Hossny Elham, Adachi Yuichi, Anastasiou Eleni, Badellino Héctor, Custovic Adnan, El-Owaidy Rasha, El-Sayed Zeinab A, Filipovic Ivana, Gomez R Maximiliano, Kalayci Ömer, Le Souëf Peter, Miligkos Michael, Morais-Almeida Mário, Nieto Antonio, Phipatanakul Wanda, Shousha Ghada, Teijeiro Alvaro, Wang Jiu-Yao, Wong Gary W K, Xepapadaki Paraskevi, Yong Su Boon, Papadopoulos Nikolaos G
Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
Pediatric Allergy Center, Toyama Red Cross Hospital, Japan.
World Allergy Organ J. 2024 May 22;17(5):100909. doi: 10.1016/j.waojou.2024.100909. eCollection 2024 May.
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
关于影响儿童哮喘的合并健康状况的范围和影响的真实世界数据很少，尤其是来自发展中国家的数据。数据的缺乏阻碍了对这些复杂病例的有效诊断、治疗和整体管理。在此，我们从关联证据、对哮喘控制的潜在影响机制以及治疗益处等方面描述常见的儿童哮喘合并症。肥胖、上气道过敏、呼吸功能障碍、多重致敏、抑郁症、食物过敏和胃食管反流是难治性哮喘的常见关联因素。另一方面，哮喘症状和/或管理可能通过药物不良反应、过敏反应症状恶化以及影响心理健康对儿童的健康产生负面影响。认识这些疾病对于为每个哮喘儿童设计最佳护理可能至关重要，并最终可能改善患者及其家庭的生活质量。需要一个多学科的医生团队来识别和管理这些合并症，以减少哮喘药物治疗的过度使用。哮喘研究应针对临床实践中遇到的相关真实世界困难，并专注于减轻此类合并症影响的干预措施。最后，敦促政策制定者和全球医疗保健组织将儿童哮喘控制视为医疗保健的优先事项，并为研究和临床干预分配资源。换句话说，全球哮喘控制需要富有同情心的科学伙伴关系的支持。
