Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma
Anti-inflammatory therapy, centered on inhaled steroids, suppresses airway inflammation in asthma, reduces asthma mortality and hospitalization rates, and achieves clinical remission in many pediatric patients. However, the spontaneous remission rate of childhood asthma in adulthood is not high, and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/8/1253 |
| _version_ | 1797432321038614528 |
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| author | Mitsuru Tsuge Masanori Ikeda Hirokazu Tsukahara |
| author_facet | Mitsuru Tsuge Masanori Ikeda Hirokazu Tsukahara |
| author_sort | Mitsuru Tsuge |
| collection | DOAJ |
| description | Anti-inflammatory therapy, centered on inhaled steroids, suppresses airway inflammation in asthma, reduces asthma mortality and hospitalization rates, and achieves clinical remission in many pediatric patients. However, the spontaneous remission rate of childhood asthma in adulthood is not high, and airway inflammation and airway remodeling persist after remission of asthma symptoms. Childhood asthma impairs normal lung maturation, interferes with peak lung function in adolescence, reduces lung function in adulthood, and increases the risk of developing chronic obstructive pulmonary disease (COPD). Early suppression of airway inflammation in childhood and prevention of asthma exacerbations may improve lung maturation, leading to good lung function and prevention of adult COPD. Biological drugs that target T-helper 2 (Th2) cytokines are used in patients with severe pediatric asthma to reduce exacerbations and airway inflammation and improve respiratory function. They may also suppress airway remodeling in childhood and prevent respiratory deterioration in adulthood, reducing the risk of COPD and improving long-term prognosis. No studies have demonstrated a suppressive effect on airway remodeling in childhood severe asthma, and further clinical trials using airway imaging analysis are needed to ascertain the inhibitory effect of biological drugs on airway remodeling in severe childhood asthma. In this review, we describe the natural prognosis of lung function in childhood asthma and the risk of developing adult COPD, the pathophysiology of allergic airway inflammation and airway remodeling via Th2 cytokines, and the inhibitory effect of biological drugs on airway remodeling in childhood asthma. |
| first_indexed | 2024-03-09T09:58:41Z |
| format | Article |
| id | doaj.art-c53467e7464e43ae9616a2ba021a59e1 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T09:58:41Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-c53467e7464e43ae9616a2ba021a59e12023-12-01T23:34:31ZengMDPI AGChildren2227-90672022-08-0198125310.3390/children9081253Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial AsthmaMitsuru Tsuge0Masanori Ikeda1Hirokazu Tsukahara2Department of Pediatric Acute Diseases, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, JapanOkayama University School of Medicine, Okayama 700-8558, JapanDepartment of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, JapanAnti-inflammatory therapy, centered on inhaled steroids, suppresses airway inflammation in asthma, reduces asthma mortality and hospitalization rates, and achieves clinical remission in many pediatric patients. However, the spontaneous remission rate of childhood asthma in adulthood is not high, and airway inflammation and airway remodeling persist after remission of asthma symptoms. Childhood asthma impairs normal lung maturation, interferes with peak lung function in adolescence, reduces lung function in adulthood, and increases the risk of developing chronic obstructive pulmonary disease (COPD). Early suppression of airway inflammation in childhood and prevention of asthma exacerbations may improve lung maturation, leading to good lung function and prevention of adult COPD. Biological drugs that target T-helper 2 (Th2) cytokines are used in patients with severe pediatric asthma to reduce exacerbations and airway inflammation and improve respiratory function. They may also suppress airway remodeling in childhood and prevent respiratory deterioration in adulthood, reducing the risk of COPD and improving long-term prognosis. No studies have demonstrated a suppressive effect on airway remodeling in childhood severe asthma, and further clinical trials using airway imaging analysis are needed to ascertain the inhibitory effect of biological drugs on airway remodeling in severe childhood asthma. In this review, we describe the natural prognosis of lung function in childhood asthma and the risk of developing adult COPD, the pathophysiology of allergic airway inflammation and airway remodeling via Th2 cytokines, and the inhibitory effect of biological drugs on airway remodeling in childhood asthma.https://www.mdpi.com/2227-9067/9/8/1253bronchial asthmachronic obstructive pulmonary diseaselung function trajectorytype 2 inflammationairway remodelingomalizumab |
| spellingShingle | Mitsuru Tsuge Masanori Ikeda Hirokazu Tsukahara Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma Children bronchial asthma chronic obstructive pulmonary disease lung function trajectory type 2 inflammation airway remodeling omalizumab |
| title | Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma |
| title_full | Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma |
| title_fullStr | Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma |
| title_full_unstemmed | Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma |
| title_short | Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma |
| title_sort | novel lung growth strategy with biological therapy targeting airway remodeling in childhood bronchial asthma |
| topic | bronchial asthma chronic obstructive pulmonary disease lung function trajectory type 2 inflammation airway remodeling omalizumab |
| url | https://www.mdpi.com/2227-9067/9/8/1253 |
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