Allergy Asthma Respir Dis.  2014 May;2(2):85-90. 10.4168/aard.2014.2.2.85.

Phenotype and endotype in pediatric asthma

Affiliations
  • 1Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 2Department of Pediatrics, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
  • 3Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 4Department of Pediatrics, Kangwon National University School of Medicine, Chunchon, Korea.
  • 5Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 6Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 7Department of Pediatrics, CHA University College of Medicine, Pocheon, Korea.
  • 8Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 9Department of Pediatrics, Inha University School of Medicine, Incheon, Korea. dhyunlim@inha.ac.kr
  • 10Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon, Korea.
  • 11Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
  • 12Environmental Health Center for Asthma, Korea University Anam Hospital, Ministry of Environment, Seoul, Korea.
  • 13Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Abstract

Asthma is not a homogeneous disease presenting variable clinical features, but a complex disorder consisting of many different disease entities characterized by variable air-flow limitation. To date, there are little effective preventive-strategies for the development of asthma, and it has been emphasized that early identification and intervention are the best ways to reduce the associated morbidities, quality of life, and socioeconomic burden. Predicting the natural course of asthma is still difficult, although various phenotypic approaches and predictive scores are developed and widely used. The present phenotypes and predictive scores may be reliable in the population, but those appear to be unreliable in each individual in real practice. Either undertreatment or overtreatment in childhood asthma is an important issue, because they are associated with poor compliance, increments of socioeconomic burdens, and poor quality of life. There is no doubt about the clinical efficacy of inhaled corticosteroid (ICS) in childhood asthma, but the negative effect of long-term use of ICS on the height is emerging. Therefore general physicians should consider an individualized management using specific phenotypes and endotypes, and regularly re-evaluate the drug-response, level of control, and adherence/compliance to avoid inadequate treatment.

Keyword

Phenotype; Endotype; Asthma; Child

MeSH Terms

Asthma*
Child
Compliance
Humans
Phenotype*
Quality of Life
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