Rancé F, Deschildre A, Bidat E, Just J, Couderc L, Wanin S, Weiss L
TSA 70034, Pôle Médicochirurgical de Pédiatrie, Hôpital des Enfants, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex, France.
Rev Mal Respir. 2010 Dec;27(10):1221-30. doi: 10.1016/j.rmr.2010.06.024. Epub 2010 Nov 13.
Asthma is a disease of the lung epithelial barrier, most often associated with allergy in children. Asthma and allergy are two distinct diseases, but the phenotypic expression of asthma depends on atopic status. A better definition of phenotypes of asthma would result in better targeting of prevention and treatment modalities. Secondary prevention aims to prevent the onset of asthma and the acquisition of new sensitizations in sensitized children. Studies concerning allergen avoidance are insufficient to reach a definitive conclusion and antihistamines have not been shown to be effective. The results for specific immunotherapy suggest a benefit to prevent transition from allergic rhinitis to asthma and the onset of new sensitizations. Tertiary prevention aims to reduce symptoms in children with an existing allergic asthma diagnosis. The avoidance of known respiratory allergens will only be effective in combination with management of the whole environment. Specific immunotherapy has a real place, in combination with background therapy. It should be used according to guidelines in appropriately treated patients.
哮喘是一种肺上皮屏障疾病，在儿童中最常与过敏相关。哮喘和过敏是两种不同的疾病，但哮喘的表型表达取决于特应性状态。对哮喘表型进行更好的定义将有助于更有针对性地采取预防和治疗措施。二级预防旨在预防致敏儿童哮喘的发作和新致敏原的产生。关于避免接触过敏原的研究不足以得出明确结论，且尚未证明抗组胺药有效。特异性免疫疗法的结果表明，它有助于预防从过敏性鼻炎转变为哮喘以及新致敏原的产生。三级预防旨在减轻已确诊为过敏性哮喘儿童的症状。避免接触已知的呼吸道过敏原只有在结合整个环境管理时才有效。特异性免疫疗法与基础治疗相结合具有重要作用。应根据指南在经过适当治疗的患者中使用。
