TY - JOUR T1 - Nonatopic asthma is associated with helminth infections and bronchiolitis in poor children JF - European Respiratory Journal JO - Eur Respir J SP - 1154 LP - 1160 DO - 10.1183/09031936.00127606 VL - 29 IS - 6 AU - M. U. Pereira AU - P. D. Sly AU - P. M. Pitrez AU - M. H. Jones AU - D. Escouto AU - A. C. O. Dias AU - S. K. Weiland AU - R. T. Stein Y1 - 2007/06/01 UR - http://erj.ersjournals.com/content/29/6/1154.abstract N2 - Asthma is common in urban centres in Latin America, but atopic asthma may not be the main phenotype among children. Helminth infections are highly prevalent in poor populations, and it was hypothesised that they attenuate allergic asthma, whereas other factors are related to the expression of a nonatopic wheeze/asthma phenotype. A total of 1,982 children from Southern Brazil with a mean±sd age of 10.1±0.76 yrs completed asthma questionnaires, and 1,011 were evaluated for intestinal parasites and atopy using skin-prick tests (SPTs). Wheeze in the previous 12 months was reported by 25.6%, and 9.3% showed current asthma; 13% were SPT-positive and 19.1% were positive for any helminths. Most children with either wheeze or asthma were SPT-negative; however, severe wheeze was more prevalent among the atopic minority. Helminth infections were inversely associated with positive SPT results. Bronchiolitis before the age of 2 yrs was the major independent risk factor for asthma at age 10 yrs; high-load Ascaris infection, a family history of asthma and positive SPT results were also asthma risk factors. Most asthma and wheeze are of the nonatopic phenotype, suggesting that some helminths may exert an attenuating effect on the expression of the atopic portion of the disease, whereas viral bronchiolitis predisposes more specifically to recurrent airway symptoms. ER -