Assessing bronchial remodelling identified severe preschool wheezers at risk of frequent and severe subsequent exacerbations with a favourable benefit-to-risk ratio suggests a recent study published in the American Journal of Respiratory and Critical Care Medicine

Children with preschool wheezing represent a heterogeneous population with wide variability regarding their clinical, inflammatory, obstructive, and/or remodelling patterns. We hypothesized that assessing bronchial remodelling would help clinicians to better characterize severe preschool wheezers.

The main objective was identifying bronchial remodelling-based latent classes of severe preschool wheezers. Secondary objectives were to compare cross-sectional and longitudinal clinical and biological data between classes and assess bronchoscopy's safety.

This double-centre prospective study (NCT02806466) included severe preschool wheezers (1-5 years old), requiring fiberoptic bronchoscopy. Bronchial remodelling parameters (i.e., epithelial integrity, reticular basement membrane (RBM) thickness, mucus gland, fibrosis and bronchial smooth muscle (BSM) areas, the density of blood vessels, and RBM-BSM distance) were assessed and evaluated by Latent Class Analysis. An independent cohort of severe preschool wheezers (NCT04558671) was used to validate our results.

Thus, assessing bronchial remodelling identified severe preschool wheezers at risk of frequent and severe subsequent exacerbations with a favourable benefit-to-risk ratio.

Michael Fayon et al. Bronchial Remodeling-based Latent Class Analysis Predicts Exacerbations in Severe Preschool Wheezers. https://doi.org/10.1164/rccm.202205-0913OC PubMed: 36108144

Bronchial, Remodeling, based, Latent, Class, Analysis, Predicts, Exacerbations, Severe, Preschool Wheezers, Michael Fayon ; Fabien Beaufils , Pauline Esteves , Marilyne Campagnac ; Elise Maurat , Marine Michelet , Valerie Siao-Him-Fa ; Frederic Lavrand , Guillaume Simon , Hugues Begueret , and Patrick Berger, American Journal of Respiratory and Critical Care Medicine, Asthma; Child; Bronchoscopy; Latent Class Analysis; Exacerbation

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.