title: Advancing our understanding of infant bronchiolitis through phenotyping and endotyping: clinical and molecular approaches.
abstract: Bronchiolitis is a major public health problem worldwide. However, no effective treatment strategies are available, other than supportive care.
  
  
  
  Although bronchiolitis has been considered a single disease diagnosed based on clinical characteristics, emerging evidence supports both clinical and pathobiological heterogeneity. The characterization of this heterogeneity supports the concept that bronchiolitis consists of multiple phenotypes or consistent grouping of characteristics. Expert commentary: Using unbiased statistical approaches, multidimentional clinical characteristics will derive bronchiolitis phenotypes. Furthermore, molecular and systems biology approaches will, by linking pathobiology to phenotype, identify endotypes. Large cohort studies of bronchiolitis with comprehensive clinical characterization and system-wide profiling of the '-omics' data (e.g., host genome, transcriptome, epigenome, viral genome, microbiome, metabolome) should enhance our ability to molecularly understand these phenotypes and lead to more targeted and personalized approaches to bronchiolitis treatment.
authors.affiliation: a Department of Emergency Medicine , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA.
authors.forename: Kohei
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: b INSERM U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Univ. Versailles St-Quentin-en-Yvelines , Villejuif , France.
authors.forename: Orianne
authors.initials: O
authors.lastname: Dumas
authors.affiliation: c Center for Asthma & Environmental Health Sciences Research, Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine , Vanderbilt University School of Medicine , Nashville , TN , USA.
authors.forename: Tina V
authors.initials: TV
authors.lastname: Hartert
authors.affiliation: a Department of Emergency Medicine , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D001988:Bronchiolitis / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007223:Infant; D064307:Microbiota; D010641:Phenotype
keywords: Bronchiolitis; endotypes; genome; immune response; infants; lower respiratory infection; microbiome; phenotypes; systems biology; transcriptome