Pediatric and Neonatology Unit, Imola Hospital, Imola (BO), Italy.
General Medical Sciences and Services, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Curr Med Chem. 2018;25(16):1909-1919. doi: 10.2174/0929867324666170303162651.
Asthma represents a worldwide health problem with a strong morbidity and a major impact on the health care system. Multiple efforts have been made towards the development of new strategies for the prevention and treatment of this disorder. In the light of this the present review of the literature aimed at summarizing the latest advances in prevention and treatment of pediatric asthma with a focus on the most effective options of interventions during the first stages of life.
References were identified by searches of PubMed. Search terms used in the search were "pediatric asthma", "treatment" and "prevention". We included only meta-analysis, randomized controlled trials, reviews and systematic review articles pertaining to humans and subjects aged 0-18 years. All the interventions have been classified as "non-pharmacological" and "pharmacological".
Non-pharmacological interventions have been focused in identifying the genetic and environmental factors underlying the pathogenesis of this disease, including the individual genetic susceptibility, the early allergic sensitization, the role of the environmental microbiome and the exposure to infections and to pollutants. Moreover, the optimization of the existing pharmacological strategies and the development of new treatment options have improved markedly the management of this disease, thereby reducing the health care costs and ameliorating the quality of life of patients.
Childhood asthma prevention and treatment still represents a worldwide challenge. Future efforts should be aimed at identifying high risk target populations, minimizing the costs of each policy of intervention and increasing adherence to treatment strategies.
哮喘是一个全球性的健康问题，具有很高的发病率，对医疗保健系统有重大影响。为了预防和治疗这种疾病，已经做出了许多努力来开发新的策略。有鉴于此，本文对预防和治疗儿童哮喘的最新进展进行了综述，重点介绍了生命早期最有效的干预措施。
通过在 PubMed 上搜索，确定了参考文献。搜索中使用的术语是“儿童哮喘”、“治疗”和“预防”。我们只纳入了与人类和 0-18 岁的受试者有关的荟萃分析、随机对照试验、综述和系统评价文章。所有干预措施均被归类为“非药物”和“药物”。
非药物干预集中在确定这种疾病发病机制的遗传和环境因素，包括个体遗传易感性、早期过敏致敏、环境微生物组的作用、以及暴露于感染和污染物的情况。此外，优化现有的药物治疗策略和开发新的治疗选择，极大地改善了这种疾病的管理，从而降低了医疗保健成本，提高了患者的生活质量。
儿童哮喘的预防和治疗仍然是一个全球性的挑战。未来的努力应旨在确定高风险目标人群，尽量降低每种干预政策的成本，并提高对治疗策略的依从性。
