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Published on: August 7, 2017
Predicting asthma exacerbations in children
1Division of Pediatric Pulmonology, Department of Pediatrics, Miller School of Medicine, University of Miami, 1580 North West 10th Avenue, Miami, FL 33136, USA. eforno@med.miami.edu
Insights
Optimal asthma control significantly reduces exacerbations in children. However, predicting future asthma attacks requires further research, as current tools have limited success in identifying high-risk children.
Area of Science:
- Pediatric Pulmonology
- Asthma Research
- Predictive Medicine
Background:
- Asthma exacerbations pose a significant risk to children's health.
- Effective asthma control is crucial for reducing severe events.
- Identifying children at high risk for exacerbations remains a challenge.
Purpose of the Study:
- Critically review recent literature on predicting childhood asthma exacerbations.
- Provide recommendations for future research in this area.
Main Methods:
- Systematic literature review of recent publications.
- Analysis of current predictive tools and biomarkers.
- Assessment of factors influencing asthma exacerbations.
Main Results:
- Optimal asthma treatment is key to reducing severe exacerbations.
- Children with prior exacerbations are at highest subsequent risk.
- Existing predictive tools and biomarkers require further validation and show only partial success.
Conclusions:
- Progress has been made, but predicting asthma exacerbations needs improvement.
- Future studies must differentiate exacerbations based on asthma control.
- Understanding complex genetic, environmental, and lifestyle interactions is vital for accurate prediction.
Purpose Of Review:
This review critically assesses recently published literature on predicting asthma exacerbations in children, while also providing general recommendations for future research in this field.
Recent Findings:
Current evidence suggests that every effort should be made to provide optimal treatment to achieve adequate asthma control, as this will significantly reduce the risk of severe disease exacerbations. Children who have had at least one asthma exacerbation in the previous year are at highest risk for subsequent exacerbations, regardless of disease severity and/or control. Although several tools and biomarkers to predict asthma exacerbations have been recently developed, these approaches need further validation and/or have only had partial success in identifying children at risk.
Summary:
Although considerable progress has been made, much remains to be done. Future studies should clearly differentiate severe asthma exacerbations due to inadequate asthma control from those occurring in children whose asthma is well controlled, utilize standardized definitions of asthma exacerbations, and use a systematic approach to identify the best predictors after accounting for the multiple dimensions of the problem. Our ability to correctly predict the development of severe asthma exacerbations in an individual child should improve in parallel with increased knowledge and/or understanding of the complex interactions among genetic, environmental (e.g. viral infections) and lifestyle (e.g. adherence to treatment) factors underlying these events.
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Critical processes in asthma pathophysiology include:
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