Modern approach to pediatric asthma

Background:  The article reviews aims to promote the communication between scientists engaged in basic research and clinicians working with children, in order to better understand the mechanism and work together towards an optimal management of this prominent pediatric condition. We reviewed the recent advancements in regards to pediatric asthma related to pathogenesis, diagnostic criteria and differential diagnosis, and peer-reviewed evidence for efficiency of pharmacological and non- pharmacological/alternative/adjuvant treatment; we also emphasize the importance of education of all parties involved in care, outpatient management, age-appropriate involvement of children in their own care, and asthma prevention measures in children. Clinically asthma is characterized by recurrent episodes of wheezing, dyspnea, and cough; at the pathophysiological level the airway wall thickness is increased and involves both smooth muscle and collagen tissue, the mucous glands and mucus production are increased, and the vascularity of the airways is increased, all leading to chronic inflammatory remodeling of the airways and resulting in reduction of lung function.

Conclusions:  Asthma among children has been on the rise for decades. With an estimated prevalence of 10-30%, asthma is the most prevalent chronic disease of pediatric population worldwide and one with a large health care burden. The approach to diagnosis and treatment of asthma in children is distinct from adults; so is the management, prevention and the education of parties involved in care. Recently there has been a significant progress in mechanistic understanding of asthma; further, asthma management in children is becoming a top priority.