Abstract
Currently, asthma represents the most common chronic disorder in children, showing an increasingly consistent burden worldwide. Childhood asthma, similar to what happens in adults, is a diversified disease with a great variability of phenotypes, according to genetic predisposition of patients, age, severity of symptoms, grading of risk, and comorbidities, and cannot be considered a singular well-defined disorder, but rather a uniquely assorted disorder with variable presentations throughout childhood. Despite several developments occurring in recent years in pediatric asthma, above all, in the management of the disease, some essential areas, such as the improvement of pediatric asthma outcomes, remain a hot topic. Most treatments of the type 2 (T2) target phenotype of asthma, in which IL-4, IL-5, and IL-13 modulate the central signals of inflammatory reactions. Although, there may be an unresolved need to identify new biomarkers used as predictors to improve patient stratification using disease systems and to aid in the selection of treatments. Moreover, we are globally facing many dramatic challenges, including climate change and the SARS-CoV2 pandemic, which have a considerable impact on children and adolescent asthma. Preventive strategies, including allergen immunotherapy and microbiome evaluation, and targeted therapeutic strategies are strongly needed in this population. Finally, the impact of asthma on sleep disorders has been reviewed.
Highlights
Overview on Pediatric AsthmaAsthma represents a very common condition in childhood and adolescence
Biomarkers to identify the right patient and related therapy for both screening and followup have not been identified in normal clinical practice, and this is the main unmet need for precision medicine in the coming years [2]
Stratification of patient type and corresponding drug of choice is currently limited to the use of blood eosinophil counts or sputum, fractionated exhaled nitric oxide (FENO) or blood protein markers such as total immunoglobulin E (IgE) or periostin, which do not provide sensitive and specific data
Summary
Asthma represents a very common condition in childhood and adolescence. The importance of biomarkers related to the inflammatory status of the airways represents a hot topic of research in both adults and children. Biomarkers to identify the right patient and related therapy for both screening and followup have not been identified in normal clinical practice, and this is the main unmet need for precision medicine in the coming years [2]. In recent years, research has begun to focus on the pediatric population, on phenotyping, and on clustering groups of patients on the basis of different clinical characteristics and inflammatory phenotypes. Asthma in adolescents and children is statistically correlated with the need for specialist visits and as a cause of hospitalizations and access to the emergency room (ED). There were no major specific correlates between disease and severity
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