Article ; Online: Considerations for the Child with Nonatopic Asthma.
Pediatric allergy, immunology, and pulmonology
2021 Volume 33, Issue 1, Page(s) 39–42
Abstract: Asthma guidelines provide clinicians with evidence-based management strategies for this chronic condition. The preferred therapy for patient with persistent asthma is inhaled corticosteroids. However, ∼40% of the patients with persistent asthma continue ... ...
| Abstract | Asthma guidelines provide clinicians with evidence-based management strategies for this chronic condition. The preferred therapy for patient with persistent asthma is inhaled corticosteroids. However, ∼40% of the patients with persistent asthma continue to present with symptoms while treated according to the guidelines. Multiple factors are being explored to explain the variability in response to inhaled corticosteroids including asthma phenotype and genetic predisposition among others. The nonatopic asthma phenotype has been described in the literature. These patients tend to have milder symptoms of asthma and typically outgrow their asthma by adolescence. They present with chronic asthma symptoms in the absence of a positive allergy test, either skin prick test or specific immunoglobulin E blood test. Although patients with nonatopic asthma share many characteristics with patients with atopic asthma, there are several studies that suggest a different inflammatory pathway may be involved in their pathophysiology. Therefore, it is possible that children with nonatopic asthma could respond differently to inhaled corticosteroids compared with those with atopic asthma. Currently there is a variable definition of this phenotype. Furthermore, there is a paucity of therapeutic trial directed toward the patients with nonatopic asthma specifically. Future research should be guided toward identifying the inflammatory pathways in nonatopic asthma and potential phenotype-guided therapies. |
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| MeSH term(s) | Allergy and Immunology/standards ; Anti-Asthmatic Agents/administration & dosage ; Asthma/diagnosis ; Asthma/drug therapy ; Asthma/immunology ; Asthma/physiopathology ; Bronchi/drug effects ; Bronchi/immunology ; Bronchi/physiopathology ; Child ; Chronic Disease/therapy ; Diagnosis, Differential ; Gastroesophageal Reflux/complications ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/immunology ; Humans ; Mometasone Furoate/administration & dosage ; Practice Guidelines as Topic ; Proton Pump Inhibitors/administration & dosage ; Respiratory Mucosa/drug effects ; Respiratory Mucosa/immunology ; Respiratory Sounds/drug effects ; Respiratory Sounds/immunology ; Respiratory Sounds/physiopathology ; Tiotropium Bromide/administration & dosage ; Treatment Outcome |
| Chemical Substances | Anti-Asthmatic Agents ; Proton Pump Inhibitors ; Mometasone Furoate (04201GDN4R) ; Tiotropium Bromide (XX112XZP0J) |
| Language | English |
| Publishing date | 2021-01-06 |
| Publishing country | United States |
| Document type | Journal Article ; Review |
| ZDB-ID | 2566338-0 |
| ISSN | 2151-3228 ; 2151-321X |
| ISSN (online) | 2151-3228 |
| ISSN | 2151-321X |
| DOI | 10.1089/ped.2019.1104 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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