Advances in the pathogenesis and personalised treatment of paediatric asthma

Area of Science:

• Pediatric Pulmonology
• Clinical Medicine
• Immunology

Background:

• Severe paediatric asthma presents diverse pathologies, rendering generalized treatment guidelines inadequate.
• The term "asthma" describes a clinical syndrome, necessitating accurate diagnosis and optimized basic management before personalized therapy.
• Current approaches are shifting from symptom patterns to identifying underlying phenotypes for targeted treatments.

Purpose of the Study:

• To highlight the inadequacy of uniform treatment approaches for paediatric asthma due to its diverse pathologies.
• To emphasize the importance of correct diagnosis and individualized management strategies for children with asthma.
• To discuss the evolving landscape of asthma treatment, including new options for specific phenotypes and the need for pediatric-focused research.

Main Methods:

• Review of current understanding of paediatric asthma heterogeneity.
• Analysis of emerging treatment options, including biologics for type 2 inflammation.
• Discussion on the transition from symptom-based to phenotype-based treatment strategies.

Main Results:

• Paediatric asthma is not a single entity; distinct pathologies necessitate tailored therapeutic interventions.
• New treatments, such as biologics targeting type 2 inflammation, are available for school-age asthma, but options for non-type 2 disease are limited.
• Short-acting beta2-agonists are being superseded by combination inhalers for managing underlying inflammation in mild asthma.

Conclusions:

• A personalized approach is essential for managing severe paediatric asthma, moving beyond generic guidelines.
• Accurate diagnosis and understanding of specific asthma phenotypes are critical for effective treatment selection in children.
• Increased inclusion of children in research is vital to advance asthma treatment and ensure they benefit from new therapeutic developments.