Predicting asthma exacerbations in children.
Predicting asthma exacerbations in children.
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DOI：
10.1097/mcp.0b013e32834db288
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发表时间：
2012-01
影响因子：
3.3
通讯作者：
Celedón JC
中科院分区：
文献类型：
--
作者：
Forno E;Celedón JC
批判性地评估最近发表的关于预测儿童哮喘恶化的文献，同时为该领域的未来研究提供一般性建议。目前的证据表明，应尽一切努力提供最佳治疗，以实现充分的哮喘控制，因为这将显著降低疾病严重恶化的风险。在过去一年中至少有一次哮喘发作的儿童，无论疾病严重程度和/或控制情况如何，随后发作的风险最高。虽然最近开发了几种预测哮喘恶化的工具和生物标志物，但这些方法需要进一步验证和/或仅在识别有风险的儿童方面取得了部分成功。虽然已经取得了相当大的进展，但仍有许多工作要做。未来的研究应明确区分哮喘控制不充分引起的严重哮喘发作与哮喘控制良好的儿童发生的严重哮喘发作，利用哮喘发作的标准化定义，并在考虑问题的多个维度后，使用系统的方法来确定最佳预测因子。我们正确预测单个儿童严重哮喘恶化发展的能力应该随着对这些事件背后的遗传、环境（如病毒感染）和生活方式（如坚持治疗）因素之间复杂相互作用的认识和/或理解的增加而提高。
To critically assess recently published literature on predicting asthma exacerbations in children, while also providing general recommendations for future research in this field. Current evidence suggests that every effort should be made to provide optimal treatment to achieve adequate asthma control, as this will significantly reduce the risk of severe disease exacerbations. Children who have had at least one asthma exacerbation in the previous year are at highest risk for subsequent exacerbations, regardless of disease severity and/or control. Although several tools and biomarkers to predict asthma exacerbations have been recently developed, these approaches need further validation and/or have only had partial success in identifying children at risk. Although considerable progress has been made, much remains to be done. Future studies should clearly differentiate severe asthma exacerbations due to inadequate asthma control from those occurring in children whose asthma is well controlled, utilize standardized definitions of asthma exacerbations, and use a systematic approach to identify the best predictors after accounting for the multiple dimensions of the problem. Our ability to correctly predict the development of severe asthma exacerbations in an individual child should improve in parallel with increased knowledge and/or understanding of the complex interactions among genetic, environmental (e.g., viral infections) and lifestyle (e.g., adherence to treatment) factors underlying these events.