Part 2 book “Recent advances in pediatric medicine” has contents: Recent advances in pediatric asthma, evaluation and treatment of bronchiolitis, what is new with management of pediatric central sleep apnea, practical considerations in the treatment of pediatric obstructive sleep apnea, and other contents. | 160 Recent Advances in Pediatric Medicine, 2017, Vol. 1, 160-172 CHAPTER 11 Recent Advances in Pediatric Asthma Amine Daher, Rivera-Sánchez* Tanya M. Martínez Fernández and Yadira M. University of Texas Southwestern (UTSW) Medical Center, Dallas Children’s Health, Dallas, Texas, USA Abstract: In the past decade, there have been great advances in the approach to and management of pediatric asthma. Recent progress includes improved definitions, established guidelines, and novel therapeutic modalities. There is growing recognition that asthma is a heterogeneous entity and as such, individualized therapy is now standard when creating intervention plans. Asthma severity is classically categorized based on the concepts of impairment and risk. As more specific data is gathered on asthma subgroups, molecular pathways and cluster analysis, there has been a movement for categorizing patients into asthma phenotypes, which could serve to tailor therapies and optimize clinical response. This chapter will review the pathophysiologic processes involved in asthma; expose the latest definitions of asthma and management guidelines; discuss the implications of the “phenotypic” approach in pediatric asthma and present an overview of pertinent recent therapeutic advances. Keywords: Asthma guidelines, Asthma pathophysiology, Asthma phenotypes, Inhaled corticosteroids, Macrolides, Mepolizumab, Omalizumab, Pediatric asthma, Type 2 Hi asthma, Type 2 Lo asthma, Vitamin D. INTRODUCTION Asthma is the most common chronic disease in children and affects over 6 million children in the US [1]. It has been increasingly recognized as a heterogeneous disorder in terms of its phenotypic presentation, pathophysiology and response to therapy. Asthma patients experience recurrent symptoms of airflow obstruction due to airway inflammation, bronchial hyper-responsiveness and in some cases progressive permanent changes [1]. The essence of asthma therapy is control of symptoms and inflammation .
