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Early\u2010life wheezing and asthma exacerbations are triggered by common respiratory viruses, mainly rhinoviruses (RV), and to a lesser extent, respiratory syncytial virus, parainfluenza, human metapneumovirus, coronaviruses, adenoviruses, influenza, and bocavirus. The excess presence of bacteria, several of which are part of the microbiome, has also been identified in association with wheezing and acute asthma exacerbations, including haemophilus influenza, streptococcus pneumoniae, moraxella catarrhalis, mycoplasma pneumoniae, and chlamydophila pneumonia. While it is not clear when asthma starts, its characteristics develop over time. Airway remodeling already appears between the ages of 1 and 3\u2009years of age even prior to the presence of atopic inflammation or an asthma diagnosis. The role of genetic defect or variations hampering the airway epithelium in response to environmental stimuli and severe disease morbidity are now considered as major determinants for early structural changes. Repeated viral infections can induce and perpetuate airway hyperresponsiveness. Allergic sensitization, that often precedes infection\u2010induced wheezing, shifts inflammation toward type\u20102, while common respiratory infections themselves promote type\u20102 inflammation. Nevertheless, most children who wheeze with viral infections during infancy and during preschool years do not develop persistent asthma. Multiple factors, including illness severity, viral etiology, allergic sensitization, and the exposome, are associated with disease persistence. Here, we summarize current knowledge and developments in infection epidemiology of asthma in children, describing the known impact of each individual agent and mechanisms of transition from recurrent wheeze to asthma.<\/jats:p>","DOI":"10.1111\/pai.14098","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T04:38:26Z","timestamp":1709699906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Bacteria and viruses and their role in the preschool wheeze to asthma transition"],"prefix":"10.1111","volume":"35","author":[{"given":"Nikolaos G.","family":"Papadopoulos","sequence":"first","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic National and Kapodistrian University of Athens  Athens Greece"},{"name":"Division of Infection, Immunity and Respiratory Medicine University of Manchester  Manchester 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