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Advances in the pathogenesis and personalised treatment of paediatric asthma

The diversity of pathology of severe paediatric asthma demonstrates that the one-size-fits-all approach characterising many guidelines is inappropriate. The term “asthma” is best used to describe a clinical syndrome of wheeze, chest tightness, breathlessness, and sometimes cough, making no assumptions about underlying pathology. Before personalising treatment, it is essential to make the diagnosis correctly and optimise basic management. Clinicians must determine exactly what type of asthma each child has. We are moving from describing symptom patterns in preschool wheeze to describing multiple underlying phenotypes with implications for targeting treatment. Many new treatment options are available for school age asthma, including biological medicines targeting type 2 inflammation, but a paucity of options are available for non-type 2 disease. The traditional reliever treatment, shortacting β2 agonists, is being replaced by combination inhalers containing inhaled corticosteroids a

Mucus plugs revealed via imaging correlate with airflow obstruction, eosinophilia

WASHINGTON — Providers can measure mucus plugs directly with computer tomography and indirectly with MRI imaging, according to data presented at the American Thoracic Society International Conference.Also, mucus scores based on CT imaging correlate with changes in airflow obstruction and eosinophilia over time, Eleanor Dunican, MB, BCH, BAO, PhD (ED), consultant respiratory physician, St.

Mucus-plugged airways marked by prominent airway remodeling in patients with asthma

WASHINGTON — Airways plugged with mucus experience more remodeling than airways that have not been plugged with mucus among patients with asthma, according to data presented at the American Thoracic Society International Conference.But although this remodeling occurs throughout the airway wall, it is not uniform, Aileen Hsieh, MS, PhD candidate, Hackett Lab, UBC Centre for Heart Lung

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