Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments

Jartti, Tuomas; Smits, Hermelijn H.; Bønnelykke, Klaus; Bircan, Ozlem; Elenius, Varpu; Konradsen, Jon R.; Maggina, Paraskevi; Makrinioti, Heidi; Stokholm, Jakob; Hedlin, Gunilla; Papadopoulos, Nikolaos; Ruszczynski, Marek; Ryczaj, Klaudia; Schaub, Bianca; Schwarze, Jürgen; Skevaki, Chrysanthi; Stenberg-Hammar, Katarina; Feleszko, Wojciech

year-round and preseasonal treatment with omalizumab has been shown to eliminate the seasonal peaks in asthma exacerbations, most of which are associated with RV infection. 98 In addition to the reduction in allergic inflammation by preventing IgE binding to its receptor, omalizumab also enhances the IFN-γ response. 99 Thus, it has been argued that omalizumab may improve the antiviral responses. RSV immunoprophylaxis with palivizumab has also been shown to reduce recurrent wheezing (see section 7 and 8). 60, 70, 82, 83 In the development of RV vaccine, promising results have been seen with a cross-reactive recombinant capsid protein in a mouse model. 14 Non-specific antiviral approaches to reduce asthma include strategies aiming at enhancing the patient's resistance to multiple respiratory viruses through the administration of interferons or other immunostimulatory molecules. 72, 73 Strategies (microbial and others) to promote healthy epithelial barrier and the development of mucosal immune responses that can better resist viral infection might also help in preventing the development of asthma, as well as bacterial lysates, which may reduce the recurrent wheezing by increasing antiviral activity. 100 However, the level of evidence still remains to be low.