Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Apr:34:53-58.
doi: 10.1016/j.prrv.2019.04.003. Epub 2019 Apr 12.

The impact of viral bronchiolitis phenotyping: Is it time to consider phenotype-specific responses to individualize pharmacological management?

Carlos E Rodríguez-Martínez  1 , Jose A Castro-Rodriguez  2 , Gustavo Nino  3 , Fabio Midulla  4
Affiliations
Review

The impact of viral bronchiolitis phenotyping: Is it time to consider phenotype-specific responses to individualize pharmacological management?

Carlos E Rodríguez-Martínez et al. Paediatr Respir Rev. 2020 Apr.

Abstract

Although recent guidelines recommend a minimalist approach to bronchiolitis, there are several issues with this posture. First, there are concerns about the definition of the disease, the quality of the guidelines, the method of administration of bronchodilators, and the availability of tools to evaluate the response to therapies. Second, for decades it has been assumed that all cases of viral bronchiolitis are the same, but recent evidence has shown that this is not the case. Distinct bronchiolitis phenotypes have been described, with heterogeneity in clinical presentation, molecular immune signatures and clinically relevant outcomes such as respiratory failure and recurrent wheezing. New research is critically needed to refine viral bronchiolitis phenotyping at the molecular and clinical levels as well as to define phenotype-specific responses to different therapeutic options.

Keywords: Bronchiolitis; Clinical practice guidelines; Phenotype-specific treatment; Viral bronchiolitis phenotyping.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
The multiple faces of the umbrella term “viral bronchiolitis” RV: rhinovirus; RSV: respiratory syncytial virus, LOS: length of stay.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Leader S, Kohlhase K. Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000. J Pediatr 2003;143(5 Suppl):S127–32. - PubMed
    1. Calvo C, Pozo F, Garcia-Garcia ML, Sanchez M, Lopez-Valero M, Perez-Brena P, Casas I. Detection of new respiratory viruses in hospitalized infants with bronchiolitis: a three-year prospective study. Acta Paediatr (Oslo, Norway: 1992) 2010;99(6):883–7. - PMC - PubMed
    1. Miller EK, Gebretsadik T, Carroll KN, Dupont WD, Mohamed YA, Morin LL, et al. Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J 2013;32(9):950–5. - PMC - PubMed
    1. Skjerven HO, Megremis S, Papadopoulos NG, Mowinckel P, Carlsen KH, Lodrup Carlsen KC. Virus type and genomic load in acute bronchiolitis: severity and treatment response with inhaled adrenaline. J Infect Dis 2016;213(6):915–21. - PMC - PubMed
    1. Scheltema NM, Gentile A, Lucion F, Nokes DJ, Munywoki PK, Madhi SA, et al. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series. The Lancet Global Health 2017;5(10): e984–91. - PMC - PubMed

MeSH terms