Analysis of Anti-Inflammatory Therapy Options for Bronchiolitis Obliterans in Children
https://doi.org/10.31550/1727-2378-2023-22-3-40-44
Abstract
Aim: To present the relevant information on the new approaches to the management of obliterating bronchiolitis in children, based on the data generated by foreign researchers.
Key Points. Obliterating bronchiolitis is a non-reversible chronic obstructive lung disease associated with respiratory insufficiency, significant deterioration in the quality of life, and steady signs of disability. Despite the fact that this topic is of high interest, the management of patients and efficient therapy algorithms are a burning issue. A risk of side effects from systemic corticosteroids necessitates the search for alternative therapies. This overview presents information on a combined use of inhaled corticosteroids, azithromycin, monteleukast, and N-acetylcysteine.
Conclusion. Further development of alternative therapies for chronic obliterating bronchiolitis can help in achieving efficient control of this disease.
About the Authors
N. L. PotapovaRussian Federation
39а Gor’kogo Str., Chita, 672000
A. I. Markovskaya
Russian Federation
39а Gor’kogo Str., Chita, 672000
References
1. Kavaliunaite E., Aurora P. Diagnosing and managing bronchiolitis obliterans in children. Expert Rev. Respir. Med. 2019;13(5):481– 488. DOI: 10.1080/17476348.2019
2. Fischer G.B., Sarria E.E., Mattiello R. et al. Post infectious bronchiolitis obliterans in children. Paediatr. Respir. Rev. 2010;11(4):233–239. DOI: 10.1016/j.prrv.2010.07.005
3. Boitsova E.V., Ovsyannikov D.Yu. Postinfectious obliterans bronchiolitis in children. Childhood infections. 2014;(2):24–28. (in Russian)
4. Li Y.N., Liu L., Qiao H.M. et al. Post-infectious bronchiolitis obliterans in children: a review of 42 cases. BMC Pediatr. 2014;14:238. DOI: 10.1186/1471-2431-14-238
5. Yu X., Ma Y., Gao Y., You H. Epidemiology of adenovirus pneumonia and risk factors for bronchiolitis obliterans in children during an outbreak in Jilin, China. Front. Pediatr. 2021;9:722885. DOI: 10.3389/fped.2021.722885
6. Бочкарева Л.С., Мироманова Н.А. Клинические особенности острого вирусного бронхиолита у детей с предикторами тяжести. Забайкальский медицинский вестник. 2022;(1):71–80.
7. Duecker R.P., De Mir Messa I., Jerkic S.P. et al. Epigenetic regulation of inflammation by microRNAs in post-infectious bronchiolitis obliterans. Clin. Transl. Immunol. 2022;11(2):e1376. DOI: 10.1002/cti2.1376
8. Kang M.J., Ahn H.S., Lee S.Y. et al. TGFβ1 and POSTN as biomarkers of postinfectious bronchiolitis obliterans and asthma in children. Pediatr. Pulmonol. 2022;57(12):3161–3164. DOI: 10.1002/ppul.26139
9. Jerkic S.P., Brinkmann F., Calder A. et al. Postinfectious bronchiolitis obliterans in children: diagnostic workup and therapeutic options: a workshop report. Can. Respir. J. 2020;2020:5852827. DOI: 10.1155/2020/5852827
10. Colom A.J., Teper A.M. Post-infectious bronchiolitis obliterans. Pediatr. Pulmonol. 2019;54(2):212–219. DOI: 10.1002/ppul.24221
11. Спичак Т.В. Облитерирующий бронхиолит в детском возрасте — это болезнь или синдром? Педиатрия. 2016;95(4):124– 130.
