Pediatric Asthma: An Approach to Pharmacogenetics Analysis

Abstract

Numerous studies have clearly demonstrated that inhaled glucocorticoids alleviate clinical symptoms, improve pulmonary function, and reduce airway inflammation; there is some evidence that they may alter disease progression. Current guidelines identify inhaled glucocorticoids as the “preferred” long-term controller asthma medication, especially for moderate and severe persistent asthma. 1 Global Initiative for Asthma Global strategy for asthma management and prevention: NHLBI/NIH workshop report. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD1995 Google Scholar 2 National Asthma Education and Prevention Program Expert panel report 2: Guidelines for the diagnosis and management of asthma. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD1997 Google Scholar Clinical observations suggest that the response to inhaled glucocorticoids is highly dependent on the time of intervention: the earlier used, the more efficacious 3 Agertoft L Pedersen S Effects of long term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir Med. 1994; 88: 373-381 Abstract Full Text PDF PubMed Scopus (704) Google Scholar ; however, it is also clear that the response to inhaled glucocorticoids can vary among patients with some patients being considered “steroid resistant.” 4 Leung DYM Spahn JD Szefler SJ Steroid-resistant asthma: new insights and implications for management. in: Szefler SJ Leung DYM Severe asthma: a multidisciplinary approach. 2nd ed. Marcel Dekker, New York, NY2001: 597-619 Google Scholar