Post-infectious bronchiolitis obliterans in children: pathogenesis, treatment strategies, and future directions

Purpose of review To provide a comprehensive and updated overview of post-infectious bronchiolitis obliterans (PIBO) in children, focusing on pathogenesis, diagnostic approaches, and current management strategies, while highlighting emerging mechanistic insights and future therapeutic directions. Recent findings Recent studies emphasize neutrophilic inflammation, inflammasome activation (e.g., interleukin-18, caspase-1), and genetic susceptibility as key contributors to disease development and progression. Summary PIBO is a heterogeneous and often underrecognized chronic lung disease requiring a structured diagnostic approach based on clinical, functional, and radiologic criteria. Management remains largely empirical and supportive, with limited evidence for disease-modifying therapies. Improved understanding of disease mechanisms may enable the development of targeted, phenotype-directed interventions in the future.