Early intervention for asthma prevention in children

The last few decades have seen a global rise in asthma prevalence. In the United States, based on the National Health Interview Survey sample in 1998, the National Center for Health Statistics determined that asthma was the most commonly diagnosed chronic disease of childhood, with 12.1% or 8.65 million U.S. children reported as being diagnosed with asthma in their lifetime. As a result, asthma pathogenesis has received much attention, with the hope of reversing this concerning global trend by developing new approaches to asthma prevention. Current evidence suggests that most childhood asthma begins in the early years. In addition, early pathogenic development of the immune systems and lungs of children with asthma suggests that the early years may be the best time for preventive intervention. To consider intervention for asthma in early childhood (i.e., in the first 6 years of life), we will discuss (1) childhood risk factors for chronic persistent asthma, (2) early pathogenic changes in asthma, (3) potential pharmacologic and nonpharmacologic interventions for the young asthmaprone child, and (4) potential future immune modulatory therapies and prevention.