Article in Japanese

Clinical characteristics of viral infection in children with bronchial asthma

Shunji Hasegawa^1）, Taira Ariyoshi^1）, Junichiro Tezuka^2）, Yasufumi Sakata^1）, Hidenobu Kaneyasu^1）, Yusuke Okada^1）

Many pediatricians often see children who have asthmatic exacerbation caused by viral infections. There are many reports about the asthma exacerbation and onset associated with rhinovirus (RV), respiratory syncytial virus, etc., and we often meet them practically. Recently, it has been reported human metapneumovirus, pandemic A/H1N1 2009, A(H1N1)pdm09, and enterovirus D68 (EV-D68) can also induce asthma exacerbation. On the other hand, there are few reports about relationship between asthma exacerbation and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). We report that RV was most detected in specimens of nasopharyngeal mucosa cells from hospitalized asthmatic children with exacerbation between 2012 and 2015. Some patients were hospitalized repeatedly by RV-induced asthmatic exacerbation, similar to previous reports. RV infection may be involved in pediatric asthma, because there have been some reports about relationship between risk of hospitalization by exacerbation and phenotype of RV receptor gene. We experienced EV-D68 associated asthmatic exacerbation in Yamaguchi prefecture. During pandemic of A(H1N1)pdm09, there were a lot of pediatric patients who were hospitalized by severe pulmonary complication, such as pneumonia, severe asthmatic exacerbation, and atelectasis. We try to analyze the pathophysiology and to establish treatment and prevention of severe pulmonary complications in asthmatic children during A(H1N1)pdm09 infection using animal model. Because our animal model may be similar to clinical features in A(H1N1)pdm09-infected asthmatic children. In this review, we explain the clinical characteristics and the results of our research about the pathophysiology of virus-induced severe complication in children with bronchial asthma.

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1）Department of Pediatrics, Yamaguchi University Graduate School of Medicine
2）Department of Allergy and Pulmonology, Fukuoka Children’s Hospital

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Received	May 26, 2023
Accepted	May 26, 2023

36 (4)：373─384,2024