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[Childhood asthma].

R Ronchetti1, M P Villa, M Barreto

  • 1Clinica Pediatrica, Azienda Ospedaliera Sant'Andrea, II Facoltà di Medicina e Chirurgia, Università degli Studi di Roma, La Sapienza, Roma, Italy. roberto.ronchetti@uniroma1.it

Minerva Pediatrica
|July 14, 2004
PubMed
Summary
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Asthma chronicity and irreversibility are debated in children, with varied phenotypes and increasing prevalence. New diagnostic methods and individualized therapy, involving families, are crucial for effective pediatric asthma management.

Area of Science:

  • Pulmonology
  • Pediatric Allergy
  • Immunology

Context:

  • Recent asthma definitions emphasize airway inflammation and remodeling, but chronicity and irreversibility are debated in pediatric populations.
  • Pediatric asthma presents diverse phenotypes, with many infants experiencing recurrent wheezing not progressing to persistent asthma.
  • Global asthma prevalence, particularly mild forms, has risen, stabilizing in Italy but increasing elsewhere.

Purpose:

  • To explore the concept of asthma chronicity in children, considering variable phenotypes and the impact of environmental factors.
  • To highlight advancements in noninvasive diagnostic tools for assessing airway inflammation in pediatric asthma.
  • To advocate for clinically guided, individualized asthma treatment strategies in children, emphasizing family involvement.

Summary:

Related Experiment Videos

  • Childhood asthma chronicity and irreversibility are questionable, with varied clinical presentations and a significant number of infants outgrowing early wheezing.
  • Increased histamine skin response correlates with higher positive skin test prevalence, and processed foods may contribute to new asthma forms with GI symptoms.
  • Accurate assessment using pulmonary function tests, inflammatory markers, and noninvasive methods like exhaled nitric oxide is vital.

Impact:

  • Advances in noninvasive diagnostics like exhaled nitric oxide testing aid in assessing airway inflammation.
  • Individualized asthma therapy, guided by clinical criteria and patient/parent involvement, is recommended over rigid guidelines to mitigate risks like growth impairment from inhaled steroids.