Respiratory Syncytial Virus Bronchiolitis: Enter the Microbiome

Severe bronchiolitis profiles and risk of recurrent wheeze by age 3 years

“…19 The timing and mechanisms of the interplay between viral infections, airway microbiota, and host immune response in relation to respiratory outcomes have yet to be determined. 16,19 Although our findings are consistent with previous studies reporting associations between microbiota profiles and individual characteristics of bronchiolitis (severity and viral etiology), 18,42,43 they question whether microbiota profiles are independently associated with each of these characteristics or are part of the features of distinct bronchiolitis endotypes. Overall, our findings add evidence to a contribution of both viruses and bacteria to the pathogenesis of acute and chronic respiratory illnesses.…”

“…Overall, our findings add evidence to a contribution of both viruses and bacteria to the pathogenesis of acute and chronic respiratory illnesses. 16,42 This study had potential limitations. First, recurrent wheezing was defined by using parental reports of breathing problems episodes.…”

“…10 There is increasing evidence for a complex interplay between viral pathogens, host immune response, and respiratory microbiota in the pathogenesis and severity of acute respiratory tract infections, as well as their link with asthma-related outcomes. [16][17][18][19] Thus examining the heterogeneity of bronchiolitis in relation to allergy markers, immune response parameters, nasopharyngeal microbiota, and long-term respiratory outcomes might provide insight into asthma susceptibility pathways. However, to date, no study has investigated the association of severe bronchiolitis profiles defined by using a clustering approach with objectively measured biomarkers and long-term respiratory outcomes.…”