PBB is a common cause of chronic cough in children. PBB was first described by our team in 2006 and since then has been incorporated into national and international paediatric guidelines. To date we are the only group in the world that has studied PBB prospectively. Although many children with PBB get better within two weeks, some have recurrent episodes.
The factors leading to recurrent PBB are currently unknown and form the basis of our studies. Our pilot data shows that children with recurrent PBB are more likely to develop the debilitating chronic respiratory illness, bronchiectasis. There is an unacceptably high prevalence of bronchiectasis in Australia’s Indigenous children.
Our study involves clinical follow up of children with PBB for 3-5 years. We used blood and lung fluid to identify markers of inflammation and immune dysfunction which may predict children at risk of recurrent PBB.
Our study found;
- PBB is associated with a future diagnosis of bronchiectasis in a subgroup of children.
- Lower airway infection with H.influenzae and recurrent PBB are associated with the development of bronchiectasis.
- Airway macrophage phagocytic capacity was lower in children with PBB or bronchiectasis compared to control children, and this may contribute to neutrophilic inflammation and H.influenzae colonisation in the airways.
- Adenovirus C is the main adenovirus found in the airways on children with PBB and bronchiectasis and was associated with higher bacterial colonisation.
- PBB is characterised by increased IL-1β pathway activation.
Chief Investigators: Chang AB, Upham JW, Gibson PG, Yerkovich S, Baines K, Hodge S, Pizzutto S, Masters IB, Buntain H
Clin Infect Dis. 2014;59(1):34-40
Funding: NHMRC Project Grant