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Asthma Management in Children
Cassie L Shipp1, Peter J Gergen2, James E Gern3
1Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Insights
Childhood asthma is a complex respiratory disease influenced by prenatal and postnatal factors. Management involves medication, treating comorbidities, and patient education, with social determinants impacting outcomes.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Public Health
Background:
- Asthma is a common, heterogeneous childhood respiratory disease.
- Phenotypic variations impact comorbidities and treatment in pediatric asthma.
- Prenatal and postnatal microbial exposures are linked to asthma risk.
Purpose of the Study:
- To review the multifaceted nature of childhood asthma.
- To discuss the impact of phenotypic differences on management.
- To highlight key areas of asthma care in children.
Main Methods:
- Literature review of asthma pathophysiology and management in children.
- Analysis of factors influencing asthma risk and progression.
- Synthesis of current treatment guidelines and emerging research.
Main Results:
- Childhood asthma presents with diverse phenotypes affecting management.
- Maternal diet, microbiome, and early-life microbial exposures are critical risk factors.
- Effective asthma management requires pharmacologic treatment, comorbidity management, and education.
Conclusions:
- Understanding asthma heterogeneity is crucial for personalized pediatric care.
- Addressing prenatal and postnatal environmental factors may mitigate asthma development.
- Integrated management strategies, including social determinants of health, optimize treatment response.
Abstract:
Asthma is a common, complex heterogeneous disease often beginning in early life and is characterized by reversible airflow obstruction. The phenotypic differences that exist in children with asthma may impact underlying comorbid conditions and pharmacologic treatment choices. Prenatal factors for increased risk of asthma could include maternal diet and the maternal microbiome. Evidence also suggests that postnatal microbial exposures and colonization contribute to the risk of allergic diseases and asthma. After confirming the diagnosis, asthma management in children centers on 3 broad areas: pharmacologic treatment, treatment of underlying comorbidities, and education of the patient and caregivers on the importance of adherence and device technique. Moreover, social determinants of health significantly impact on symptom burden and treatment response.
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