Moving toward consensus on diagnosis and management of severe asthma in children

Current Medical Research and Opinion
Désirée Larenas-LinnemannGherson Cukier

Abstract

Children with severe asthma continue to experience symptoms despite long-term treatment with high doses of corticosteroids. Moreover, the heterogeneous nature of asthma and the presence of several phenotypes have limited our ability to develop an optimized management strategy for these patients. Adequate management of severe asthma in children necessitates a detailed understanding of what makes asthma difficult to control, knowledge of the causal factors, review of diagnosis for accurate identification of pediatric patients with severe asthma and a precise definition of the phenotypes to be able to better target the therapy. Advancement in all these aspects is likely to improve childhood asthma treatment in the future. Although our understanding of severe pediatric asthma has grown in recent years, there remains a lack of consensus and clarity around critical aspects of this condition. This review attempts to present a harmonized view on the definition of severe asthma in the pediatric age group, identification of phenotypes and diagnosis, the inflammatory cascade, pharmacological and non-pharmacological treatment strategies, considerations for follow-up and referral to specialists, and disease prevention strategies.

References

Aug 1, 1977·Archives of Disease in Childhood·H Blair
Oct 1, 1992·The American Review of Respiratory Disease·J W YungingerM D Silverstein
Feb 2, 1989·The New England Journal of Medicine·B BurrowsM G Cline
Sep 1, 1987·The Journal of Allergy and Clinical Immunology·R C Strunk
Jan 21, 1974·JAMA : the Journal of the American Medical Association·T E MinorC E Reed
Oct 1, 1984·The Journal of Allergy and Clinical Immunology·D D Stevenson
Feb 1, 1995·American Journal of Respiratory and Critical Care Medicine·R N RivingtonA C Darke
Dec 1, 1993·The American Review of Respiratory Disease·R J RoordaK Knol
Sep 26, 1996·The New England Journal of Medicine·D R GoldD W Dockery
Jan 1, 1997·Drug and Therapeutics Bulletin
May 14, 1998·Archives of Disease in Childhood·G A OrdoñezC F Robertson
Jul 3, 1998·American Journal of Respiratory Cell and Molecular Biology·A M CampbellJ Bousquet
May 27, 1999·BMJ : British Medical Journal·L IrvineJ I Cater
Aug 10, 2000·American Journal of Respiratory and Critical Care Medicine·J C VirchowA Harris
Sep 13, 2000·The Journal of Allergy and Clinical Immunology·G L Larsen
Oct 19, 2000·Advances in Genetics·J P RiceE Rasmussen
Jan 10, 2001·The Journal of Allergy and Clinical Immunology·A L FuhlbriggeS T Weiss
Mar 21, 2001·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·H MochizukiA Morikawa
Nov 13, 2001·American Journal of Respiratory and Critical Care Medicine·T A Platts-Mills
Feb 15, 2002·The European Respiratory Journal·P GodardG Duru
Feb 28, 2002·Annual Review of Immunology·Charles A Janeway, Ruslan Medzhitov
Mar 19, 2002·The Journal of Allergy and Clinical Immunology·Stanley J SzeflerUNKNOWN Asthma Clinical Research Network of the National Heart Lung, and Blood Institute
Jun 6, 2002·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·S H ArshadUNKNOWN SPACE study group
Aug 8, 2002·Pediatrics·Lara J Akinbami, Kenneth C Schoendorf
Mar 19, 2003·The Journal of Allergy and Clinical Immunology·Andrew H Liu, James R Murphy
Jan 24, 2004·The European Respiratory Journal·B G ToelleG B Marks
Jul 17, 2004·American Journal of Respiratory and Critical Care Medicine·Eric D BatemanUNKNOWN GOAL Investigators Group
Aug 25, 2004·Trends in Immunology·A Barry KayDouglas S Robinson
Dec 14, 2004·Current Opinion in Pulmonary Medicine·Alan James
Mar 9, 2005·The Journal of Allergy and Clinical Immunology·Stephen HolgateColin Reisner
Jul 22, 2005·The Journal of Immunology : Official Journal of the American Association of Immunologists·Christophe von GarnierPhilip A Stumbles
Oct 21, 2005·The Journal of Immunology : Official Journal of the American Association of Immunologists·John T SchroederMark C Liu
Feb 9, 2006·European Journal of Pharmacology·Joost J Smit, Nicholas W Lukacs
May 12, 2006·The New England Journal of Medicine·Theresa W GuilbertFernando D Martinez
Oct 20, 2006·The New England Journal of Medicine·Geir HålandUNKNOWN ORAACLE
Dec 22, 2006·The Journal of Immunology : Official Journal of the American Association of Immunologists·Kenichi KitamuraErwin W Gelfand
Mar 14, 2007·The Journal of Allergy and Clinical Immunology·Andrew H LiuRanjani Manjunath
Aug 28, 2007·Current Opinion in Immunology·Taylor Doherty, David Broide
May 16, 2008·American Journal of Respiratory and Critical Care Medicine·Pranab HaldarRuth H Green
Jul 8, 2008·The Journal of Allergy and Clinical Immunology·Bruce Bender, Lening Zhang

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Citations

Feb 10, 2018·Current Medical Research and Opinion·Amelia Licari, Gian Luigi Marseglia
Oct 13, 2018·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Nikolaos G PapadopoulosDavid B Price

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