The Respiratory Microbiome in Paediatric Chronic Wet Cough: What Is Known and Future Directions

Brianna Atto, Yitayal Anteneh, Seweryn Bialasiewicz, Michael J. Binks, Mostafa Hashemi, Jane Hill, Ruth B. Thornton, Jacob Westaway, Robyn L. Marsh

    Research output: Contribution to journalReview articlepeer-review

    1 Citation (Scopus)
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    Chronic wet cough for longer than 4 weeks is a hallmark of chronic suppurative lung diseases (CSLD), including protracted bacterial bronchitis (PBB), and bronchiectasis in children. Severe lower respiratory infection early in life is a major risk factor of PBB and paediatric bronchiectasis. In these conditions, failure to clear an underlying endobronchial infection is hypothesised to drive ongoing inflammation and progressive tissue damage that culminates in irreversible bronchiectasis. Historically, the microbiology of paediatric chronic wet cough has been defined by culture-based studies focused on the detection and eradication of specific bacterial pathogens. Various ‘omics technologies now allow for a more nuanced investigation of respiratory pathobiology and are enabling development of endotype-based models of care. Recent years have seen substantial advances in defining respiratory endotypes among adults with CSLD; however, less is understood about diseases affecting children. In this review, we explore the current understanding of the airway microbiome among children with chronic wet cough related to the PBB–bronchiectasis diagnostic continuum. We explore concepts emerging from the gut–lung axis and multi-omic studies that are expected to influence PBB and bronchiectasis endotyping efforts. We also consider how our evolving understanding of the airway microbiome is translating to new approaches in chronic wet cough diagnostics and treatments.

    Original languageEnglish
    Article number171
    Pages (from-to)1-26
    Number of pages26
    JournalJournal of Clinical Medicine
    Issue number1
    Publication statusPublished - Jan 2024

    Bibliographical note

    Funding Information:
    This work was supported by funding from the Garnett Passe and Rodney Williams Memorial Foundation (early-career Fellowship, BA; mid-career Fellowship, RBT); the National Health and Medical Research Council of Australia grants #1182929 (YA, JH, RLM), #1181054 (SB, RLM), #1170958 (MJB, RLM), and 1138604 (MJB); the University of British Columbia (four year Doctoral Fellowship, MH); and the Rebecca L Cooper Foundation (Al and Val Rosenstrauss Fellowship, RLM).

    Publisher Copyright:
    © 2023 by the authors.


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