Integrated associations of nasopharyngeal and serum metabolo
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While infant bronchiolitis contributes to substantial acute (e.g., severity) and chronic (e.g., asthma development) morbidities, its pathobiology remains uncertain. Researchers examined the integrated relationships of local (nasopharyngeal) and systemic (serum) responses with bronchiolitis morbidities.

In a multicenter prospective cohort study of infants hospitalized for bronchiolitis, researchers applied a network analysis approach to identify distinct networks (modules)—clusters of densely interconnected metabolites—of the nasopharyngeal and serum metabolome. Their individual and integrated relationships with acute severity (defined by positive pressure ventilation [PPV] use) and asthma development by age 5 years were identified.

--In 140 infants, 285 nasopharyngeal and 639 serum metabolites were identified. Network analysis revealed 7 nasopharyngeal and 8 serum modules.

--At the individual module-level, nasopharyngeal-amino acid, tricarboxylic acid (TCA) cycle, and carnitine modules were associated with higher risk of PPV use , while serum-carnitine, amino acid and glycerophosphorylcholine (GPC)/glycerophosphorylethanolamine (GPE) modules were associated with lower risk.

--The integrated analysis for PPV use revealed consistent findings—e.g., nasopharyngeal-TCA (adjOR 2.87) and serum-GPC/GPE (adjOR 0.54) modules—and an additional module—serum-glucose-alanine cycle module (adjOR 0.69).

--With asthma risk, there were no individual associations but there were integrated associations (e.g, nasopharyngeal-carnitine module; adjOR 1.48).

Conclusively, In infants with bronchiolitis, we found integrated relationships of local and systemic metabolome networks with acute and chronic morbidity. These findings advance research into the complex interplay among respiratory viruses, local and systemic response, and disease pathobiology in infants with bronchiolitis.