From bronchiolitis endotyping to asthma risk assessment

Bronchiolitis is the most common lower respiratory tract infection in young children, and it is associated with significant morbidity and high rate of hospitalisation.1 In addition, epidemiological data show that bronchiolitis during early life may be associated with long-term respiratory morbidity.2 The identification of children who will present with recurrent respiratory symptoms after acute bronchiolitis represents a research challenge with possible significant impact on clinical practice. A promising approach to answer such research question derives from the application of multivariate statistical methods that can manage simultaneously a multiplicity of data obtained from different sources.

In their multicentre study, Fujiogi et al 3 analysed data collected in 917 infants (<1 year of age) hospitalised for acute bronchiolitis in 17 US centres participating to the 35th Multicenter Airway Research Collaboration study. In enrolled children, nasopharyngel airway specimens were collected and analysed through both lipidomic and transcriptomic approaches.

Applying a consensus clustering analysis, the authors could classify these children according to four endotypes, each defined by a variable combination of clinical, virological and lipidomic data. Thanks to the lipidomic approach the authors could simultaneously study a great number of lipids, enabling a deep characterisation of recruited infants from a metabolic standpoint. Nonetheless, the most interesting aspect of the …

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