New views on the diagnosis and treatment of asthma in children
Keywords:asthma, diagnosis, children, treatment
The medical and social significance of the problem of asthma in childhood is extremely high. Global Initiative for Asthma (GINA) for the management of this disease has been known since 1993, based on the best information available to date. Global Initiative for Asthma has now been updated — the 2022 GINA revision. GINA 2022, in particular, considers the use of a single inhaler (inhaled glucocorticoid and formoterol) both to relieve symptoms and to provide basic therapy, emphasizes the importance of having a written plan of action for asthma. Today, children with asthma are thought to have a similar risk of contracting SARS-CoV-2 as children without asthma. In the context of a coronavirus pandemic, it is essential for asthma patients to continue their proper treatment with good control of clinical symptoms. A new aspect is that when COVID-19 is confirmed or suspected, the use of nebulizers should be avoided where possible due to the risk of transmitting the infection to other patients, family members and healthcare professionals. Although spirometry monitoring is indeed an important tool, in a pandemic it is recommended to limit it to patients in whom the results of this study may affect treatment. It is important to follow the recommendations of infection control, take precautions to reduce the risk of infection. Recent developments in asthma treatment strategies offer biological drugs as an alternative. Monoclonal antibodies, drugs targeting IgE-dependent mechanisms, IL-5, IL-4, IL-13, IL-33, anti-alarmin agents, etc. are considered. The focus of special attention in the optimal use of biological therapy for asthma is proper immune endotyping, development of appropriate biomarkers, determination of the main immunological mechanism for choosing the right targeted therapy. Much attention is now being paid to the molecular aspects of asthma. In-depth knowledge of allergenic structures has led to molecular component diagnostics, which has led to a better understanding of patient sensitization. Molecular-oriented diagnostics is used to determine the best approach to allergen-specific immunotherapy.
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