Torres-Borrego Javier, Sánchez-Solís Manuel
Pediatric Allergy and Pulmonology Unit, Reina Sofia Children's University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University of Cordoba, Av. Menendez Pidal sn, 14004 Cordoba, Spain.
Pediatric Respiratory and Cystic Fibrosis Unit, Virgen de la Arrixaca University Children's Hospital, Biomedical Research Institute of Murcia (IMIB), University of Murcia, Avda Teniente Flomesta, 5, 30003 Murcia, Spain.
J Clin Med. 2023 Sep 8;12(18):5856. doi: 10.3390/jcm12185856.
Asthma is a heterogeneous and very complex group of diseases, and includes different clinical phenotypes depending on symptoms, progression, exacerbation patterns, or responses to treatment, among other characteristics. The allergic phenotype is the most frequent, especially in pediatric asthma. It is characterized by sensitization (the production of specific IgEs) to allergens and frequent comorbidity with rhinitis as well as atopic dermatitis. Given the complexity of allergic asthma, knowledge of it must be approached from different points of view: clinical, histological, physiological, epidemiological, biochemical, and immunological, among others. Since partial approaches do not allow for the understanding of this complexity, it is necessary to have multidimensional knowledge that helps in performing the optimal management of each case, avoiding a "blind men and elephant parable" approach. Allergens are antigens that trigger the production of specific IgE antibodies in susceptible individuals, who present symptoms that will depend on the type and intensity of the allergenic load as well as the tissue where the interaction occurs. Airborne allergens cause their effects in the respiratory tract and eyes, and can be indoor or outdoor, perennial, or seasonal. Although allergens such as mites, pollens, or animal dander are generally considered single particles, it is important to note that they contain different molecules which could trigger distinct specific IgE molecules in different patients. General practitioners, pediatricians, and other physicians typically diagnose and treat asthma based on clinical and pulmonary function data in their daily practice. This nonsystematic and nonexhaustive revision aims to update other topics, especially those focused on airborne allergens, helping the diagnostic and therapeutic processes of allergic asthma and rhinitis.
哮喘是一组异质性且非常复杂的疾病,根据症状、病情进展、加重模式或对治疗的反应等特征,包括不同的临床表型。过敏型是最常见的,尤其是在儿童哮喘中。其特征是对过敏原致敏(产生特异性IgE),常合并鼻炎和特应性皮炎。鉴于过敏性哮喘的复杂性,必须从不同角度来认识它:临床、组织学、生理学、流行病学、生物化学和免疫学等。由于片面的方法无法理解这种复杂性,因此有必要具备多维度知识,以帮助对每个病例进行最佳管理,避免采用“盲人摸象”的方法。过敏原是在易感个体中引发特异性IgE抗体产生的抗原,这些个体出现的症状将取决于致敏原负荷的类型和强度以及相互作用发生的组织。空气传播的过敏原在呼吸道和眼睛中产生影响,可分为室内或室外、常年性或季节性。尽管螨虫、花粉或动物皮屑等过敏原通常被视为单一颗粒,但需要注意的是,它们含有不同的分子,可能在不同患者中引发不同的特异性IgE分子。全科医生、儿科医生和其他医生在日常实践中通常根据临床和肺功能数据来诊断和治疗哮喘。本次非系统性且非详尽的综述旨在更新其他主题,尤其是那些聚焦于空气传播过敏原的主题,以帮助过敏性哮喘和鼻炎的诊断及治疗过程。