Unveiling the Complexities of Pediatric Asthma Treatment: Evidence, Controversies, and Emerging Approaches

Pediatric Drugs, Journal Year: 2025, Volume and Issue: unknown

Published: March 22, 2025

Pediatric asthma remains a prevalent and challenging chronic condition globally, affecting quality of life imposing significant burdens on families healthcare systems. Despite advancements in understanding pathophysiology treatment, key controversies persist optimizing management strategies. Inhaled corticosteroids (ICS) are the cornerstone reducing inflammation preventing exacerbations. While concerns about growth suppression exist, evidence suggests that this effect is primarily associated with high doses prolonged use, rather than standard maintenance therapy. Nonetheless, adherence to ICS suboptimal, necessitating strategies ensure effective sustained treatment. The introduction reliever therapy (MART) ICS–formoterol has offered improved outcomes by simplifying regimens reliance short-acting beta-agonists (SABA). However, supporting MART ICS-SABA younger children limited, highlighting gaps pediatric-focused research. Biologics targeting inflammatory pathways, such as omalizumab, mepolizumab, dupilumab, represent personalized approach for severe but face challenges including costs, limited long-term safety data, uncertainty regarding their ability modify disease progression. In addition, complexity treatment decisions compounded insufficient biomarkers age-specific guide Addressing these requires robust clinical studies tailored pediatric populations. This review critically examines current pharmacological strategies, unresolved issues, evolving approaches management, emphasizing need evidence-based care. Enhancing necessitates balancing therapeutic benefits minimal adverse effects leveraging ongoing research inform future practice.

Language: Английский

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Genetic and Epigenetic Interconnections Between Atopic Dermatitis, Allergic Rhinitis, and Rhinitis with Nasal Polyps

Allergies, Journal Year: 2025, Volume and Issue: 5(2), P. 9 - 9

Published: March 27, 2025

Background: Atopic dermatitis (AD), allergic rhinitis (AR), and chronic rhinosinusitis with nasal polyps (CRSwNP) represent interconnected conditions within the spectrum of type 2 inflammatory diseases. While these share common genetic epigenetic pathways, precise molecular mechanisms remain underexplored. Methods: This review integrates latest insights on factors linking AD, AR, CRSwNP, focusing genome-wide association studies, DNA methylation patterns, histone modifications, microRNA regulation. Results: In all three conditions, including (Me) acetylation (Ac) methylation, regulate barrier-related genes, influencing disease severity. Notably, miRNAs such as miR-146a miR-155 play pivotal roles in modulating inflammation across diseases, while disease-specific contribute to airway remodeling (miR-125b miR-21 AR CRSwNP). Emerging evidence underscores role microbiome-driven inflammasome activation matrix metalloproteinases (MMP-2, MMP-9, MMP-12) perpetuating remodeling. Conclusions: The interplay between predispositions, exposomal systemic nature inflammation. A deeper understanding could lead transformative, personalized diagnostic therapeutic advancements.

Language: Английский

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IgE‐Mediated Activation of Mast Cells and Basophils in Health and Disease

Immunological Reviews, Journal Year: 2025, Volume and Issue: 331(1)

Published: March 31, 2025

Type 2-mediated immune responses protect the body against environmental threats at barrier surfaces, such as large parasites and toxins, facilitate repair of inflammatory tissue damage. However, maladaptive to typically nonpathogenic substances, commonly known allergens, can lead development allergic diseases. 2 immunity involves a series prototype TH2 cytokines (IL-4, IL-5, IL-13) alarmins (IL-33, TSLP) that promote generation adaptive CD4+ helper cells humoral products allergen-specific IgE. Mast basophils are integral players in this network, serving primary effectors IgE-mediated responses. These bind IgE via high-affinity receptors (FcεRI) expressed on their surface and, upon activation by release variety mediators regulate responses, attract modulate other cells, contribute repair. Here, we review biology effector mechanisms these focusing primarily role mediating both physiological pathological contexts.

Language: Английский

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A tri-compound formula comprising ginsenoside Rg1, tetrandrine and icariin alleviates atopic dermatitis symptoms in a mouse model

Phytomedicine, Journal Year: 2025, Volume and Issue: unknown, P. 156737 - 156737

Published: April 1, 2025

Language: Английский

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Leveraging an mRNA Platform for the Development of Vaccines Against Egg Allergy

Vaccines, Journal Year: 2025, Volume and Issue: 13(5), P. 448 - 448

Published: April 24, 2025

Background: Food allergy (FA) poses a major global health issue due to the increasing prevalence and lack of effective prevention strategies. Allergen-specific immunotherapy (AIT) has emerged as disease-modifying therapy for FA. However, long-term treatment duration unexpected adverse reactions, only minority patients benefit from AIT. Therefore, prophylactic interventions are urgently needed FA patients. Methods: In this proof-of-concept study, using well-established mRNA platform, we developed vaccine candidates encoding egg white allergen Gal d2 comprehensively evaluated their efficacy against anaphylaxis in d2-induced allergic mouse model. Results: Two formulations, d2-IL-10 vaccine, both demonstrated potent ability inducing allergen-specific IgG Th1-type T cells. Importantly, two formulations showed promise preventing onset disease, which is indicated by body temperature decline during anaphylaxis. Conclusions: We provided preliminary evidence showing that platform unique holds development anti-allergy vaccines. This largely attributed capacities vaccines eliciting an allergen-blocking antibody, shifting Th2 towards Th1 immunity, well generating peripheral tolerance. further investigations required better understand mode action.

