Editorial: Difficult and Severe Asthma in Children

Frontiers in Pediatrics

article

Andrew Bush¹  Renato Cutrera⁴  Giorgio Piacentini⁵  Francesca Santamaria⁶  Nicola Ullmann⁴ 

[1] Professor of Paediatrics and Head of Section (Paediatrics), Imperial College London, United Kingdom;National Heart and Lung Institute, United Kingdom;Royal Brompton Harefield NHS Foundation Trust, United Kingdom;Pediatric Pulmonology and Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital;Professor of Paediatrics and Head of Paediatric Section AOUI Verona, University of Verona;Department of Translational Medical Sciences, Federico II University

关键词: allergy;    atopy;    endotype;    phenotype;    eosinphil;    airway inflammation;    airway obstruction;   

DOI  :  10.3389/fped.2019.00205

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The global burden of asthme and its treatment is huge (1), and is reviewed by Ferrante and La Grutta. Part of the problem requires a political solution; in large parts of the world, children do not have access to basic asthma treatments (2) [and shamefully, this is not just a low and middle income setting problem; children in the so-called developed world die of asthma because their parents cannot afford to pay for treatment (3), and there is no uniform health coverage]. Of course, asthma is an umbrella term covering a multiplicity of airways diseases in children (4, 5), many of which differ from adult disease (6, 7). Oksel et al. cover the topic of phenotype discovery and its clinical relevance. They explore the complimentary approaches of unsupervised discovery and investigator-imposed approaches. They stress the need for cross-disciplinary approaches if we are to maximize the opportunities offered by big data. Licari et al. also underline the heterogeneity of the disease and highlight the difficulties of measuring control and risk, especially in severe asthma. Importantly, their focus is on factors which can be modified (8). There can be few greater challenges than the child with asthma who does not respond to treatment as anticipated, and this is the main theme of this Topic. The human misery of chronic symptoms and the ever-present risks of acute attacks including death1 , impaired lung growth with the likely consequence of chronic obstructive pumonary disease (9), and side-effects of medications, especially systemic corticosteroids, are a huge burden to a thankfully small, but certainly significant, group of children.

【 授权许可】

CC BY