Astma u djece - osvrt na kraju 2024. godinene
DOI:
https://doi.org/10.13112/pc.965Ključne riječi:
astma u djece, predškolsko piskanje u prsima, biološka terapija, prevencijaSažetak
Astma je najčešća kronična bolest dišnih puteva u dječjoj dobi. U podlozi astme dva su glavna endotipa; jaki T2 endotip (engl. T2 high) i slabi T2 endotip (engl. T2 low), a osnovu liječenja čine inhalacijski kortikosteroidi (IKS). Zbog slabe adherencije liječenju u bolesnika s blagim simptomima, smjernice Globalne inicijative za astmu (GINA) u prvom koraku liječenja preporučaju intermitentnu primjenu kombiniranog lijeka (IKS+formoterol ili IKS+kratkodjelujući β2 agonist). Po prvi puta u GINA smjernicama je opisan koncept remisije astme. Razlikujemo kliničku i potpunu (patofiziološku) remisiju, pod terapijom i bez terapije,. Piskanje u prsima u preškolskoj dobi povezano je sa slabijom plućnom funkcijom u odrasloj dobi. Novi dokument Europskog respiratornog društva iz 2024. godine predlaže novu definiciju piskanja u prsima u predškolskoj dobi, te ističe važnost biomarkera u fenotipizaciji ovog kliničkog entiteta. Periferna eozinofilija i alergijska senzibilizacija na inhalacijske alergene za sada se čine najboljim markerom odgovora ovih bolesnika na terapiju IKS. Biološki lijekovi u astmi omogućavaju personalizirani pristup liječenju, a trenutni je znanstveni interes posebno usmjeren prema ranoj prevenciji astme.
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Autorska prava (c) 2024 Iva Topalušić, Ozana Hofmann Jaeger, Ivan Pavić, Irena Ivković Jureković
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