Defining pediatric asthma: phenotypes to endotypes and beyond.
Defining pediatric asthma: phenotypes to endotypes and beyond.
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DOI：
10.1038/s41390-020-01231-6
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发表时间：
2021-07
影响因子：
3.6
通讯作者：
Rastogi D
中科院分区：
文献类型：
--
作者：
Conrad LA;Cabana MD;Rastogi D
哮喘是最常见的儿童慢性肺部疾病，传统上被定义为一种以咳嗽和喘息等临床症状为特征的气道炎症综合征。本综述强调了哮喘的复杂性和异质性，总结了基于病理生物学的哮喘分类的最新进展，从而直接解决了现有哮喘定义的局限性。通过回顾和对比成人哮喘和儿童哮喘的临床及机制特征，综述总结了区分儿童哮喘亚型的关键生物标志物。虽然特应性及其严重程度是儿童哮喘的重要特征，但有证据支持存在一种不同于特应性表型的儿童哮喘内型。尽管非特应性哮喘的生物标志物是未来研究的一个领域，但我们总结了一种临床方法，该方法在儿童哮喘的定义中包括现有的气道特异性和全身性特应性测量指标、共存的疾病、疾病严重程度和控制情况，以使医疗服务提供者能够更好地描述儿童哮喘疾病负担。识别非特应性哮喘的生物标志物以及遗传学和表观遗传学对儿童哮喘负担的贡献仍然是一项研究需求，这可能使精准医学应用于儿童哮喘成为可能。
Asthma is the most common chronic pediatric lung disease that has traditionally been defined as a syndrome of airway inflammation characterized by clinical symptoms of cough and wheeze. Highlighting the complex and heterogenous nature of asthma, this review summarizes recent advances in asthma classification that are based on pathobiology, and thereby directly addresses limitations of existent definitions of asthma. By reviewing and contrasting clinical and mechanistic features of adult and childhood asthma, the review summarizes key biomarkers that distinguish childhood asthma subtypes. While atopy and its severity are important features of childhood asthma, there is evidence to support the existence of a childhood asthma endotype distinct from the atopic endotype. Although biomarkers of non-atopic asthma are an area of future research, we summarize a clinical approach that includes existing measures of airway-specific and systemic measures of atopy, co-existing morbidities, and disease severity and control, in the definition of childhood asthma, to empower health care providers to better characterize asthma disease burden in children. Identification of biomarkers of non-atopic asthma and of the contribution of genetics and epigenetics to pediatric asthma burden remain a research need, which can potentially allow delivery of precision medicine to pediatric asthma.
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影响因子：
14.2
作者：
Chang, Timothy S.;Lemanske, Robert F., Jr.;Mauger, David T.;Fitzpatrick, Anne M.;Sorkness, Christine A.;Szefler, Stanley J.;Gangnon, Ronald E.;Page, C. David;Jackson, Daniel J.
通讯作者：
Jackson, Daniel J.
DOI：
10.1111/cea.13014
发表时间：
2018-01
期刊：
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
影响因子：
--
作者：
Deliu M;Yavuz TS;Sperrin M;Belgrave D;Sahiner UM;Sackesen C;Kalayci O;Custovic A
通讯作者：
Custovic A
DOI：
10.1016/j.cct.2004.03.002
发表时间：
2004-06-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
Guilbert, TW;Morgan, WJ;Martinez, FD
通讯作者：
Martinez, FD
影响因子：
24.3
作者：
Chung, Kian Fan;Wenzel, Sally E.;Teague, W. Gerald
通讯作者：
Teague, W. Gerald
影响因子：
14.2
作者：
Brandt, Eric B.;Kovacic, Melinda Butsch;Lee, Gerald B.;Gibson, Aaron M.;Acciani, Thomas H.;Le Cras, Timothy D.;Ryan, Patrick H.;Budelsky, Alison L.;Hershey, Gurjit K. Khurana
通讯作者：
Hershey, Gurjit K. Khurana