Four biologically and clinically meaningful endotypes identified; asthma risk higher for endotype B compared with endotype A<\/p>\n<\/h3>\n
<\/b><\/p>\n
<\/b><\/p>\n
MONDAY, June 21, 2021 (HealthDay News) — Distinct molecular subtypes of respiratory syncytial virus (RSV) bronchiolitis have been identified and are associated with differing levels of asthma risk, according to a study published online June 14 in Nature Communications<\/em>.<\/p>\n Yoshihiko Raita, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues integrated clinical, virus, airway microbiome (species-level), transcriptome, and metabolome data of 221 infants hospitalized with RSV bronchiolitis in a prospective cohort study to examine biologically distinct endotypes.<\/p>\n The researchers identified four biologically and clinically meaningful endotypes: clinicalclassic<\/sup>microbiomeM. nonliquefaciens<\/sup>inflammationIFN-intermediate<\/sup> (A); clinicalatopic<\/sup>microbiomeS. pneumoniae\/M. catarrhalis<\/sup>inflammationIFN-high<\/sup> (B); clinicalsevere<\/sup>microbiomemixed<\/sup>inflammationIFN-low<\/sup> (C); and clinicalnon-atopic<\/sup>microbiomeM. catarrhalis<\/sup>inflammationIL-6<\/sup> (D). Endotype B infants, who are characterized by a high proportion of immunoglobulin E sensitization and rhinovirus coinfection, S. pneumoniae\/M. catarrhalis<\/em> codominance, and high IFN-\u00ce\u00b1 and -\u00ce\u00b3 response, had a significantly higher risk for developing asthma compared with endotype A infants (38 versus 9 percent; odds ratio, 6.00).<\/p>\n “Our data add significant support to the emerging concept that bronchiolitis represents several diseases with unique biological mechanisms,” Raita said in a statement. “For clinicians, our findings give an evidence base for the early identification of high-risk children during an important period of airway development: early infancy. For researchers, our data offer new avenues for the development of subgroup-specific strategies — such as fine-tuning the airway immune response and microbiome — for treating bronchiolitis and preventing asthma.”<\/p>\n