A Possible Explanation Why Steroids Do Not Work in Treating Bronchiolitis

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There have been a number of articles in our journal and others discussing whether or not steroids have a role in the treatment of bronchiolitis. While the overall evidence currently suggests that steroids do not help, one wonders why this might be the case. Fortunately, Diaz et al. (doi: 10.1542/peds.2012-0160) test a hypothesis that RSV infected patients have receptors on cells that are unable to bind cortisol and hence reduce the anti-inflammatory response that ensues when this virus infects an infant’s respiratory tract. With an inability to bind the steroid, there is an inability for the steroid to make a difference. So does this hypothesis play out in vivo? Take a deep breath and look at the results coughed up in this fascinating study. If you are still thinking of using steroids to treat bronchiolitis, this study will make you think again.