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KMID : 1035620140020020085
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Allergy Asthma & Respiratory Disease
2014 Volume.2 No. 2 p.85 ~ p.90
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Phenotype and endotype in pediatric asthma
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Yang Hyeon-Jong
Kim Bong-Seong
Kim Woo-Kyung
Kim Ja-Kyoung
Kim Jin-Tack
Suh Dong-In
Koh Young-Yull
Shin Youn-Ho
Lee So-Yeon
Lim Dae-Hyun
Choung Ji-Tae
Kim Hyo-Bin
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Abstract
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Asthma is not a homogeneous disease presenting variable clinical features, but a complex disorder consisting of many different disease entities characterized by variable air-flow limitation. To date, there are little effective preventive-strategies for the development of asthma, and it has been emphasized that early identification and intervention are the best ways to reduce the associated morbidities, quality of life, and socioeconomic burden. Predicting the natural course of asthma is still difficult, although various phenotypic approaches and predictive scores are developed and widely used. The present phenotypes and predictive scores may be reliable in the population, but those appear to be unreliable in each individual in real practice. Either undertreatment or overtreatment in childhood asthma is an important issue, because they are associated with poor compliance, increments of socioeconomic burdens, and poor quality of life. There is no doubt about the clinical efficacy of inhaled corticosteroid (ICS) in childhood asthma, but the negative effect of long-term use of ICS on the height is emerging. Therefore general physicians should consider an individualized management using specific phenotypes and endotypes, and regularly re-evaluate the drug-response, level of control, and adherence/compliance to avoid inadequate treatment.
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KEYWORD
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Phenotype, Endotype, Asthma, Child
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