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Precision medicine in childhood asthma
Elise M Slob1,2, Anke-Hilse Maitland-Van der Zee1,2, Gerard H Koppelman3,4
1Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam.
Current Opinion in Allergy and Clinical Immunology
|January 17, 2019
Summary
Precision medicine offers a tailored approach to childhood asthma management. Current strategies use clinical factors and biomarkers, with genomics and pharmacogenomics showing future potential for personalized asthma care.
Area of Science:
- Pediatric Pulmonology
- Precision Medicine
- Asthma Research
Background:
- Childhood asthma is a complex, heterogeneous condition often leading to uncontrolled disease.
- An individualized treatment approach is crucial for improving asthma outcomes in children.
- Current treatment selection based solely on clinical characteristics remains challenging.
Purpose of the Study:
- To review the role of precision medicine in managing childhood asthma.
- To explore the application of clinical characteristics, biomarkers, genomics, and pharmacogenomics for personalized asthma care.
- To identify strategies for achieving asthma control and reducing risks with minimized side effects in children.
Main Methods:
- Review of current clinical characteristics and biomarkers (eosinophils, IgE, FeNO) for asthma management.
- Evaluation of novel monoclonal antibodies for severe, eosinophilic asthma.
- Analysis of pharmacogenetic studies identifying risks associated with inhaled corticosteroids.
Main Results:
- Monoclonal antibodies demonstrate efficacy in severe, eosinophilic asthma.
- Reduced lung function growth and early decline are common in persistent childhood asthma.
- Pharmacogenetic studies highlight risks of cortisol suppression with inhaled corticosteroids.
Conclusions:
- Clinical characteristics and basic biomarkers can guide a foundational precision medicine approach.
- Inhaled corticosteroids and biologics (omalizumab, mepolizumab) can be targeted using current precision methods.
- Further research into pharmacogenomics and breathomics is needed for advanced precision medicine applications in pediatric asthma.
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