Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; Pediatric Asthma Research Program, Section of Pediatric Pulmonary Medicine, Breathing Institute, Department of Pediatrics, Children's Hospital Colorado, and the Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
J Allergy Clin Immunol. 2015 Oct;136(4):848-59. doi: 10.1016/j.jaci.2015.07.007. Epub 2015 Aug 28.
Symptomatic asthma in childhood has lifelong effects on lung function and disease severity, emphasizing the need for improved pediatric asthma control. Control of pediatric risk and impairment domains can be achieved through increased medication adherence or new therapeutic strategies. Developing electronic monitoring device technology with reminders might be a key noninvasive resource to address poor adherence in children and adolescents in a clinical setting. In patients who have persistently poor control despite optimal medication compliance, newly emerging pharmaceuticals, including inhaled therapies and biologics, might be key to their treatment. However, barriers exist to their development in the pediatric population, and insights must be drawn from adult studies, which has its own unique limitations. Biomarkers to direct the use of such potentially expensive therapies to those patients most likely to benefit are imperative. In this review the current literature regarding strategies to improve pediatric asthma control is addressed with the goal of exploring the potential and pitfalls of strategies that might be available in the near future.
儿童哮喘的症状会对肺功能和疾病严重程度产生终身影响，这强调了需要改善儿科哮喘的控制。通过提高药物依从性或新的治疗策略，可以实现儿科风险和损伤领域的控制。开发带有提醒功能的电子监测设备技术可能是解决临床环境中儿童和青少年药物依从性差的关键非侵入性资源。对于尽管药物依从性最佳但仍持续控制不佳的患者，包括吸入疗法和生物制剂在内的新出现的药物可能是其治疗的关键。然而，儿科人群的发展存在障碍，必须从成人研究中吸取经验，而成人研究本身也有其独特的局限性。生物标志物对于指导此类潜在昂贵疗法的使用非常重要，应将其用于最有可能受益的患者。在这篇综述中，讨论了改善儿科哮喘控制的现有策略，目的是探索未来可能出现的策略的潜力和陷阱。
