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Asthma pp 95-103 | Cite as

Allergic asthma in children

  • M. Götz
  • I. Eichler
  • C. Wojnarowski
  • D. Y. Koller
Conference paper

Summary

Childhood asthma appears characterised by interactions of viral infections, action of allergens, environmental influences and their isolated or combined influence on bronchial hyperresponsiveness as the pathophysiologically measurable substrate of the disease. In view of lack of direct evidence of airway inflammation in children assessment of indirect markers either in the form of eosinophil products or late bronchial reactions have become more important. Both variables will allow for definition of disease activity and treatment responses. Little is known as to the onset of bronchial responsiveness and the differential weight of variables mentioned above. Although a genetic basis for atopy and asthma has become likely recently its relative contribution to the individual disease expression remains questionable. From a practical point antiinflammatory prophylactic medication influencing the longterm bronchial hyperresponsiveness has moved up in the ladder of therapeutic regimes. Future treatment will possibly be directed towards suppression of IgE/IL4 formation while at present balanced drug regimes, prevention of infection and environmental sanitation remain major tools for modulation of asthma severity.

Keywords

Airway Inflammation Childhood Asthma Allergic Asthma Airway Responsiveness Eosinophil Cationic Protein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Allergisches Asthma im Kindesalter

Zusammenfassung

Kindliches Asthma ergibt sich aus einem Zusammenspiel zwischen genetischer Prädisposition, viraler Infektion, Allergie sowie Einflüssen aus der Umwelt. Die resultierende bronchiale Hyperreagibilität ist in ihrem Ausmaß variabel, im Gegensatz zu anderen Erkrankungen wie der zystischen Fibrose, dem postviralen Giemen etc. jedoch mehr oder weniger permanent nachweisbar. Hinsichtlich der Prognose sind die auslösenden Momente insofern von Bedeutung, als Atopie und Hyperreagibilität enge, lebenslange Verbindungen zeigen, reine virusbedingte bronchiale Hyperreagibilität aber eine günstige Prognose aufweist und nach den ersten Lebensjahren verschwinden kann. Die Atemwegsgeometrie trägt bei jungen Kindern zusätzlich zur rascher eintretenden Obstruktion bei. Aus therapeutischer Sicht ist aus Vorsichtsgründen gegenüber der Verwendung von Beta-2-Mimetika im Langzeitmanagement eine gewisse Zurückhaltung eingetreten, die auf der für das Kindesalter anzunehmenden entzündlichen Natur des Asthmas beruht, wenn auch konkrete Daten zur Schädlichkeit der Beta-2-Mimetika fehlen. Der Trend geht unverkennbar in Richtung antiinflammatorischer Substanzen wie den topischen Steroiden oder dem DNCG. Der hohe Wert der Beta-2-Mimetika für die Behebung der akuten Bronchusobstruktion ist davon nicht berührt.

Zur Beurteilung der Aktivität der Eosinophilen-vermittelten Aktivität des Asthmaprozesses haben sich Eosinophilen-Marker wie das ECP und EPX bewährt.

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Copyright information

© Springer-Verlag/Wien 1993

Authors and Affiliations

  • M. Götz
    • 1
    • 2
  • I. Eichler
    • 2
  • C. Wojnarowski
    • 2
  • D. Y. Koller
    • 2
  1. 1.Universitäts-Klinik für KinderheilkundeWienÖsterreich
  2. 2.University Children’s HospitalVienna

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