This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We hypothesize that family history of atopy is a risk factor for severe RSV bronchiolitis. We propose that full-term infants hospitalized for presumptive RSV bronchiolitis are more likely to have a family history of allergies compared with either the general population or non-hospitalized infants with RSV bronchiolitis. We also propose that infants with a family history of allergies will have more severe or prolonged illness with this viral infection. To test our hypotheses we will compare the prevalence of a family history of allergies among hospitalized infants with RSV bronchiolitis to both population statistics and to normal infants treated for RSV bronchiolitis as outpatients. When the infant presents with presumptive RSV bronchiolitis, we will review the infant's chart and interview their mothers. We will obtain nasal specimens from the infant to test for RSV infection and a urine specimen to test for leukotrienes, a marker of allergic inflammation. We will test the infant's mothers for allergies by prick skin testing. If the mother is taking medication that interferes with skin test results or is unable to stay for prick skin testing, we will arrange for prick skin testing at a follow-up visit. If the mother is pregnant we will either perform blood radioallergosorbent tests (RAST) or postpone skin testing until after the pregnancy. To test the hypothesis that the severity of RSV bronchiolitis is increased in infants that have a family history of allergies we will compare lengths of hospital stay of those infants to infants who do not have a family history of allergies. When the infants are at least nine months old, we will ask them to return to VUMC for a brief interview and a peripheral blood draw; this follow-up visit is the portion of the study which will be conducted in the GCRC. The blood specimen will be used to measure IgE levels.
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