Childhood Asthma by Stanley J Szefler, Soren Pedersen

By Stanley J Szefler, Soren Pedersen

This reference collects the most recent reviews at the improvement, prognosis, and remedy of youth bronchial asthma and provides present views on new applied sciences that might form the administration of pediatric bronchial asthma within the approaching decade-illustrating how advances in pulmonary functionality size, inflammatory markers, imaging, and pharmacogenetics will increase the analysis and tracking of bronchial asthma in years yet to come.

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II. Working Definitions of Asthma Prior to determining the prevalence of pediatric asthma it is important to establish a working definition of asthma in children. Two longitudinal studies provide complementary data to begin this process. The Tucson Children’s Respiratory Study (TCRS) offers an initial classification system for childhood asthma (6). It describes three distinct phenotypes of wheezing illnesses based on duration of symptoms and atopic status: transient wheeze, nonatopic wheeze, and persistent wheeze.

More recently, it has been proposed that environmental changes may be in some way affecting regulatory systems such that they inadequately prevent over-expression of inappropriate Th-1 and Th-2 responses in predisposed individuals (Fig. 1) (16). This new model may also explain the otherwise paradoxical observation that ‘‘Th-1 diseases’’ (such as type 1 Figure 1 Cells involved in immune regulation. Regulation of Immune Functions and Risk for Allergy and Asthma 19 diabetes, Crohn’s disease, and multiple sclerosis) have also increased during the same period of the ‘‘Th-2 allergy epidemic’’ (17).

606 III. New Bronchodilators . . 607 IV. Mediator Antagonists . . 611 V. Cytokine Inhibitors . . 615 VI. Anti-inflammatory Cytokines . . 618 VII. Chemokine Inhibitors . . 620 VIII. New Corticosteroids . . 622 IX. Phosphodiesterase-4 Inhibitors . . 623 X. Transcription Factor Inhibitors . . 625 XI. Kinase Inhibitors . . 626 XII. Immunomodulators . . 627 XIII. Cell Adhesion Blockers . . 628 XIV. Anti-allergic Drugs . . 629 XV. Preventive Therapies . . 632 XVI. Gene Therapy .

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