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Biomarkers in inflammometry pediatric asthma: utility in daily clinical practice
Silvia Sánchez-García1, Alicia Habernau Mena2, Santiago Quirce3
1Allergy Section, Hospital Infantil Universitario Niño Jesús and Health Research Institute La Princesa, Madrid, Spain.
Insights
Accurate childhood asthma diagnosis is crucial. Combining serum total IgE, blood eosinophilia, and fractional exhaled nitric oxide (FeNO) levels improves diagnosis, phenotyping, and management for better adult asthma outcomes.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Asthma is a prevalent chronic respiratory disease affecting children globally.
- Early and accurate diagnosis, treatment, and follow-up in childhood are vital for managing adult asthma and preventing undertreatment or overtreatment.
Purpose of the Study:
- To evaluate the utility of Th2 inflammatory markers in diagnosing and managing childhood asthma.
- To assess the combined diagnostic and prognostic value of serum total IgE, blood eosinophilia, and fractional exhaled nitric oxide (FeNO) levels.
Main Methods:
- Assessment of Th2 inflammation using serum total IgE and blood eosinophilia.
- Measurement of fractional exhaled nitric oxide (FeNO) levels.
- Evaluation of marker combinations for diagnostic accuracy and treatment monitoring in pediatric asthma patients.
Main Results:
- Serum total IgE, blood eosinophilia, and FeNO levels can predict asthma, especially in young children unable to perform lung function tests.
- FeNO measurements can help monitor treatment adherence.
- An isolated marker measurement is insufficient; combining these markers enhances diagnostic capability.
Conclusions:
- The combination of serum total IgE, blood eosinophilia, and FeNO offers improved diagnosis, phenotyping, and follow-up for children with asthma.
- This multi-marker approach is essential for optimizing the care of pediatric asthma patients.
- Utilizing these markers aids in understanding the transition from childhood to adult asthma.
Abstract:
Asthma is a common disease in both high and lower income countries that starts early and persists often for life. A correct and accurate diagnosis, treatment and follow-up during childhood are essential for a better understanding of adult asthma and avoiding over- or under-treatment. Th2 inflammation in children with asthma symptoms is usually assessed by measuring with serum total IgE, blood eosinophilia and FeNO levels that may help to predict asthma, particularly in those infants and young children in whom lung function tests are difficult to perform. FeNO measurement, compared to intra-individual levels, may be useful also for ascertaining treatment adherence. Nevertheless, an isolated measurement may be insufficient and only the combination of these markers improves the diagnosis, phenotyping and follow-up of an asthmatic child.
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