Licari Amelia, Manti Sara, Castagnoli Riccardo, Marseglia Alessia, Foiadelli Thomas, Brambilla Ilaria, Marseglia Gian Luigi
Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Unit of Pediatric Genetics and Immunology, Department of Pediatrics, University of Messina, Messina, Italy.
Front Pediatr. 2019 Jul 12;7:289. doi: 10.3389/fped.2019.00289. eCollection 2019.
Childhood asthma is actually defined as a heterogeneous disease, including different clinical variants and partially sharing similar immune mechanisms. Asthma management is mainly focused on maintaining the control of the disease and reducing the risk of adverse outcomes. Most children achieve good control with standard therapies, such as low doses of inhaled corticosteroids (ICS) and/or one or more controller. These medications are targeted to suppress bronchial inflammation and to restore airway responsiveness. However, they are not disease-modifying and do not specifically target inflammatory pathways of asthma; in addition, they are not significantly effective in patients with severe uncontrolled asthma. The aim of this review is to update knowledge on current and novel therapeutic options targeted to immunomodulate inflammatory pathways underlying pediatric asthma, with particular reference on biologic therapies.
儿童哮喘实际上被定义为一种异质性疾病，包括不同的临床变体且部分共享相似的免疫机制。哮喘管理主要集中在维持疾病的控制并降低不良后果的风险。大多数儿童通过标准疗法，如低剂量吸入性糖皮质激素（ICS）和/或一种或多种控制药物，可实现良好控制。这些药物旨在抑制支气管炎症并恢复气道反应性。然而，它们并不能改变疾病进程，也未特异性针对哮喘的炎症途径；此外，它们对严重未控制的哮喘患者效果并不显著。本综述的目的是更新有关针对免疫调节小儿哮喘潜在炎症途径的现有及新型治疗选择的知识，尤其侧重于生物疗法。
