Stone Kelly D
Children's Hospital Boston, Department of Pediatrics, Harvard Medical School, Massachusetts, USA.
Curr Opin Pediatr. 2003 Oct;15(5):495-511. doi: 10.1097/00008480-200310000-00009.
The incidence of atopic diseases, including atopic dermatitis, allergic rhinitis, and asthma, has increased in developed countries over the past several decades. These diseases comprise a large component of general pediatric practice. This review will highlight some of the recent advances in understanding the pathogenesis and natural history of these diseases, as well as the current approaches to the treatment of children with atopic diseases.
Recent studies have identified multiple risk factors for the development and progression of atopic diseases. As a result, much research is focused on identifying therapies that can be initiated at a young age to prevent disease progression. New treatment options have become available in recent years, such as topical immunomodulators for atopic dermatitis, leukotriene antagonists for seasonal allergic rhinitis, and alpha-immunoglobulin E therapy for asthma. The importance of viewing allergic rhinitis and asthma as disorders of a single airway has been emphasized. Finally, an update on the national asthma guidelines was recently released in an effort to promote optimal asthma care.
This review summarizes many of the recent advances in the diagnosis and treatment of atopic diseases in children. Although not intended to be a comprehensive review of this broad field, it provides a framework for appreciating the complexity of these diseases and for effectively managing them.
在过去几十年中，包括特应性皮炎、过敏性鼻炎和哮喘在内的特应性疾病在发达国家的发病率有所上升。这些疾病在普通儿科诊疗中占很大比重。本综述将重点介绍在理解这些疾病的发病机制和自然史方面的一些最新进展，以及目前治疗儿童特应性疾病的方法。
最近的研究已经确定了特应性疾病发生和发展的多种风险因素。因此，许多研究集中在确定可以在幼年时开始使用的预防疾病进展的疗法。近年来出现了新的治疗选择，如用于特应性皮炎的局部免疫调节剂、用于季节性过敏性鼻炎的白三烯拮抗剂以及用于哮喘的α-免疫球蛋白E疗法。已经强调了将过敏性鼻炎和哮喘视为单一气道疾病的重要性。最后，最近发布了国家哮喘指南的更新版，以促进最佳哮喘护理。
本综述总结了儿童特应性疾病诊断和治疗方面的许多最新进展。虽然并非旨在对这个广泛领域进行全面综述，但它提供了一个框架，以认识这些疾病的复杂性并有效管理它们。
