Interactions between RSV Infection, Asthma, and Atopy : Unraveling the Complexities

In this issue, Culley et al. (1) present findings from an infant mouse model of respiratory syncitial virus (RSV) infection, which provides a new perspective on the pathogenesis of RSV-mediated lung disease in early life. RSV is one of the most common respiratory pathogens encountered in pediatric practice, and virtually all children experience one or more infectious episodes by the age of 2 yr (2). The initial focus of the infection is the nasopharyngeal epithelium, and in the majority of cases it remains localized to this area and the symptomatology is restricted to a runny nose. In a subset of subjects, however, the virus spreads to the lower respiratory tract, resulting in a wheezing illness or acute bronchiolitis that requires hospitalization. Between 50 and 90% of hospitalizations for bronchiolitis amongst children in the U.S. are directly attributable to RSV and substantial...