Feleszko, Wojciecha,∗; Jartti, Tuomasb,c,d,∗; Bacharier, Leonard B.e. Current strategies for phenotyping and managing asthma in preschool children. Current Opinion in Allergy and Clinical Immunology 22(2):p 107-114, April 2022. | DOI: 10.1097/ACI.0000000000000819
Current strategies for phenotyping and managing asthma in preschool children
|Author:||Feleszko, Wojciech1; Jartti, Tuomas2,3,4; Bacharier, Leonard B.5|
1Department of Pediatric Pneumonology and Allergy, The Medical University of Warsaw, Warsaw, Poland
2Department of Pediatrics, Turku University Hospital and University of Turku, Turku
3Department of Pediatrics, Oulu University Hospital and the University of Oulu
4Research Unit, Medical Research Center, University of Oulu, Oulu, Finland
5Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee, USA
|Online Access:||PDF Full Text (PDF, 0.4 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2023030830610
|Publish Date:|| 2023-03-08
Purpose of review: Half of all children will experience an episode of wheezing by 6 years. Recurrent preschool wheezing is associated with early lung function loss and has a lifelong impact on airway health, so deciding which children should be treated to prevent exacerbations while also avoiding irreversible health consequences is crucial. The purpose of this review is to provide a practical approach to the pediatric patient under 5 years of age with asthma, with particular attention to the recent enhanced identification of wheeze phenotypes.
Recent findings: Here, we note the difficulty of defining ‘asthma’ for this age group and advocate that it be determined by the set of respiratory symptoms presented, without assumptions about the underlying mechanisms of the disease. In addition, we propose a forward-looking approach, what treatment to apply to particular phenotypes, which child should be treated, and, if so, which treatment strategy to choose. No clear recommendation exists for the management of nonallergic preschool wheezing, a substantial clinical and research gap.
Summary : We recommend an empathetic approach to parent anxiety and considering objective markers: timing, severity, and frequency of symptoms, along with an assessment of other biomarkers, including viral etiology, aeroallergen sensitization, and blood eosinophils, that contribute to successful decision-making.
Current opinion in allergy and clinical immunology
|Pages:||107 - 114|
|Type of Publication:||
A2 Review article in a scientific journal
|Field of Science:||
3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
© 2022 Wolters Kluwer Health, Inc. This is a non-final version of an article published in final form in Feleszko, Wojciecha,∗; Jartti, Tuomasb,c,d,∗; Bacharier, Leonard B.e. Current strategies for phenotyping and managing asthma in preschool children. Current Opinion in Allergy and Clinical Immunology 22(2):p 107-114, April 2022. | DOI: 10.1097/ACI.0000000000000819.