bacterial abundance. The timing of these changes and the bacterial strains that are altered are likely important factors in asthma development that are continually being investigated. Beyond viral triggers, asthma and recurrent wheeze in preschoolers result from a complex interplay of microbial (urban vs rural living), environmental (eg, air pollution levels and diet) and host immune factors. Strategies focusing on microbiome modulation (eg, bacterial lysate ingestion), pollution reduction, increasing biodiversity, and nutritional support (eg, vitamin D) may offer promising paths for prevention and improved management.

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感染和免疫发育与学龄前复发性喘息和哮喘的关系。

感染、免疫发育与学龄前复发性喘息和哮喘之间的关系是复杂和多方面的。RSV和RV是早期生活中重要的喘息触发因素，具有不同的免疫和遗传关联。RV，特别是RV- c，与哮喘的发展密切相关，特别是过敏性哮喘。呼吸道合胞病毒喘息疾病可以识别易感儿童，并与非过敏性哮喘有关。正在进行的对足月婴儿进行更广泛的RSV预防（疫苗、单克隆抗体）的研究可能会进一步阐明这些关系。RSV和RV感染都与细菌丰度的变化有关。这些变化发生的时间和被改变的细菌菌株可能是哮喘发展的重要因素，这些因素正在不断被研究。除了病毒诱因外，学龄前儿童的哮喘和反复喘息是微生物（城市与农村生活）、环境（如空气污染水平、饮食）和宿主免疫因素复杂相互作用的结果。侧重于微生物组调节（如细菌裂解物摄入）、减少污染、增加生物多样性和营养支持（如维生素D）的战略可能为预防和改善管理提供有希望的途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.