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Persistent Bacterial Bronchitis: Time to Venture beyond the Umbrella.
Andrew Bush1,2,3
1Imperial College London, London, United Kingdom.
Frontiers in Pediatrics
|January 12, 2018
Summary
Persistent bacterial bronchitis (PBB) in children is a common cause of chronic wet cough, often misdiagnosed as asthma. Further research is needed to identify underlying airway endotypes beyond PBB for better treatment.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Microbiology
Background:
- Chronic cough in children is frequently misdiagnosed, often treated as asthma with inappropriate therapies.
- Persistent bacterial bronchitis (PBB) is increasingly recognized as a common cause of chronic wet cough in children.
- Current definitions of PBB (PBB-micro, PBB-clinical, PBB-extended, recurrent PBB) focus on clinical presentation and response to antibiotics.
Purpose of the Study:
- To highlight the limitations of current PBB classifications.
- To advocate for the urgent need to extend endotyping into PBB, particularly recurrent PBB.
- To emphasize the necessity of employing advanced -omics and systems biology approaches for deeper understanding.
Main Methods:
- Review of current understanding and definitions of Persistent Bacterial Bronchitis (PBB).
- Comparison of PBB with other neutrophilic airway diseases like cystic fibrosis and primary ciliary dyskinesia.
- Call for the application of modern -omics technologies and systems biology.
Main Results:
- The term PBB has been crucial in shifting focus from asthma-centric treatments for infected airways in children.
- Neutrophilic airway disease is a common feature across various chronic lung conditions, suggesting shared underlying mechanisms.
- Current PBB definitions lack detailed endotyping, hindering personalized treatment strategies.
Conclusions:
- Persistent Bacterial Bronchitis (PBB) has improved the management of chronic wet cough in children by differentiating it from asthma.
- There is a critical need to move beyond descriptive PBB classifications towards identifying distinct underlying endotypes.
- Advanced research methodologies, including -omics and systems biology, are essential to unravel the complex pathophysiology of PBB and improve therapeutic outcomes.
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