☆ 4.5 Review

Asthma Management in Children

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2023)

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Chromosome 17q12-21 Variants Are Associated with Multiple Wheezing Phenotypes in Childhood

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Summary: Growing up in disadvantaged urban neighborhoods, Black and Hispanic children have the highest rates of asthma and related morbidity in the United States. This study identified distinct respiratory phenotypes in this population, linking early life environmental exposures to childhood allergic sensitization and asthma. Unique patterns of airway gene expression underlie specific molecular pathways of different respiratory phenotypes, including allergic and nonallergic asthma.

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Maternal stress and depression are associated with respiratory phenotypes in urban children

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Summary: Maternal stress and depression in early life are positively associated with respiratory illnesses and a moderate-wheeze-low-atopy phenotype in urban children, indicating the importance of addressing these factors to reduce viral respiratory illnesses and recurrent wheeze during early childhood.

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Lower Use of Biologics for the Treatment of Asthma in Publicly Insured Individuals

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Summary: Despite bearing a disproportionate burden of poorly controlled asthma, publicly insured individuals are less likely to receive biologics, according to data from IQVIA in the United States. The lower use of biologics among publicly insured individuals, where the burden of uncontrolled asthma is greatest, requires further investigation.

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US Childhood Asthma Incidence Rate Patterns From the ECHO Consortium to Identify High-risk Groups for Primary Prevention

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JAMA PEDIATRICS (2021)

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Summary: Maternal smoking during pregnancy impacts multiple organ systems in the fetus and offspring, with lifelong deficits in pulmonary function and increased risk of respiratory issues. Vitamin C supplementation can ameliorate the adverse effects of maternal smoking on placental DNA methylation and gene expression, potentially improving placental function and respiratory health outcomes in offspring. Further research is needed to validate candidate loci and elucidate the causal pathway between placental methylation changes and outcomes in offspring exposed to maternal smoking.

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US Childhood Asthma Incidence Rate Patterns From the ECHO Consortium to Identify High-risk Groups for Primary Prevention

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Summary: Asthma incidence rates in children are influenced by family history, race/ethnicity, and sex. Black children have higher rates during preschool years, suggesting the need for targeted interventions in early life.

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