A growing body of literature has investigated optimizing asthma management by identifying phenotypes and biomarkers to guide the treatment. In particular, management of asthma in preschool children remains challenging due to different phenotype presentation in early life. The focus of this review is to summarize the recent data on personalized medicine in management of preschool children with wheezing.
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References
1.
National Asthma Education and Prevention Program. Expert Panel Report III: guidelines for the diagnosis and management of asthma. Bethesda, MD: US Department of Health and Human Services, 2007.
2.
ZeigerRS, MaugerD, BacharierLB, GuilbertTW, MartinezFD, LemanskeRFJr, et al.; CARE Network of the National Heart, Lung, and Blood Institute. Daily or intermittent budesonide in preschool children with recurrent wheezing. N Engl J Med, 2011; 365:1990–2001.
3.
RaissyHH, BlakeK. Management of wheezing in preschool children. Pediatr Allergy Immunol Pulmonol, 2012; 25:172–173.
4.
DucharmeFM, LemireC, NoyaFJ, DavisGM, AlosN, LeblondH, et al.Preemptive use of high-dose fluticasone for virus induced wheezing in young children. N Engl J Med, 2009; 360:339–353.
5.
DepnerM, FuchsO, GenuneitJ, KarvonenAM, HyvärinenA, KaulekV, et al.; PASTURE Study Group. Clinical and epidemiologic phenotypes of childhood asthma. Am J Respir Crit Care Med, 2014; 189:129–138.
6.
SavenijeOE, GranellR, CaudriD, KoppelmanGH, SmitHA, WijgaA, et al.Comparison of childhood wheezing phenotypes in 2 birth cohorts: ALSPAC and PIAMA. J Allergy Clin Immunol, 2011; 127:1505–1512.
7.
FitzpatrickAM, JacksonDJ, MaugerDT, BoehmerSJ, PhipatanakulW, SheehanWJ, et al.; NIH/NHLBI AsthmaNet. Individualized therapy for persistent asthma in young children INFANT. J Allergy Clin Immunol, 2016; 138:1608–1618.
8.
Castro-RodríguezJA, HolbergCJ, WrightAL, MartinezFD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med, 2000; 162(4 Pt 1):1403–1406.
9.
MartinezFD, ChinchilliVM, MorganWJ, BoehmerSJ, LemanskeRFJr, MaugerDT, et al.Use of beclomethasone dipropionate as rescue treatment for children with mild persistent asthma (TREXA): a randomized, double-blind, placebo-controlled trial. Lancet, 2011; 377:650–657.
10.
RaissyHH, BlakeK. As needed use of inhaled corticosteroids for management of mild persistent asthma in children. Pediatr Allergy Immunol Pulmonol, 2011; 24:231–233.
11.
GeraldJK, GeraldLB, VasquezMM, MorganWJ, BoehmerSJ, LemanskeRFJr, et al.Markers of differential response to inhaled corticosteroid treatment among children with mild persistent asthma. J Allergy Clin Immunol Pract, 2015; 3:540–546.
12.
Castro-RodriguezJA, RodrigoGJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics, 2009; 123:e519–e525.
13.
GuilbertTW, MorganWJ, ZeigerRS, MaugerDT, BoehmerSJ, SzeflerSJ, et al.Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med, 2006; 354:1985–1997.
14.
BrandPL, BaraldiE, BisgaardH, BonerAL, Castro-RodriguezJA, CustovicA, et al.Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J, 2008; 32:1096–1110.
15.
BacharierLB, PhillipsBR, BloombergGR, ZeigerRS, PaulIM, KrawiecM, et al.; Childhood Asthma Research and Education network, National Heart, Lung, and Blood Institute. Severe intermittent wheezing in preschool children: a distinct phenotype. J Allergy Clin Immunol, 2007; 119:604–610.
16.
HornerCC, BacharierLB. Management approaches to intermittent wheezing in young children. Curr Opin Allergy Clin Immunol, 2007; 7:180–184.
17.
KaiserSV, HuynhT, BacharierLB, RosenthalJL, BakelLA, ParkinPC, CabanaMD. Preventing exacerbations in preschoolers with recurrent wheeze: a meta-analysis. Pediatrics, 2016; 137:e20154496.