info:eu-repo/semantics/article
New perspectives in the treatment of allergic rhinitis and asthma in children
Autor
Baena Cagnani, Carlos E.
Passalacqua, Giovanni
Gómez, Maximiliano
Zernotti, Mario Emilio
Canonica, Giorgio Walter
Institución
Resumen
PURPOSE OF REVIEW: Allergic rhinitis and asthma are some of the most prevalent chronic diseases in children. Meticulous evaluations of the therapeutic options and interventions are needed to control this burden. The central pathogenic mechanism is an immediate hypersensitivity reaction, followed by interventions in the allergic cascade. Once inflammation is established, potent anti-inflammatory agents or mediator antagonists could help control the phenomenon and reduce the characteristic symptoms related to severity. RECENT FINDINGS: Monoclonal antibody against IgE has demonstrated its efficacy in reducing the symptoms of asthma and rhinitis. In difficult-to-treat asthma patients it allows a reduction in the dose of inhaled steroids, the number of exacerbations, emergency visits and hospitalizations. Its broad implementation is limited by its high cost because adverse events are not a concern. Specific sublingual immunotherapy gave promising results in clinical trials, while modifying immunoglobulins and cytokine profiles, also inducing T-cell tolerance. Safety issues of subcutaneous immunotherapy have been surpassed by the sublingual route, with equivalent efficacy. The new inhaled steroid ciclesonide is effective in established inflammation, is activated only in the respiratory system, and has negligible systemic effects. SUMMARY: Robust evidence on the efficacy and safety of several novel therapies in rhinitis and asthma is available. Fil: Baena Cagnani, Carlos E. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina Fil: Passalacqua, Giovanni. Allergy and Respiratory Disease, DIMI, University of Genoa, Genoa, Italy Fil: Gómez, Maximiliano. Alas Medical Centre, Salta, Argentina Fil: Zernotti, Mario Emilio. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina Fil: Canonica, Giorgio Walter. Allergy and Respiratory Disease, DIMI, University of Genoa, Genoa, Italy