University of Oulu

Ambrozéj D, Makrinioti H, Whitehouse A, Papadopoulos N, Ruszczyski M, Adamiec A, Castro-Rodriguez JA, Alansari K, Jartti T and Feleszko W (2022) Respiratory virus type to guide predictive enrichment approaches in the management of the first episode of bronchiolitis: A systematic review. Front. Immunol. 13:1017325.doi: 10.3389/fimmu.2022.1017325

Respiratory virus type to guide predictive enrichment approaches in the management of the first episode of bronchiolitis : a systematic review

Saved in:
Author: Ambrożej, Dominika1,2; Makrinioti, Heidi3; Whitehouse, Abigail4;
Organizations: 1Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
2Doctoral School, Medical University of Warsaw, Warsaw, Poland
3Harvard T.H. Chan School of Public Health, Boston, MA, United States
4Centre for Genomics and Child Health, Queen Mary University of London, London, United Kingdom
5Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
6Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
7Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
8Department of Pediatric Pulmonology and Cardiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
9Department of Pediatric Emergency Medicine, Sidra Medicine, Doha, Qatar
10Clinical Pediatrics, Qatar University College of Medicine, Doha, Qatar
11Clinical Pediatrics, Weill Cornell Medical College- Qatar, Doha, Qatar
12Department of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland
13PEDEGO Research Unit, Medical Research Center, University of Oulu, Oulu, Finland
14Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
Persistent link:
Language: English
Published: Frontiers Media, 2022
Publish Date: 2023-06-16


It has become clear that severe bronchiolitis is a heterogeneous disease; even so, current bronchiolitis management guidelines rely on the one-size-fits-all approach regarding achieving both short-term and chronic outcomes. It has been speculated that the use of molecular markers could guide more effective pharmacological management and achieve the prevention of chronic respiratory sequelae. Existing data suggest that asthma-like treatment (systemic corticosteroids and beta2-agonists) in infants with rhinovirus-induced bronchiolitis is associated with improved short-term and chronic outcomes, but robust data is still lacking. We performed a systematic search of PubMed, Embase, Web of Science, and the Cochrane’s Library to identify eligible randomized controlled trials to determine the efficacy of a personalized, virus-dependent application of systemic corticosteroids in children with severe bronchiolitis. Twelve studies with heterogeneous methodology were included. The analysis of the available results comparing the respiratory syncytial virus (RSV)-positive and RSV-negative children did not reveal significant differences in the associatons between systemic corticosteroid use in acute episode and duration of hospitalization (short-term outcome). However, this systematic review identified a trend of the positive association between the use of systematic corticosteroids and duration of hospitalization in RSV-negative infants hospitalized with the first episode of bronchiolitis (two studies). This evidence is not conclusive. Taken together, we suggest the design for future studies to assess the respiratory virus type in guiding predictive enrichment approaches in infants presenting with the first episode of bronchiolitis.

see all

Series: Frontiers in immunology
ISSN: 1664-3224
ISSN-E: 1664-3224
ISSN-L: 1664-3224
Volume: 13
Article number: 1017325
DOI: 10.3389/fimmu.2022.1017325
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3123 Gynaecology and paediatrics
Funding: The Sigrid Juselius Foundation, Helsinki, Finland (D. Ambroż ej and T. Jartti).
Copyright information: © 2022 Ambrozéj, Makrinioti, Whitehouse, Papadopoulos, Ruszczynski, Adamiec, Castro-Rodriguez, Alansari, Jartti and Feleszko. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.