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Original Research: ASTHMA |

Causal Direction Between Respiratory Syncytial Virus Bronchiolitis and Asthma Studied in Monozygotic Twins

Porntiva Poorisrisak, MD; Liselotte Brydensholt Halkjaer, MD, PhD; Simon Francis Thomsen, MD, PhD; Lone Graff Stensballe, MD, PhD; Kirsten Ohm Kyvik, MD, PhD; Axel Skytthe, PhD; Peter Oluf Schioetz, MD, DMSci; Hans Bisgaard, MD, DMSci
Author and Funding Information

From the Danish Pediatric Asthma Center (Drs Poorisrisak, Halkjaer and Bisgaard), Copenhagen University Hospital, Copenhagen; the Department of Pediatrics (Dr Poorisrisak), Naestved Hospital, Naestved; the Department of Respiratory Medicine (Dr Thomsen), Bispebjerg Hospital, Copenhagen; the Bandim Health Project (Dr Stensballe), Statens Serum Institut, Copenhagen; the Institute of Regional Health Research and The Danish Twin Registry (Dr Kyvik), and the Department of Epidemiology, Institute of Public Health, and The Danish Twin Registry (Dr Skytthe), University of Southern Denmark, Odense C; and the Danish Pediatric Asthma Center (Dr Schioetz), Aarhus University Hospital, Skejby, Denmark.

Correspondence to: Hans Bisgaard, MD, DMSci, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, L213, Ledreborg alle 34, DK-2820 Copenhagen, Denmark; e-mail: Bisgaard@copsac.dk


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(2):338-344. doi:10.1378/chest.10-0365
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Background:  Respiratory syncytial virus (RSV) bronchiolitis has been associated with later development of asthma, wheezing, abnormal pulmonary function, and sensitization. Our aim was to determine the differential effect within monozygotic (MZ) twin pairs discordant for severe RSV bronchiolitis in infancy on the subsequent development of asthma, pulmonary function, and allergy.

Methods:  Thirty-seven MZ twin pairs discordant for RSV hospitalization in infancy (mean age 10.6 months) were compared at the mean age of 7.6 years for lung function, bronchial responsiveness, fractional exhaled nitric oxide (Feno), asthma diagnosis, use of asthma medication, and skin prick test to common inhalant allergens.

Results:  There were no differences within MZ twin pairs discordant for RSV hospitalization in infancy with respect to pulmonary function, Feno, asthma prevalence, asthma medication use, or sensitization (P > .1 for all comparisons).

Conclusions:  We found no differential effect from severity of RSV infection on the development of asthma and allergy in MZ twin pairs discordant for RSV hospitalization in infancy. This argues against a specific effect of severe RSV infection in the development of asthma and allergy. Because of the small sample size, this study must be considered as a hypothesis-generating study.

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