Asthma in Childhood: Current Perspectives on Diagnosis and Treatment

Abstract

This narrative review aims to appraise the current perspectives on the diagnosis and treatment of asthma in childhood, with a focus on diagnostic steps, disease phenotypes and endotypes, and novel biologic therapies. Asthma in children and adults is now regarded as a complex cluster of disease phenotypes linked to specific endotypes. Unravelling asthma heterogeneity is key to understanding the pathogenic mechanisms of the disease and developing novel treatment strategies that are tailored according to these phenotypes and endotypes. This will make for a more precise diagnosis and more personalised treatments. There is currently no gold-standard method for making the diagnosis of asthma due to the non-specific nature of asthma symptoms; respiratory symptoms and airflow limitation need to be carefully evaluated to establish a causal relationship with the disease. Although corticosteroids and bronchodilators still constitute the recommended step-wise pharmacological based therapy in both childhood and adult asthma, novel biologic therapies targeting type 2 immunity have been proven effective in severe childhood and adult asthma and will likely lead to improved disease outcomes.