The usual suspects: Respiratory Syncytial Virus and Rhinovirus drive asthma development and exacerbation

Victoria T Nguyen; Kristina Roth; Emily Engelhardt; Adam Pearlstein; Theresia R Davita; Mitchell H Grayson

doi:10.1016/j.anai.2025.04.013

The usual suspects: Respiratory Syncytial Virus and Rhinovirus drive asthma development and exacerbation

Ann Allergy Asthma Immunol. 2025 Apr 24:S1081-1206(25)00205-4. doi: 10.1016/j.anai.2025.04.013. Online ahead of print.

Authors

Victoria T Nguyen¹, Kristina Roth², Emily Engelhardt², Adam Pearlstein², Theresia R Davita³, Mitchell H Grayson⁴

Affiliations

¹ Division of Allergy and Immunology, Department of Otolaryngology, The Ohio State University Wexner Medical Center and Nationwide Children's Hospital, Columbus, OH. Electronic address: victoria.nguyen@osumc.edu.
² Division of Allergy and Immunology, Department of Otolaryngology, The Ohio State University Wexner Medical Center and Nationwide Children's Hospital, Columbus, OH.
³ Division of Internal Medicine, Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH.
⁴ Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio; Center for Clinical and Translational Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.

PMID: 40287012
DOI: 10.1016/j.anai.2025.04.013

Abstract

Recurrent wheeze and asthma are major health problems especially in children. Respiratory viral infections are known to induce recurrent wheeze and asthma. Two respiratory viruses associated with a majority of the recurrent wheeze and asthma development are respiratory syncytial virus (RSV) and rhinovirus (RV). This review exams the roles these two viruses play in the development of wheeze and asthma. RSV tends to drive recurrent wheeze in those infants who have a severe infection in the first 2-6 months of life and do not have pre-existing atopy. This is in contrast to RV, which tends to drive wheeze and asthma in those with pre-existing atopy. In the review, the mechanisms that have been proposed to drive the development of asthma and wheeze are explored. Finally, newer developments, such as vaccines, are discussed. In particular, vaccines and treatment for RSV has the potential to alter the development of recurrent wheezing, while vaccines and treatment for RV remain elusive. Both RSV and RV remain a major source of recurrent wheezing in young children.

Publication types

Review