Issues and unmet needs in pediatric asthma

P J Helms

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Asthma is common and becoming more so in childhood. Although mild asthma may incur low average annual costs per child, these estimates need to be viewed in the context of the very large numbers of affected individuals. Whereas asthma and wheezing illness in childhood had in the past been broadly subdivided into asthma (often associated with atopy) and wheezy bronchitis (wheeze only, with associated upper respiratory tract infection), this distinction was lost during the 1970s in view of the demonstrated underdiagnosis and undertreatment of symptomatic school-age children. The acceptance of asthma as a chronic inflammatory disease and evidence for airway remodeling and progressive deterioration in airway function in association with symptoms and atopy have led to earlier use of topical steroids at higher starting doses delivered by improved age-appropriate devices. Treating all children as if they were destined to become atopic asthmatics and at risk of airway remodeling may not be rational, particularly in those whose symptoms will subsequently resolve. However, there are as yet no screening tests which can clearly identify individuals at risk of long-term chronic airway inflammation and airway remodeling. The large number of infants and young children with current symptoms suggestive of asthma and in whom resolution is likely in the majority poses problems for the clinician in deciding the best initial therapy. There is an urgent need to develop simple and reliable measures that can identify the early manifestations of atopic airway sensitisation and to establish the place of early intervention with nonsteroidal drugs, including leukotriene antigonists. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish
Pages (from-to)159-165
Number of pages7
JournalPediatric Pulmonology - Supplement
Volume30
Publication statusPublished - 2000

Keywords

  • asthma
  • children
  • epidemiology
  • therapy
  • identification
  • leukotriene antagonists
  • montelukast
  • INHALED BECLOMETHASONE DIPROPIONATE
  • BRONCHOALVEOLAR LAVAGE FLUID
  • SHORT-TERM GROWTH
  • CHILDHOOD ASTHMA
  • RESPIRATORY SYMPTOMS
  • PULMONARY-FUNCTION
  • WHEEZY BRONCHITIS
  • ABERDEEN SCHOOLCHILDREN
  • AIRWAYS INFLAMMATION
  • NATURAL-HISTORY

Cite this

Issues and unmet needs in pediatric asthma. / Helms, P J .

In: Pediatric Pulmonology - Supplement, Vol. 30, 2000, p. 159-165.

Research output: Contribution to journalArticle

Helms, P J . / Issues and unmet needs in pediatric asthma. In: Pediatric Pulmonology - Supplement. 2000 ; Vol. 30. pp. 159-165.
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