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Updated: Jul 5, 2026

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Clinical need for a nebulized corticosteroid
1Division of Clinical Pharmacology, National Jewish Medical and Research Center and the Departments of Pediatrics and Pharmacology, University of Colorado Health Sciences Center, Denver 80206, USA.
Insights
Pediatric asthma cases are rising, impacting children
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Pediatric Respiratory Medicine
Background:
- Asthma is a significant cause of childhood illness, leading to increased emergency visits and hospitalizations.
- There is a concerning rise in pediatric asthma cases and mortality rates.
- Diagnosing asthma in young children relies on symptoms, with onset often before age two.
Purpose of the Study:
- To review the challenges and recommendations for managing pediatric asthma, particularly in children under five.
- To highlight the importance of early intervention with inhaled corticosteroids.
- To address the limitations in current treatment delivery for very young children.
Main Methods:
- Literature review of current asthma management guidelines and research.
- Analysis of diagnostic criteria and prognostic indicators for pediatric asthma.
- Examination of inhaled corticosteroid therapy efficacy and delivery methods in young children.
Main Results:
- Respiratory symptoms persisting until ages 3-4 are strong predictors of future asthma.
- Early inhaled corticosteroid use can reduce airway inflammation and potentially prevent long-term obstruction.
- Current inhaler devices are challenging for children under five, and specific formulations are unavailable for those under four in the US.
Conclusions:
- Early corticosteroid treatment is crucial for persistent pediatric asthma to mitigate inflammation and prevent irreversible changes.
- Improved inhaler device design and age-appropriate formulations are needed for effective asthma management in infants and young children.
- Addressing these challenges is vital to improve outcomes for the growing population of children with asthma.
Abstract:
Asthma is a leading cause of morbidity in children, leading to frequent emergency room visits and hospitalizations. In recent years, a steady increase in the number of cases of pediatric asthma has been observed. Mortality rates among children also have increased. The diagnosis of asthma in infants and young children relies on symptoms, and most children become symptomatic before the age of 2 years. The prognosis of an individual child is difficult to predict because of a lack of clear markers; however, respiratory symptoms that begin at, or persist through, the ages of 3 to 4 years are significantly associated with future asthma. The inflammatory nature of asthma has prompted recommendations for the routine use of inhaled corticosteroids for all patients with persistent asthma. Studies have indicated that early initiation of corticosteroid therapy can reduce airway inflammation and may prevent more serious asthma or irreversible obstruction in later years. Although treatment guidelines recommend the use of inhaled corticosteroids in infants and children younger than 5 years of age, metered-dose and dry-powder inhalers may be difficult for this population to use because of a lack of coordination or understanding. In addition, there are no commercially available inhaled corticosteroids for use in children younger than 4 years of age in the United States.
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