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Steroid responsiveness and wheezing phenotypes
Oral corticosteroids are the cornerstone of management of acute moderate or severe asthma whilst preventive inhaled corticosteroids are the mainstay of the preventive management of children with asthma. Yet, variation in the magnitude of response to corticosteroids has been observed. There is increa...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106147/ https://www.ncbi.nlm.nih.gov/pubmed/21722845 http://dx.doi.org/10.1016/j.prrv.2011.02.007 |
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author | Ducharme, Francine M. Krajinovic, Maja |
author_facet | Ducharme, Francine M. Krajinovic, Maja |
author_sort | Ducharme, Francine M. |
collection | PubMed |
description | Oral corticosteroids are the cornerstone of management of acute moderate or severe asthma whilst preventive inhaled corticosteroids are the mainstay of the preventive management of children with asthma. Yet, variation in the magnitude of response to corticosteroids has been observed. There is increasing evidence that preschool-aged children with viral-induced asthma may display a certain degree of corticosteroid resistance, requiring higher doses of corticosteroids to overcome it. The identification of determinants of responsiveness is complicated by design issues, including heterogeneous populations of children with asthma and bronchiolitis or of children with viral-induced and multi-trigger asthma phenotypes in published trials. Potential key determinants of responsiveness may include age, trigger, phenotype, tobacco smoke exposure and genotype. The mechanistic pathway for corticoresistance may originate from a gene-environment interaction, leading to non-eosinophilic airway inflammation. The clinician should carefully confirm the diagnosis of asthma and ascertain the phenotype to select appropriate phenotype-specific therapy. |
format | Online Article Text |
id | pubmed-7106147 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-71061472020-03-31 Steroid responsiveness and wheezing phenotypes Ducharme, Francine M. Krajinovic, Maja Paediatr Respir Rev Article Oral corticosteroids are the cornerstone of management of acute moderate or severe asthma whilst preventive inhaled corticosteroids are the mainstay of the preventive management of children with asthma. Yet, variation in the magnitude of response to corticosteroids has been observed. There is increasing evidence that preschool-aged children with viral-induced asthma may display a certain degree of corticosteroid resistance, requiring higher doses of corticosteroids to overcome it. The identification of determinants of responsiveness is complicated by design issues, including heterogeneous populations of children with asthma and bronchiolitis or of children with viral-induced and multi-trigger asthma phenotypes in published trials. Potential key determinants of responsiveness may include age, trigger, phenotype, tobacco smoke exposure and genotype. The mechanistic pathway for corticoresistance may originate from a gene-environment interaction, leading to non-eosinophilic airway inflammation. The clinician should carefully confirm the diagnosis of asthma and ascertain the phenotype to select appropriate phenotype-specific therapy. Elsevier Ltd. 2011-09 2011-06-29 /pmc/articles/PMC7106147/ /pubmed/21722845 http://dx.doi.org/10.1016/j.prrv.2011.02.007 Text en Copyright © 2011 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Ducharme, Francine M. Krajinovic, Maja Steroid responsiveness and wheezing phenotypes |
title | Steroid responsiveness and wheezing phenotypes |
title_full | Steroid responsiveness and wheezing phenotypes |
title_fullStr | Steroid responsiveness and wheezing phenotypes |
title_full_unstemmed | Steroid responsiveness and wheezing phenotypes |
title_short | Steroid responsiveness and wheezing phenotypes |
title_sort | steroid responsiveness and wheezing phenotypes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106147/ https://www.ncbi.nlm.nih.gov/pubmed/21722845 http://dx.doi.org/10.1016/j.prrv.2011.02.007 |
work_keys_str_mv | AT ducharmefrancinem steroidresponsivenessandwheezingphenotypes AT krajinovicmaja steroidresponsivenessandwheezingphenotypes |