Department of Paediatrics/ Paediatric Respiratory Medicine, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
The Breathing Institute / Pulmonary Medicine, Department of Pediatrics, Children's Hospital Colorado; University of Colorado Denver School of Medicine, Aurora (CO), USA.
Paediatr Respir Rev. 2015 Mar;16(2):101-7. doi: 10.1016/j.prrv.2014.10.003. Epub 2014 Nov 8.
Personalized medicine for children with asthma aims to provide a tailored management of asthma, which leads to faster and better asthma control, has less adverse events and may be cost saving. Several patient characteristics, lung function parameters and biomarkers have been shown useful in predicting treatment response or predicting successful reduction of asthma medication. As treatment response to the main asthma therapies is partly genetically determined, pharmacogenetics may open the way for personalized medicine in children with asthma. However, the number of genes identified for the various asthma drug response phenotypes remains small and randomized controlled trials are lacking. Biomarkers in exhaled breath or breath condensate remain promising but did not find their way from bench to bedside yet, except for the fraction of exhaled nitric oxide. E-health will most likely find its way to clinical practice and most interventions are at least non-inferior to usual care. More studies are needed on which interventions will benefit most individual children.
儿童哮喘的个体化医学旨在提供哮喘的个体化管理，从而更快更好地控制哮喘，减少不良事件，并可能节省成本。已经有几项患者特征、肺功能参数和生物标志物被证明有助于预测治疗反应或预测成功减少哮喘药物治疗。由于对主要哮喘治疗方法的治疗反应在一定程度上是由遗传决定的，因此药物遗传学可能为哮喘儿童的个体化医学开辟道路。然而，确定各种哮喘药物反应表型的基因数量仍然很少，并且缺乏随机对照试验。呼气或呼出气冷凝物中的生物标志物仍然很有前途，但除了呼气一氧化氮的分数外，它们还没有从实验室走向临床。电子健康很可能会找到进入临床实践的途径，而且大多数干预措施至少与常规护理一样有效。需要更多的研究来确定哪些干预措施对大多数个体儿童最有益。
