Severe pediatric asthma endotypes: current limits and future perspectives

Expert Rev Respir Med. 2023 Aug 30. doi: 10.1080/17476348.2023.2254234. Online ahead of print.ABSTRACTINTRODUCTION: Althoughrare, pediatric severe therapy-resistant asthma (STRA) is a highlyheterogeneous, resource-demanding disease that differs significantly fromsevere adult asthma and whose pathogenesis is still poorly understood.AREAS COVERED: This reviewsummarizes the latest ten years of English-written studies defining pediatricSTRA endotypes using lung-specific techniques such as bronchoalveolar lavageand endobronchial biopsy. Results of the studies and limits on the field arediscussed, together with some future perspectives.EXPERT OPINION: Over theyears, it has become increasingly clear that 'one size does not fitall" in asthma. However, "Does an extremely tailored size fit morethan one?'. Only using multicentric, longitudinal pediatric studies, willwe be able to answer. Three issues could be particularly critical for futureresearch. First, to provide, if existing, a distinction between prepuberal STRAand puberal STRA endotypes to understand the transition from pediatric to adultSTRA and to design effective, tailored therapies in adolescents, usuallysuffering from poorer asthma control. Second, design early treatments forpediatric airway remodeling to preserve lifelong good lung function. Finally,to better characterize inflammation before and during biological therapies, toprovide clues on whether to stop or change treatments.PMID:37647343 | DOI:10.1080/17476348.2023.22...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Authors: Source Type: research