Shipp Cassie L, Gergen Peter J, Gern James E, Matsui Elizabeth C, Guilbert Theresa W
Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
J Allergy Clin Immunol Pract. 2023 Jan;11(1):9-18. doi: 10.1016/j.jaip.2022.10.031. Epub 2022 Nov 9.
Asthma is a common, complex heterogeneous disease often beginning in early life and is characterized by reversible airflow obstruction. The phenotypic differences that exist in children with asthma may impact underlying comorbid conditions and pharmacologic treatment choices. Prenatal factors for increased risk of asthma could include maternal diet and the maternal microbiome. Evidence also suggests that postnatal microbial exposures and colonization contribute to the risk of allergic diseases and asthma. After confirming the diagnosis, asthma management in children centers on 3 broad areas: pharmacologic treatment, treatment of underlying comorbidities, and education of the patient and caregivers on the importance of adherence and device technique. Moreover, social determinants of health significantly impact on symptom burden and treatment response.
哮喘是一种常见的、复杂的异质性疾病,通常始于幼年,其特征为可逆性气流受限。哮喘患儿存在的表型差异可能会影响潜在的合并症及药物治疗选择。哮喘风险增加的产前因素可能包括母亲的饮食和母亲的微生物群。有证据还表明,出生后的微生物暴露和定植会增加过敏性疾病和哮喘的风险。确诊后,儿童哮喘管理主要集中在三个广泛领域:药物治疗、潜在合并症的治疗,以及对患者及其护理人员进行关于坚持治疗和使用设备技巧重要性的教育。此外,健康的社会决定因素会显著影响症状负担和治疗反应。