Modern Technologies of Bronchial Asthma Control in Children (Review)

Abstract

Bronchial asthma ranks among the most common allergic diseases in children. It is chronic inflammatory disease of the respiratory tract, in which many cells of innate and adaptive immune system participate together with epithelial cells causing the main clinical syndromes typical for the disease. Currently, bronchial asthma therapy aims at obtaining the control over the symptoms and course of asthma by providing an anti-inflammatory baseline therapy using different groups of pharmaceuticals: inhaled glucocorticosteroids, leukotriene receptor antagonists, cromones, beta-2-agonists and long-acting theophyllines, systemic glucocorticosteroids and anti-IgE-therapy. However, despite a wide range of approaches to anti-inflammatory baseline therapy, it is still a problem to obtain the disease control in most patients indicating the necessity for searching new therapeutic approaches. In this regard, to optimize pathogenetic therapy of bronchial asthma, the work is being currently carried out to improve the existing anti-inflammatory drugs and their combinations. Moreover, there is a search for crucially new approaches to asthma treatment with due consideration of the disease phenotypes and endotypes including development and practical application of pharmaceutical drugs with anti-cytokine and anti-mediator effects. Probably, as far as the knowledge of molecular characteristics of asthma endotypes is being refined, and there being introduced the biomarkers enabling to diagnose asthma phenotypes and endotypes and monitor asthma control, there will be implemented an individual approach in individual therapy administration.

Real-life effectiveness and safety of the inhalation suspension budesonide comparator vs the originator product for the treatment of patients with asthma: a historical cohort study using a US health claims database

“…Budesonide is the only nonhalogenated inhaled glucocorticoid, and it has been used for asthma therapy for >35 years 5. Budesonide inhalation suspension, used for the management of persistent asthma and for the treatment of asthma exacerbations,6,7 has demonstrated efficacy and safety in multiple clinical trials 6,8–10.…”

Effect of Nasal Obstructive Disorders on Sinonasal Symptoms in Children with Different Levels of Bronchial Asthma Control

“…Treatment of asthma and related diseases of the upper respiratory tract was conducted by the existing consensus documents with current therapeutic strategies [ 1 , 8 , 34 ].…”

“…The basis for the asthma control management is anti-inflammatory basic therapy since the most significant component of the pathogenesis of the disease is chronic inflammation localized in the respiratory tract [ 7 ] and occurs in children patients by the Th2-dependent mechanism [ 1 , 7 ]. The treatment of asthma based on this approach demonstrated significant success [ 8 ]. However, modern studies demonstrate that despite the wide arsenal of pharmacological agents, the proportion of patients who do not have the proper control characteristics can reach 56% [ 8 , 9 ].…”

“…The treatment of asthma based on this approach demonstrated significant success [ 8 ]. However, modern studies demonstrate that despite the wide arsenal of pharmacological agents, the proportion of patients who do not have the proper control characteristics can reach 56% [ 8 , 9 ].…”

Metabolism of the Extracellular Matrix in Bronchial Asthma (Review)

“…The muscarinic effects on the ECM are expressed by enhancing the contractile potential of human BSM cells [104]. A few recent reports described the effects of the M-choline blocker tiotropium bromide, a prolonged action drug [105]. Tiotropium bromide inhibits the remodeling of the bronchial wall, mitigates the wall thickening, the mucous gland hypertrophy, and the smooth muscle hyper-reactivity, and also reduces the level of Th2 cytokines and pulmonary eosinophilia caused by an allergen [106].…”