Related Experiment Video

Updated: May 16, 2026

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
14:39

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

The dark side of the moon: severe therapy-resistant asthma in children

F M de Benedictis1, I Carloni, A Bush

  • 1Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy. debenedictis@ospedaliriuniti.marche.it

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|December 1, 2012
PubMed

Insights

Problematic severe asthma in children requires systematic assessment to identify "difficult-to-treat" cases. Addressing underlying issues can improve outcomes, but "severe therapy-resistant" asthma needs specialized, evidence-based interventions.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Clinical Therapeutics

Background:

  • Problematic severe asthma affects children unresponsive to standard high-dose inhaled corticosteroids and controllers.
  • Over half of these children have "difficult-to-treat asthma" that may improve with optimized basic management.
  • "Severe therapy-resistant asthma" requires individualized plans after thorough investigation due to persistent uncontrolled symptoms.

Purpose of the Study:

  • To outline a systematic protocol for assessing children with problematic severe asthma.
  • To differentiate between "difficult-to-treat" and "severe therapy-resistant" asthma.
  • To review current therapeutic options and highlight evidence gaps for severe pediatric asthma.

Main Methods:

  • Systematic assessment protocol including diagnosis confirmation, comorbidity evaluation, and adherence review.
  • Categorization of children into "difficult-to-treat" or "severe therapy-resistant" asthma groups.
  • Review of existing and off-label therapeutic options for severe pediatric asthma.

Main Results:

  • Optimizing basic management improves outcomes in over 50% of "difficult-to-treat" asthma cases.
  • "Severe therapy-resistant" asthma necessitates detailed, often invasive, investigations for individualized treatment planning.
  • Most therapeutic options for severe pediatric asthma are unlicensed, with limited high-quality evidence.

Conclusions:

  • Systematic evaluation is crucial for managing problematic severe asthma in children.
  • Further international collaboration and standardized protocols are needed to understand severe therapy-resistant asthma mechanisms.
  • Developing evidence-based treatments for severe pediatric asthma remains a critical unmet need.

Related Concept Videos

Asthma-III: Symptoms and Complications01:24

Asthma-III: Symptoms and Complications

Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Asthma: Pathogenesis and Management01:20

Asthma: Pathogenesis and Management

Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma III: Clinical Manifestations01:13

Asthma III: Clinical Manifestations

Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
Asthma-II: Pathophysiology and Classification01:26

Asthma-II: Pathophysiology and Classification

Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma-IV: Nursing Management01:30

Asthma-IV: Nursing Management

The nursing management of asthma is a comprehensive approach that relies heavily on the expertise and dedication of healthcare professionals. It involves thorough assessment, accurate diagnosis, strategic planning, effective implementation, and diligent evaluation. By meticulously following this step-by-step process, healthcare professionals play a crucial role in providing the best possible care and treatment for patients with asthma, enhancing their overall health and well-being.
First, in...
Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs01:25

Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs

Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...