The Intersection Between Protracted Bacterial Bronchitis (PBB) and Bronchiectasis - Clinical and Scientific Aspects

Protracted bacterial bronchitis (PBB) is a common cause of chronic wet cough in children and an important contributor to respiratory morbidity. Increasing evidence suggests that PBB and bronchiectasis are not distinct disease entities but instead represent different stages along a spectrum. PBB and bronchiectasis share many clinical, microbiological and immunological features. Furthermore, persistent bacterial infection, neutrophilic airway inflammation and immune responses provide mechanistic links between PBB and bronchiectasis. Longitudinal follow-up studies have also demonstrated that recurrent PBB and persistent lower airway infection are associated with an increased risk of developing bronchiectasis, highlighting the importance of early recognition and effective management. Integrating advances in basic, translational, and clinical research, will improve the understanding of the PBB-bronchiectasis continuum. Identifying children at risk of developing bronchiectasis will allow targeted, implementable interventions to prevent irreversible lung disease and improve respiratory outcomes.