Biomarkers and Respiratory Omics as New CHildren Opportunities - Study of Clinical Outcomes and Predictivity Evaluation - a Multi-cohort, Multi-center Study
The goal of this observational study is to improve the identification of biomarkers that predict disease progression and to assess the effectiveness of current therapies in children with asthma and protracted bacterial bronchitis. The main aim of the study is to evaluate the microbiome composition and diversity, cellular composition, and metabolomic profile. In addition, to assess their correlation on subsequent treatment and disease course in children with asthma, protracted bacterial bronchitis, and in those receiving inhaled glucocorticosteroids without a diagnosis of asthma. Participants will undergo fiberoptic bronchoscopy. During bronchoscopy, the performing physician will collect Bronchoalveolar lavage fluid samples for metagenomic and metabolomic analysis, as well as mucosal biopsies for histopathological evaluation.
• Age at the beginning of the study 0-17 years old
• Clinical indication and qualification by the attending physician for fiberoptic bronchoscopy under general anesthesia:
‣ Obstruction of the airways:
⁃ Suspicion of foreign body aspiration
⁃ Persistent stridor
⁃ Abnormal result of functional tests of respiratory system - flattening of inspiratory or expiratory curve, presence of restriction (tested vital capacity \<5 percentile) or irreversible obstruction (persistence of Tiffneau index \<5 percentile despite administration of bronchodilators)
⁃ Radiological findings located in the course of the larynx, trachea or bronchi
⁃ Persistent atelectasis on subsequent radiological examinations
⁃ Persistent cough \>4 weeks
⁃ Hemoptysis
⁃ Suspected laryngomalacia or tracheobronchomalacia
⁃ Suspected tracheoesophageal fistula
⁃ Persistent dyspnea unresponsive to anti-asthmatic treatment used for min. 2 months, with no other identifiable causes
⁃ Radiologically detected mediastinal abnormalities
⁃ Suspected presence of a vascular ring
⁃ Presence of excessive secretions that are impossible for the patient to expectorate
⁃ Fine needle biopsy of cystic lesions
• Obtained consent from patient/legal guardian for participation in the study