New possibilities for asthma therapy in children

A review of recent publications devoted to the study of risk factors for the onset of the disease, mechanisms, diagnosis and treatment of asthma from the point of view of molecular allergology is presented. New concepts and problems in the implementation of the exposome paradigm and its practical application are considered, including genetic and epigenetic factors, environmental impact. The most relevant experimental studies are noted that contribute to further understanding of molecular and immune mechanisms with potential new targets for the development of therapeutic agents. Reliable diagnosis of asthma, endotyping of the disease and monitoring of its severity are of great importance in the treatment of asthma. The heterogeneity of asthma is due to individual genetic and epigenetic variability, exposure to individual environmental factors (depending on regional characteristics, changing climatic conditions and population distribution), which explains the occurrence of asthma is not associated only with allergies. The modern assessment and treatment of comorbid/multimorbid asthma is described, including interaction with asthma phenotypes, which is important for the formation of a new therapeutic personalized approach to precision medicine and testing of prognostic biomarkers. The results of clinical trials, multicenter international studies on the use of new approaches in the diagnosis of asthma (candidate biomarkers) based on molecular allergology and treatment in adults and children using biological preparations are given.

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Therapy and control of bronchial asthma in children and adolescents

Суровенко

Глушкова

2020

Medicinskij sovet

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Up to 22% of the population in the world suffer from bronchial asthma according to the data from different regions and sources. This is about 358 million people. At the same time, accurate figures for the prevalence of this disease cannot be obtained. Despite the many ongoing studies of this disease, developed treatment options, asthma hasn’t become a fully controlled disease. The problem of control and treatment of the disease as well as patient compliance is of great concern to modern clinicians. Every year GINA releases new documents and makes changes in the treatment and diagnosis of this chronic bronchopulmonary disease. Children’s asthma has become not only the most common chronic disease, but also the most common cause of children hospitalization.This article provides an overview of the international randomized clinical trials results and expert opinions regarding the treatment of uncontrolled bronchial asthma in children and adolescents. The results of 2017–2020 meta-analyzes regarding the use of tiotropium in children and adolescents are described. The use of basic therapy schemes is disclosed, including the use of tiotropium bromide in accordance with the recommendations of the Russian Respiratory Society and GINA.The authors also presented a clinical case of difficultly controlled bronchial asthma in a child of 12 years old. The use of tiotropium bromide in this patient is described in detail and the effectiveness of this drug is demonstrated.

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New possibilities for asthma therapy in children

Cited by 4 publications

References 19 publications

Medical rehabilitation of children with bronchial asthma

Medical rehabilitation of children with bronchial asthma

Search for new therapeutic targets in asthma. Review.

Therapy and control of bronchial asthma in children and adolescents

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