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Προσχολικό παιδί με επεισοδιακό υποτροπιάζοντα βρογχόσπασμο: Ποιό από αυτά τα περιστατικά θα αναπτύξει άσθμα αργότερα;

Ο βρογχόσπασμος νωρίς στην ζωή των παιδιών είναι κοινό φαινόμενο και πολύ ετερογενής κλινική οντότητα. Γενετική προδιάθεση, λοιμώξεις, περιβάλλον, αλλεργική ευαισθητοποίηση, διατροφή και άλλοι παράγοντες επηρεάζουν την εξέλιξη και πορεία του καλόηθους παροδικού βρογχόσπασμου σε επιμένων φαινόμενο και μετέπειτα σε εγκατεστειμένο μακροχρόνιο παιδικό αλλεργικό άσθμα.

Wheezing in early life is a common and highly heterogeneous clinical process. Although most children with episodic wheeze in early life experience a benign long-term prognosis and become (and remain) free of wheezing during school age and beyond, a substantial proportion of cases evolve into childhood persistent asthma.

Research during the past 2 decades has identified many patterns of wheezing and their potential development into asthma. Risk factors for asthma have been comprehensively studied and include recurrent wheezing and atopic features. Although several prediction models for subsequent asthma have been developed, most are limited by relatively modest prediction power for asthma, with substantial proportions of children identified by these models not progressing to persistent asthma.

Future research should focus on advancing these approaches through incorporation of biomarkers, genetics, and genomics, which might lead to more robust models for asthma prediction. With such models, targeted asthma prevention strategies can be studied in the highest-risk populations.

Annals of Allergy Asthma and Immunology, December 2015  Volume 115, Issue 6, Pages 463–470