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Asthma in inner city children: recent insights: United States
Cullen M Dutmer1, Haejin Kim2, Daniel A Searing1
1Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado.
Insights
Recent research highlights severe asthma phenotypes in inner-city children. Understanding environmental triggers and school-based interventions can improve asthma management and reduce disparities for these children.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Public Health
Background:
- Inner-city children face disproportionately high asthma burdens, including severity and exacerbations.
- Asthma disparities in these populations necessitate targeted research for effective interventions.
Purpose of the Study:
- To review recent advances in understanding asthma in US inner-city children.
- To identify factors influencing asthma prevalence, severity, and exacerbations.
- To inform interventions aimed at reducing asthma disparities.
Main Methods:
- Review of studies published in late 2016-2017 focusing on asthma in US inner-city children.
- Analysis of research on asthma phenotypes, environmental determinants, and school-based factors.
- Evaluation of new indices for asthma severity and exacerbation prediction.
Main Results:
- Identification of severe, difficult-to-control asthma phenotypes in this population.
- Elucidation of environmental factors (e.g., rhinovirus, allergens, nitrogen dioxide) and mechanisms contributing to exacerbations.
- Emphasis on schools as sites for exposure and potential for improved asthma care.
- Development and validation of tools for assessing asthma severity and predicting exacerbations.
Conclusions:
- Recent findings offer actionable insights for improving asthma care and outcomes.
- Interventions targeting environmental exposures and school environments can mitigate asthma disparities.
- Enhanced understanding of asthma phenotypes and predictive indices can personalize treatment.
Purpose Of Review:
Children living in US inner cities experience disparate burdens of asthma, especially in severity, impairment, exacerbations, and morbidity. Investigations seeking to better understand the factors and mechanisms underlying asthma prevalence, severity, and exacerbation in children living in these communities can lead to interventions that can narrow asthma disparities and potentially benefit all children with asthma. This update will focus on recent (i.e. late 2016-2017) advances in the understanding of asthma in US inner city children.
Recent Findings:
Studies published in the past year expand understanding of asthma prevalence, severity, exacerbation, and the outcomes of guidelines-based management of these at-risk children, including: asthma phenotypes in US inner city children that are severe and difficult-to-control; key environmental determinants and mechanisms underlying asthma severity and exacerbations (e.g. allergy-mediated exacerbation susceptibility to rhinovirus); the importance of schools as a place for provocative exposures (e.g. mouse allergen, nitrogen dioxide) as well as a place where asthma care and outcomes can be improved; and the development and validation of clinically useful indices for gauging asthma severity and predicting exacerbations.
Summary:
These recent studies provide a trove of actionable findings that can improve asthma care and outcomes for these at-risk children.
Related Concept Videos
01:29Asthma-I: Introduction
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
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.
01:26Asthma-II: Pathophysiology and Classification
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:
03:38Measurement: Standard Units