Severe Asthma in Children: Lessons Learned and Future Directions

• Type of Material: Article
• Authors: Anne Fitzpatrick, Emory University
• Language: English
• Date: 2016-01-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 American Academy of Allergy, Asthma & Immunology.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaip.2015.10.008
• Title of Journal or Parent Work: Journal of Allergy and Clinical Immunology
• ISSN: 0091-6749
• Volume: 4
• Issue: 1
• Start Page: 11
• End Page: 19
• Grant/Funding Information: This work was supported by National Institutes of Health grant no. U10HL098103.
• Keywords: CLUSTER-ANALYSIS; NATIONAL HEART; RESEARCH-PROGRAM; Lung function; AIR-FLOW LIMITATION; TOBACCO-SMOKE; GENOME-WIDE ASSOCIATION; TO-TREAT ASTHMA; Allergy; Inflammation; Phenotype; EXHALED NITRIC-OXIDE; Immunology; Life Sciences & Biomedicine; Science & Technology; UNITED-STATES; Children; CHILDHOOD ASTHMA; Severe asthma; Endotype
• Research Categories: Health Sciences, Human Development; Health Sciences, General

Abstract

Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.