Systematic review of montelukast's efficacy for preventing post‐bronchiolitis wheezing

  title={Systematic review of montelukast's efficacy for preventing post‐bronchiolitis wheezing},
  author={Wansheng Peng and Xin Chen and Xiao‐Yun Yang and En-Mei Liu},
  journal={Pediatric Allergy and Immunology},
  pages={143 - 150}
Infants often develop reactive airway diseases subsequent to respiratory syncytial virus (RSV) bronchiolitis. Cysteinyl leukotrienes (cysLTs), a class of lipid mediators that have been implicated in the pathogenesis of allergic rhinitis and asthma, are released during RSV infection, thereby contributing to the pathogenic changes in airway inflammation. Many pediatric patients, especially those of very young age, continue to have recurrent episodes of lower airway obstruction after bronchiolitis… 

Leukotriene inhibitors for bronchiolitis in infants and young children.

The effects of leukotriene inhibitors on length of hospital stay and clinical severity score were uncertain due to considerable heterogeneity between the study results and wide confidence intervals around the estimated effects.

Acute viral bronchiolitis in South Africa: Strategies for management and prevention.

  • H. ZarS. Madhi P. Jeena
  • Medicine
    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
  • 2016
Prophylaxis should be commenced at the start of the RSV season and given monthly during the season, and the development of an RSV vaccine may offer a more effective alternative to prevent disease, for which the results of clinical trials are awaited.

A meta-analysis of montelukast for recurrent wheeze in preschool children

This meta-analysis has examined all children with preschool wheeze and found that montelukast was not effective at preventing wheezing episodes or reducing unscheduled medical attendances, and recommended further studies to investigate if a ‘montelukasts responder’ phenotype exists.

MicroRNAs: Mediators and Therapeutic Targets to Airway Hyper Reactivity After Respiratory Syncytial Virus Infection

The potential molecular basis that miRNAs, which are produced by airway epithelial cells or peripheral blood mononuclear cells, directly or in the form of exosome to regulate the inflammation programs as well as the function, differentiation and proliferation of immune cells are summarized is summarized.

Randomized trial to evaluate azithromycin’s effects on serum and upper airway IL-8 levels, and recurrent wheezing in infants with RSV bronchiolitis

In this proof-of-concept study, azithromycin treatment during RSV bronchiolitis reduced upper airway IL-8 levels, prolonged the time to a third wheezing episode, and reduced overall respiratory morbidity over the subsequent year.

Evaluation Of The Effectiveness Of Montelukast In Children With Recurrent Obstructive Bronchitis

Using of montelukast sodium in recurrent obstructive bronchitis in children contributes to significant progress in the dynamics of the disease, leads to a significant decrease in the severity of bronchial obstruction according to the E: I index.


The initial signs and symptoms of the infection starts with mucosal inflammation and irritation of the upper respiratory tract like congestion, rhinorrhea, and sneezing, which is considered as a cardinal prerequisite for the diagnosis of bronchiolitis.

Latest options for treatment of bronchiolitis in infants

The present paper summarizes the main recommendations of national and international guidelines and the latest options for the treatment of bronchiolitis and reviews the recent literature about the drugs used during acute bronchiolaitis.



A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis.

  • H. Bisgaard
  • Medicine
    American journal of respiratory and critical care medicine
  • 2003
In conclusion, cys-LT antagonist treatment reduces lung symptoms subsequent to RSV bronchiolitis, and infants on montelukast were free of any symptoms on 22% of the days and nights compared with 4% in infants on placebo.

Inhaled corticosteroids during acute bronchiolitis in the prevention of post-bronchiolitic wheezing.

This review does not demonstrate an effect of inhaled corticosteroids given during the acute phase of bronchiolitis in the prevention of post-bronchiolitic wheezing, and the inability to pool all clinical outcomes precludes us from making strong recommendations.

Study of montelukast for the treatment of respiratory symptoms of post-respiratory syncytial virus bronchiolitis in children.

In this study, montelukast did not improve respiratory symptoms of post-RSV bronchiolitis in children and was generally well tolerated.

RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life

It is hypothesised that the effect of RSV bronchiolitis might be most prominent during the first year after bronchingiolitis, which is an important risk factor for the development of recurrent wheezing and sensitisation to common allergens during the subsequent year.

Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7.

RSV bronchiolitis in infancy severe enough to cause hospitalization was highly associatied with the development of asthma and allergic sensitization up to age 7(1)/ (2).

Nasal lavage leukotrienes in infants with RSV bronchiolitis

Cys‐LTs are significantly increased in the NLF of infants with acute RSV bronchiolitis, and remain so at 1‐month follow-up, suggesting a possible role of these eicosanoids in the pathogenesis of the disease.

Severe respiratory syncytial virus bronchiolitis in infancy and asthma and allergy at age 13.

RSV bronchiolitis in infancy severe enough to cause hospitalization is a risk factor for allergic asthma in early adolescence, and the RSV group showed mild airway obstruction both at rest and after bronchodilation, and had slightly more reactive airways.

Increased levels of BAL cysteinyl leukotrienes in acute RSV bronchiolitis

CysLT levels are increased in the lower airways during RSV bronchiolitis, although their intensities are lower than those in acute asthma.

Bronchoprotection with a leukotriene receptor antagonist in asthmatic preschool children.

It is concluded that the LTRA montelukast provided clinically significant bronchoprotection against the effect of hyperventilation of cold dry air in asthmatic children 3 to 5 yr old, and suggests that LTRAs may be of therapeutic use in limiting clinical symptoms of asthma in young children.