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.

Insights

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.
Abstract

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