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Vol. 60. Issue 4.
Pages 215-225 (April 2024)
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Vol. 60. Issue 4.
Pages 215-225 (April 2024)
Review Article
Infant Bronchiolitis Endotypes and the Risk of Developing Childhood Asthma: Lessons From Cohort Studies
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Heidi Makriniotia,
Corresponding author
cmakrynioti@mgh.harvard.edu

Corresponding author.
, Zhaozhong Zhua, Sejal Saglanib, Carlos A. Camargoa, Kohei Hasegawaa
a Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
b National Heart and Lung Institute, Imperial College, London, United Kingdom
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Table 1. Representative birth cohort studies describing associations of omics non-clustering approaches and endotypes with the development of childhood asthma.
Table 2. Representative bronchiolitis cohort studies describing associations between omics endotypes and the development of childhood asthma.
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Abstract

Severe bronchiolitis (i.e., bronchiolitis requiring hospitalization) during infancy is a heterogeneous condition associated with a high risk of developing childhood asthma. Yet, the exact mechanisms underlying the bronchiolitis-asthma link remain uncertain. Birth cohort studies have reported this association at the population level, including only small groups of patients with a history of bronchiolitis, and have attempted to identify the underlying biological mechanisms. Although this evidence has provided valuable insights, there are still unanswered questions regarding severe bronchiolitis-asthma pathogenesis. Recently, a few bronchiolitis cohort studies have attempted to answer these questions by applying unbiased analytical approaches to biological data. These cohort studies have identified novel bronchiolitis subtypes (i.e., endotypes) at high risk for asthma development, representing essential and enlightening evidence. For example, one distinct severe respiratory syncytial virus (RSV) bronchiolitis endotype is characterized by the presence of Moraxella catarrhalis and Streptococcus pneumoniae, higher levels of type I/II IFN expression, and changes in carbohydrate metabolism in nasal airway samples, and is associated with a high risk for childhood asthma development. Although these findings hold significance for the design of future studies that focus on childhood asthma prevention, they require validation. However, this scoping review puts the above findings into clinical context and emphasizes the significance of future research in this area aiming to offer new bronchiolitis treatments and contribute to asthma prevention.

Keywords:
Asthma
Bronchiolitis
Endotype
Epigenomics
Genomics
Metabolomics
Microbiome
Transcriptomics
Proteomics

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