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Published on: November 4, 2010
Asthma in childhood
Fernando Maria de Benedictis1, Marina Attanasi2
1Dept of Pediatrics, Salesi Children's Hospital, Ancona, Italy pediatria@fmdebenedictis.it.
Insights
The number of early-life respiratory infections, not the specific virus, predicts childhood asthma. Biomarkers like exhaled compounds aid early asthma detection and prediction in wheezy children.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Allergy & Immunology
Background:
- Childhood asthma remains a significant health concern with complex etiological factors.
- Identifying predictors for asthma development and exacerbation is crucial for effective prevention strategies.
- Current diagnostic and monitoring tools for pediatric asthma require refinement.
Purpose of the Study:
- To review recent advancements in understanding childhood asthma presented at the 2015 European Respiratory Society International Congress.
- To explore novel biomarkers and risk factors associated with asthma development, exacerbation, and treatment response in children.
- To highlight the importance of personalized monitoring and cautious use of interventions in pediatric asthma management.
Main Methods:
- Review of presentations from the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress.
- Analysis of data linking early-life respiratory infections to later asthma development.
- Evaluation of exhaled volatile organic compounds and gene expression as potential asthma biomarkers.
- Discussion of factors influencing asthma exacerbations and bronchodilator response in children.
Main Results:
- The frequency of respiratory episodes in early life, rather than the specific viral trigger, is associated with subsequent asthma development.
- Exhaled volatile organic compounds, combined with inflammation gene expression, significantly improve asthma prediction in preschool children.
- Personal communication is emphasized as more critical than monitoring tools for children and adolescents with asthma.
- Systemic corticosteroids do not alter the long-term prognosis of a first viral-induced wheezing episode and require cautious use.
- Stress and specific gene polymorphisms are linked to diminished bronchodilator response in pediatric asthma patients.
Conclusions:
- Asthma development is influenced by the burden of early respiratory infections.
- Novel biomarkers like exhaled volatile organic compounds show promise for early asthma detection and prediction.
- Personalized monitoring and careful consideration of exacerbating factors, including stress and genetics, are essential for managing childhood asthma effectively.
Abstract:
Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events. Recent data suggest the possibility that exhaled volatile organic compounds may qualify as biomarkers in detecting early signs of asthma. Adding information of exhaled volatile organic compounds and expression of inflammation genes to a clinical tool significantly improves asthma prediction in preschool wheezy children. Personal communication with children and adolescents is likely more important than the tools actually used for monitoring asthma. Systemic corticosteroids do not affect the long-term prognosis in children with first viral-induced wheezing episode and should be used cautiously during acute episodes. Finally, stress and a polymorphism upstream of a specific gene are both associated with reduced bronchodilator response in children with asthma.
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