Language: Английский

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Interplay Between COVID- 19 and Chronic Rhinosinusitis: Clinical Insights

Current Treatment Options in Allergy, Journal Year: 2025, Volume and Issue: 12(1)

Published: April 26, 2025

Language: Английский

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The changing epidemiology of paediatric childhood asthma and allergy in different regions of the world

Frontiers in Allergy, Journal Year: 2025, Volume and Issue: 6

Published: April 30, 2025

Allergic disorders encompass a variety of conditions including asthma, atopic dermatitis, food allergy, allergic rhinitis, and eosinophilic esophagitis. These are connected via an abnormal host immune response to the environment. A series longitudinal cross-sectional studies conducted over past 3 decades have reported on epidemiological trends that contribute towards development pediatric asthma disease. Infant birth cohort assessing microbiome offered clues as underlying biological mechanisms basis for Why this is occurring research reasons chapter. Our understanding biology system has increased exponentially with advances in genomic testing, providing further opportunity targeted treatments more importantly, primary prevention

Language: Английский

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Obesity: Next game changer of allergic airway diseases?

Clinical and Translational Medicine, Journal Year: 2025, Volume and Issue: 15(5)

Published: May 1, 2025

Abstract Obesity and allergic diseases are global health concerns, both of which seeing an increase in prevalence recent years. has been recognised as important comorbidity subpopulations with airway diseases, represents a unique phenotype endotype. Obesity‐related associated exacerbated clinical symptom burden, altered immune response, increased disease severity compromised predictive capability conventional biomarkers for evaluating endotype prognosis. Moreover, treatment obesity‐related is challenging because this poor response to standard therapeutic strategies. Therapeutic regimen that involves weight loss by non‐surgical surgical interventions, gut microbiome‐targeted treatment, glucagon‐like peptide‐1 receptor agonist other agents should be considered population. In review, we outline the current knowledge impact obesity on prevalence, endotypes, management diseases. Increased understanding implications may contribute better options refractory inflammation, particularly precision medicine. Key points can such asthma, AR, CRSwNP. alters exacerbates symptoms respiratory exhibit resistance treatment. constitute distinct category endotypes phenotypes, requiring further in‐depth research novel approaches.

Language: Английский

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Hazards of lunar surface exploration: determining the immunogenicity/allergenicity of lunar dust

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: May 8, 2025

Although infrequent, there have been Apollo program reports of lunar dust exposure leading to notable upper respiratory symptoms in select crewmembers. Possible mechanisms include particulate irritation, inflammation from toxic insult, or legitimate adaptive immune-mediated response. sterile non-protein matter would not be expected immunogenic, one flight surgeon reported increasing upon repeated perceived with associated eosinophilia, suggestive possible allergic reactions. Many International Space Station (ISS) crews display a pattern persistent immune system dysregulation and latent virus reactivation. Some ISS manifest atypical and/or dermatitis which could an component. It is logical anticipate crew worsen during prolonged deep space missions planetary surface hazards will only complicate health risks. Allergic (i.e. mast cell-mediated) reactivity adversely increase negative clinical operational impacts for long-duration astronauts affect countermeasure requirements vehicles. This study investigated whether possibly elicit IgE mediated response spaceflight by utilizing vitro cell culture models. Our laboratory was officially approved receipt actual samples the 16 mission NASA. These were used complete proposed set experiments, using human peripheral blood mononuclear cells (PBMC) healthy individuals, basophils eosinophil lines. Cells co-cultured cellular mitogens, common recall antigens (Der p1), fine ground silica quartz (control), dust, alter generation selective responses Measured outputs included supernatant-derived total IgE, tryptase, histamine, selected cytokine levels. Cellular activation monitored assessing markers via flow cytometry. EM/x-ray analysis determine interactions particles. The assessments primary indicated no evidence responsiveness nor ’allergy-like‘ dust. Assessments purified ’allergic‘ lines, did yield some unique but mild however such lines can profiles somewhat different their vivo counterparts. determining allergy specific responses, help guide NASA develop mitigation techniques potential countermeasures necessary event excessive EVAs.

Language: Английский

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Recent Studies and Prospects of Biologics in Allergic Rhinitis Treatment

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(10), P. 4509 - 4509

Published: May 9, 2025

Allergic rhinitis (AR) is a common and increasingly prevalent chronic inflammatory disorder of the nasal mucosa that severely impacts patients’ quality life, causing symptoms like congestion, sneezing, itching. AR primarily mediated by immunoglobulin E (IgE) when allergens are present, making it challenging to manage despite available therapies pharmacotherapy, immunotherapy, surgery. Recently, research has focused on biologics as an emerging therapeutic option for AR. Biologics target specific immune pathways in type 2 inflammation, which underlies many allergic diseases including offer targeted potentially more effective alternative traditional therapies, addressing underlying mechanisms rather than simply alleviating symptoms. Based key clinical trial evidence, this paper tentatively proposes multidimensional strategy selecting AR, integrating serum IgE levels, disease phenotypes (seasonal/persistent), comorbid characteristics guide individualized treatment. However, long-term cost-effectiveness, optimal dosing regimens, patient adherence require further validation through real-world data. Despite these challenges, recent advancements represent promising step forward management. With ongoing trials, may soon provide lasting relief patients suffering from rhinitis.

Language: Английский

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