Asthma Exacerbation in Children: A Practical Review

Abstract

Asthma is the most common chronic lower respiratory tract disease in childhood throughout the world. Despite advances in asthma management, acute exacerbations continue to be a major problem in patients and they result in a considerable burden on direct/indirect health care providers. A severe exacerbation occurring within 1 year is an independent risk factor. Respiratory tract viruses have emerged as the most frequent triggers of exacerbations in children. It is becoming increasingly clear that interactions may exist between viruses and other triggers, increasing the likelihood of an exacerbation. In this study, we provide an overview of current knowledge about asthma exacerbations, including its definition, impact on health care providers, and associated factors. Prevention management in intermittent asthma as well as intermittent wheeze in pre-school children and those with persistent asthma are discussed. Our review findings support the importance of controlling persistent asthma, as indicated in current guidelines. In addition, we found that early episodic intervention appeared to be crucial in preventing severe attacks and future exacerbations. Besides the use of medication, timely education after an exacerbation along with a comprehensive plan in follow up is also vitally important.

Monocytes accumulate in the airways of children with fatal asthma

“…The prevalence of asthma in childhood is continuously increasing and imposes a significant burden to society in terms of medication, hospitalization days, school absenteeism and life-years lost. 1,2 The inflammatory response of allergic asthma is characterized by aberrant activation of allergen-reactive T helper 2 (Th2) cells secreting IL-4, IL-5 and IL-13 and accumulation of activated eosinophils, both of which contribute to increased reactivity of the airways. T-cell responses in the airways are controlled by a network of antigen-presenting cells (APCs), which consist of monocytes, macrophages and dendritic cells (DCs).…”

Adolescent girls with asthma have worse asthma control and health‐related quality of life than boys—A population based study

“…Asthma control and asthma severity are often used to label the intensity of asthma symptoms such as wheeze, chest tightness, shortness of breath and cough . Poor asthma control has a negative effect on HRQoL among children and increases the risk of exacerbations among both children and adults . Additionally, asthma severity, corticosteroid use and the number of physician visits are also previously reported risk factors for a worse HRQoL, as well as allergic co‐morbid conditions such as rhino‐conjunctivitis and eczema .…”

“…5 Poor asthma control has a negative Meetings: Some of the results in this paper have been presented as an oral presentation, in the European Respiratory Society international congress in 2016. effect on HRQoL among children [6][7][8] and increases the risk of exacerbations among both children and adults. 9,10 Additionally, asthma severity, corticosteroid use and the number of physician visits are also previously reported risk factors for a worse HRQoL, 6 as well as allergic co-morbid conditions such as rhino-conjunctivitis and eczema. 11 It is well known that adolescents with asthma report a worse HRQoL than their healthy peers, 12 and that girls are more affected than boys.…”

Astmul bronşic alergic la copii – evoluţie naturală, substrat inflamator

“…Astmul bronşic alergic este cea mai frecventă boală cronică a căilor respiratorii inferioare din copilărie, care afectează până la 32,6% dintre copiii din ţările dezvoltate [3]. Conform datelor Societăţii Române de Pneumologie, în România sunt în jur de 1 milion de persoane care suferă de astm bronşic şi doar 10% dintre cazuri sunt diagnosticate şi tratate.…”