<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7531</journal-id>
<journal-title><![CDATA[Revista Cubana de Pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Pediatr]]></abbrev-journal-title>
<issn>0034-7531</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75312021000400005</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Randomized trial: inflammatory response to corticoids versus placebo in moderate and severe bronchiolitis. COTHEB study]]></article-title>
<article-title xml:lang="es"><![CDATA[Ensayo clínico aleatorizado: respuesta inflamatoria a corticoides versus placebo en bronquiolitis moderada y grave. Estudio COTHEB]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Felipe Villalobos]]></surname>
<given-names><![CDATA[Aida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Balaguer Gargallo]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alejandre Galobardes]]></surname>
<given-names><![CDATA[Carme]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Esteban Torné]]></surname>
<given-names><![CDATA[Elisabeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Manrique de Lara]]></surname>
<given-names><![CDATA[Laia Alsina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muñoz-Almagro]]></surname>
<given-names><![CDATA[Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Esteban Torné]]></surname>
<given-names><![CDATA[Maria Esther]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cambra Lasaosa]]></surname>
<given-names><![CDATA[Francisco José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jordan Garcia]]></surname>
<given-names><![CDATA[Iolanda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Barcelona Institut Recerca Paediatric Intensive Care Unit, Hospital Sant Joan de Déu]]></institution>
<addr-line><![CDATA[ Barcelona]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Barcelona Institut de Recerca Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu]]></institution>
<addr-line><![CDATA[ Barcelona]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universitat Internacional de Catalunya Hospital Sant Joan de Deu Molecular Microbiology Department]]></institution>
<addr-line><![CDATA[ Barcelona]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,University of Barcelona Institut de Recerca de la Biodiversitat ]]></institution>
<addr-line><![CDATA[ Barcelona]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Sant Joan de Déu Paediatric Infectious Diseases Research Group ]]></institution>
<addr-line><![CDATA[ Barcelona]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>93</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312021000400005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312021000400005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312021000400005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: The use of corticosteroids has been shown not to improve the prognosis of patients with bronchiolitis, but it could be assumed that steroids will reduce inflammation.  Objective:  This study aimed to assess whether corticoid therapy influenced the inflammatory and clinical response of critically ill infants.  Methods: Prospective, randomized, double blind placebo-controlled trial of glucocorticoids (GCT) in infants of less than 12 months with severe or moderate bronchiolitis. Patients were randomized to receive systemic corticoid therapy (low dose for 7 days) or placebo. The main outcomes were: a) levels of lymphocyte subsets; b) levels of IL-2, IL-12, and IFN&#947; as pro-inflammatory factors, and c) levels of IL-4 and IL-10 as anti-inflammatory response. Secondary outcomes related with the clinical response were also analyzed.  Results: 97 patients were randomized. Evolution of lymphocyte subsets was similar in both groups. Pro-inflammatory interleukins and interferon decreased, but without differences. Anti-inflammatory interleukins showed a significant decrease from baseline to the end of the study, and IL-10 values were significantly lower (p = 0.046) in the GCT group [1.82 pg/ml (1.2-3.5)] vs non-GCT [4 pg/ml (1.5-6.3)]. GCT group showed a lower time of mechanical ventilation and of hospitalization, but without statistically significant differences. No cases of severe adverse reaction to steroids were detected.  Conclusions:  Administration of systemic GCT did not modify the inflammatory nor the clinical response of patients with severe bronchiolitis, except for IL-10 levels that were significantly lower in the GCT group. This can open a line of investigation about the relation of IL-10 and response to bronchiolitis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Se ha demostrado que los glucocorticoides no mejoran el pronóstico de pacientes con bronquiolitis, pero se podría suponer que reducen la inflamación.  Objetivo:  Evaluar si los glucocorticoides influyen en la respuesta inflamatoria y clínica de los lactantes críticos.  Métodos:  Ensayo prospectivo, aleatorizado, doble ciego, controlado con placebo en lactantes &lt; 12 meses con bronquiolitis grave y administración de glucocorticoides sistémicos (dosis bajas 7 días). Se examinaron: a) concentraciones de subconjuntos de linfocitos; b) concentraciones de IL-2, IL-12 e IFN&#947; como factores proinflamatorios, y c) concentraciones de IL-4 e IL-10 como respuesta antiinflamatoria. También se analizaron los resultados relacionados con la respuesta clínica.  Resultados:  Se aleatorizaron 97 pacientes. La evolución de los subconjuntos de linfocitos fue similar en ambos grupos. Disminuyeron las interleucinas proinflamatorias y el interferón, pero sin diferencias. Las interleucinas antiinflamatorias mostraron una disminución significativa desde el inicio hasta el final del estudio, y los valores de IL-10 fueron significativamente más bajos (p= 0,046) en el grupo de glucocorticoides [1,82 pg/ml (1,2-3,5)] frente a los no glucocorticoides [4 pg/ml (1,5 - 6,3)]. El grupo glucocorticoides mostró menor tiempo de ventilación mecánica y de hospitalización, pero sin diferencias significativas. No se detectaron reacciones adversas graves a glucocorticoides.  Conclusiones:  La administración de glucocorticoides sistémicos no modificó la respuesta inflamatoria ni clínica de los pacientes con bronquiolitis severa, excepto las concentraciones de IL-10 que fueron significativamente menores en el grupo de glucocorticoides. Esto puede abrir una línea de investigación sobre la relación de IL-10 y la respuesta a la bronquiolitis.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[corticosteroids]]></kwd>
<kwd lng="en"><![CDATA[bronchiolitis]]></kwd>
<kwd lng="en"><![CDATA[inflammatory response]]></kwd>
<kwd lng="en"><![CDATA[paediatrics]]></kwd>
<kwd lng="es"><![CDATA[glucocorticoides]]></kwd>
<kwd lng="es"><![CDATA[bronquiolitis]]></kwd>
<kwd lng="es"><![CDATA[respuesta inflamatoria]]></kwd>
<kwd lng="es"><![CDATA[pediatría]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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