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Published on: May 12, 2023
Immunomodulation in Pediatric Asthma
Amelia Licari1, Sara Manti2,3, Riccardo Castagnoli1
1Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Insights
Childhood asthma is a complex disease. This review explores new biologic therapies that target underlying inflammation, offering hope for severe cases unresponsive to standard inhaled corticosteroids (ICS).
Area of Science:
- Pediatric Pulmonology
- Immunology
- Pharmacology
Background:
- Childhood asthma is a heterogeneous respiratory disease with diverse immune mechanisms.
- Current management focuses on symptom control and risk reduction using inhaled corticosteroids (ICS) and controllers.
- Standard therapies are not disease-modifying and are often ineffective for severe, uncontrolled pediatric asthma.
Purpose of the Study:
- To review current and emerging therapeutic strategies for pediatric asthma.
- To focus on immunomodulatory treatments, particularly biologic therapies.
- To update knowledge on targeting specific inflammatory pathways in pediatric asthma.
Main Methods:
- Literature review of current and novel asthma treatments.
- Focus on immunomodulatory and biologic therapies.
- Analysis of therapeutic options for pediatric asthma management.
Main Results:
- Standard therapies like ICS offer symptom control but do not modify disease progression.
- Severe pediatric asthma often remains uncontrolled with current treatments.
- Biologic therapies represent a promising avenue for targeted immunomodulation.
Conclusions:
- Novel biologic therapies show potential for modifying pediatric asthma.
- Targeting specific inflammatory pathways is crucial for severe cases.
- Further research into immunomodulatory treatments is warranted for better asthma control.
Abstract:
Childhood asthma is actually defined as a heterogeneous disease, including different clinical variants and partially sharing similar immune mechanisms. Asthma management is mainly focused on maintaining the control of the disease and reducing the risk of adverse outcomes. Most children achieve good control with standard therapies, such as low doses of inhaled corticosteroids (ICS) and/or one or more controller. These medications are targeted to suppress bronchial inflammation and to restore airway responsiveness. However, they are not disease-modifying and do not specifically target inflammatory pathways of asthma; in addition, they are not significantly effective in patients with severe uncontrolled asthma. The aim of this review is to update knowledge on current and novel therapeutic options targeted to immunomodulate inflammatory pathways underlying pediatric asthma, with particular reference on biologic therapies.
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