OPTIMISTIC evidence has been brought forward regarding infants with bronchiolitis, a leading cause of infant hospitalisation. Research conducted at Massachusetts General Hospital (MGH) has uncovered four subtypes of infection, caused by the bronchiolitis respiratory syncytial virus (RSV), one of which is linked with higher asthma risk.
Lead researcher Yoshihiko Raita, of the MGH Department of Emergency Medicine, summed up the purpose of the research: “Our limited understanding of RSV bronchiolitis, and how it varies, has held up efforts to develop RSV bronchiolitis treatment and asthma prevention strategies.” However, by analysing 221 infants from hospitalisation until 5 years of age, four endotypes of RSV bronchiolitis were identified.
Procedure included the study of the virus affecting the children, and identification of microbes, metabolites, and immune response related molecules present in the nasal passages. A 40% risk of developing asthma by the age of 5 years was classified among the sub-group characterised by coinfection with rhinovirus, dominance by bacteria, and high interferon response.
The information gathered here is useful for asthma prediction and prevention strategies, Raita noted: “Our data add significant support to the emerging concept that bronchiolitis represents several diseases with unique biological mechanisms.”
These findings are especially important when it is considered early infancy provides a critical period for airway development; they are expected to warrant future research upon sub-group specific strategies, looking into editing the airways immune response and microbiome to treat bronchiolitis and prevent asthma. Other studies will further our understanding of bronchiolitis complexity, facilitating easier classification and preventative action for associations with other conditions.