12. Lee G.M., Carroll M.B., Galvin J.R., Walker C.M. Mosaic attenuation pattern: a guide to analysis with HRCT. Radiol. Clin. North. Am. 2022;60(6):963–978. DOI: 10.1016/j.rcl.2022.06.009
13. Mauad T., Dolhnikoff M., São Paulo Bronchiolitis Obliterans Study Group. Histology of childhood bronchiolitis obliterans. Pediatr. Pulmonol. 2002;33(6):466–474. DOI: 10.1002/ppul.10097
14. Chen I.C., Hsu J.S., Chen Y.W. et al. Post-infectious bronchiolitis obliterans: HRCT, DECT, pulmonary scintigraphy images, and clinical follow-up in eight children. Front. Pediatr. 2020;8:622065. DOI: 10.3389/fped.2020.622065
15. Maia S.A., Eli D., Cunha R. et al. Clinical, functional, and cytological evaluation of sputum in postinfectious bronchiolitis obliterans: a possible overlap with asthma? J. Bras. Pneumol. 2019;45(5):e20190060. DOI: 10.1590/1806-3713/e20190060
16. Mattiello R., Vidal P.C., Sarria E.E. et al. Evaluating bronchodilator response in pediatric patients with post-infectious bronchiolitis obliterans: use of different criteria for identifying airway reversibility. J. Bras. Pneumol. 2016;42(3):174–178. DOI: 10.1590/S1806-37562015000000065
17. Yu X., Wei J., Li Y. et al. Longitudinal assessment of pulmonary function and bronchodilator response in pediatric patients with postinfectious bronchiolitis obliterans. Front. Pediatr. 2021;9:674310. DOI: 10.3389/fped.2021.674310
18. Mosquera R.A., Hashmi S.S., Pacheco S.E. et al. Dysanaptic growth of lung and airway in children with post-infectious bronchiolitis obliterans. Clin. Respir. J. 2014;8(1):63–71. DOI: 10.1111/crj.12037
19. Jung J.H., Kim G.E., Min I.K. et al. Prediction of postinfectious bronchiolitis obliterans prognosis in children. Pediatr. Pulmonol. 2021;56(5):1069–1076. DOI: 10.1002/ppul.25220
20. Cheng Q., Zhang H., Shang Y. et al. Clinical features and risk factors analysis of bronchitis obliterans due to refractory Mycoplasma pneumoniae pneumonia in children: a nomogram prediction model. BMC Infect. Dis. 2021;21(1):1085. DOI: 10.1186/s12879-021-06783-4
21. Chen D.H., Lin Y.N., Lan S.L. et al. Clinical characteristics of bronchiolitis obliterans in pediatric patients. Zhonghua Er Ke Za Zhi. 2012;50(2):98–102.
22. Wang X., Liu C., Wang M. et al. Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment. Exp. Ther. Med. 2015;9(6):2379–2383. DOI: 10.3892/etm.2015.2418
23. Zheng H., Yu X., Chen Y. et al. Effects of inhaled corticosteroids on lung function in children with post-infectious bronchiolitis obliterans in remission. Front. Pediatr. 2022;10:827508. DOI: 10.3389/fped.2022.827508
24. Jimenez A., De Jesús-Rojas W. Mycoplasma pneumoniae and Bronchiolitis obliterans: how a common organism leads to a rare pulmonary disease in pediatrics. Cureus. 2021;13(8):e17193. DOI: 10.7759/cureus.17193
25. Lee E., Park S., Yang H.J. Pulmonary function in post-infectious bronchiolitis obliterans in children: a systematic review and meta-analysis. pathogens. 2022;11(12):1538. DOI: 10.3390/pathogens11121538
26. Weng T., Lin X., Wang L. et al. Follow-up on the therapeutic effects of a budesonide, azithromycin, montelukast, and acetylcysteine (BAMA) regimen in children with post-infectious bronchiolitis obliterans. J. Thorac. Dis. 2021;13(8):4775–4784. DOI: 10.21037/jtd-20-3195
27. Sun J., Li Y. Long-term, low-dose macrolide antibiotic treatment in pediatric chronic airway diseases. Pediatr. Res. 2022;91(5):1036– 1042. DOI: 10.1038/s41390-021-01613-4
28. Williams K.M., Cheng G.S., Pusic I. et al. Fluticasone, azithromycin, and montelukast treatment for new-onset bronchiolitis obliterans syndrome after hematopoietic cell transplantation. Biol. Blood Marrow Transplant. 2016;22(4):710–716. DOI: 10.1016/j.bbmt.2015.10.009
29. Chen X., Shu J.H., Huang Y. et al. Therapeutic effect of budesonide, montelukast and azithromycin on post-infectious bronchiolitis obliterans in children. Exp. Ther. Med. 2020;20(3):2649–2656. DOI: 10.3892/etm.2020.8983
30. Dalby C., Polanowski T., Larsson T. et al. The bioavailability and airway clearance of the steroid component of budesonide/formoterol and salmeterol/fluticasone after inhaled administration in patients with COPD and healthy subjects: a randomized controlled trial. Respir. Res. 2009;10(1):104. DOI: 10.1186/1465-9921-10-104
31. Jerkic S.P., Koc-Günel S., Herrmann E. et al. Long-term course of bronchial inflammation and pulmonary function testing in children with postinfectious bronchiolitis obliterans. Pediatr. Pulmonol. 2021;56(9):2966–2972. DOI: 10.1002/ppul.25547
32. Okunishi K., Peters-Golden M. Leukotrienes and airway inflammation. Biochim. Biophys. Acta. 2011;1810(11):1096–1102. DOI: 10.1016/j.bbagen.2011.02.005
33. Blasi F., Page C., Rossolini G.M. et al. The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections. Respir. Med. 2016;117:190–197. DOI: 10.1016/j.rmed.2016.06.015
Review
For citations:
Potapova N.L., Markovskaya A.I. Analysis of Anti-Inflammatory Therapy Options for Bronchiolitis Obliterans in Children. PEDIATRICS. 2023;22(3):40-44. (In Russ.) https://doi.org/10.31550/1727-2378-2023-22-3-40-44