Bronchiectasis is a chronic respiratory disorder characterised by airway dilation, persistent mucus production and recurrent respiratory exacerbations. Although it remains under-recognised, particularly among children and adolescents, growing epidemiological evidence underscored its rising incidence and prevalence, as well as its significant burden on healthcare systems.1 Despite progress in imaging, microbiology and airway clearance methods, management still tends to be based on empirical and standardised approaches, which do not capture the marked variability seen in clinical presentation, disease severity, frequency of exacerbations and how patients respond to treatment.2 In adult bronchiectasis, the identification of clinical phenotypes substantially improved patient stratification, prognostication and therapeutic individualisation.3 4 In contrast, paediatric bronchiectasis has remained largely without validated clinical phenotypes capable of guiding treatment decisions or informing clinical trial design.
In this issue of the journal, Goyal et al5 address this significant unmet need by presenting the…
