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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
PubMed

Insights

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.

Keywords:
airway infectionairway inflammationbronchoalveolar lavagecystic fibrosisendotypeprimary ciliary dyskinesia

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