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Severe acute asthma at the pediatric intensive care unit: can we link the clinical phenotypes to immunological

Sarah van den Berg1,2, Simone Hashimoto1,2, Korneliusz Golebski1

  • 1Department of Respiratory Medicine, Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Expert Review of Respiratory Medicine
|October 28, 2021
PubMed

Insights

Severe acute asthma in children presents diverse symptoms, yet treatments remain uniform. Understanding patient characteristics and biomarkers is key to developing personalized medicine approaches for pediatric asthma care.

Area of Science:

  • Pediatric intensive care
  • Pulmonology
  • Immunology

Background:

  • Severe acute asthma in children admitted to the pediatric intensive care unit (PICU) exhibits significant clinical heterogeneity.
  • Current treatment strategies for severe pediatric asthma follow a generalized, 'one-size-fits-all' model.

Purpose of the Study:

  • To comprehensively describe the clinical features of pediatric patients with severe acute asthma in the PICU.
  • To identify relevant immunological biomarkers for severe pediatric asthma.
  • To lay the groundwork for precision medicine in treating severe pediatric asthma.

Main Methods:

  • A systematic literature search was conducted using PubMed.
  • The search focused on studies concerning severe acute asthma in pediatric populations.

Main Results:

  • Severe acute asthma in the PICU is characterized by heterogeneous clinical presentations.
  • Immunological biomarkers and omics technologies offer potential for personalized treatment strategies.
  • Identifying distinct inflammatory phenotypes can inform treatment decisions for corticosteroids and beta-agonists.

Conclusions:

  • Precision medicine approaches are needed to address the heterogeneity of severe pediatric asthma.
  • Further research utilizing omics technologies is crucial for understanding disease mechanisms.
  • Clinical trials incorporating biologics are a necessary next step for advancing treatment.
Abstract

Keywords:
PICUSevere asthmabiologicsbiomarkerschildrenendotypeexacerbationsintensive careprecision medicinetreatable traits

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