Lung function measurements in children - copsac
Lung function measurements in children - copsac
Lung function measurements in children - copsac
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onciolitis. There is an <strong>in</strong>creas<strong>in</strong>g recognition that other viruses (e.g. rh<strong>in</strong>ovirus) are as<br />
common as RSV caus<strong>in</strong>g bronciolitis <strong>in</strong> young <strong>children</strong> (142, 169-171).<br />
A recent prospective, population-based cohort study exam<strong>in</strong>ed the associations between<br />
hospitalization for RSV <strong>in</strong>fection and <strong>in</strong>vasive pneumococcal disease <strong>in</strong> Danish <strong>children</strong><br />
< 2 years. The study found that <strong>in</strong>vasive pneumococcal disease did not <strong>in</strong>crease the risk<br />
of RSV hospitalization but recent hospitalization for RSV <strong>in</strong>creased the risk of <strong>in</strong>vasive<br />
pneumococcal disease (168). On the other hand a previous study from the COPSAC<br />
cohort showed that neonates colonized <strong>in</strong> the hypopharyngeal region with S.<br />
pneumonia, H. <strong>in</strong>fluenza, or M. catarrharlis, or with a comb<strong>in</strong>ation, were at <strong>in</strong>creased<br />
risk for recurrent wheeze and asthma early <strong>in</strong> life (126). One may consider co-<strong>in</strong>fections<br />
with other viral or bacterial <strong>in</strong>fections responsible for different response to RSV<br />
<strong>in</strong>fection and the development of asthma (90). This may argue aga<strong>in</strong>st the “hygiene<br />
hypothesis”, where the absence of microbial stimulation postnatal results <strong>in</strong> a skewed<br />
Th-1/Th-2 balance, but the rate of transition from fetal to adult-like Th-1 cells is much<br />
slower <strong>in</strong> those with atopic parents (88). So the Th-1/Th-2 balance results from complex<br />
<strong>in</strong>teractions between genetic background and environmental <strong>in</strong>fluences dur<strong>in</strong>g <strong>in</strong>fancy.<br />
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