Asthma in childhood

doi:10.1016/0091-6749(83)90479-7

Journal of Allergy and Clinical Immunology

Volume 72, Issue 5, Part 2, November 1983, Pages 526-539

https://doi.org/10.1016/0091-6749(83)90479-7 Get rights and content

Abstract

Asthma is defined as an obstructive disease of the pulmonary airways resulting from spasm of airway muscle, increased mucus secretion, and inflammation. The airways of asthmatic individuals are hyperresponsive to a variety of stimuli including cold air, atmospheric irritants, pharmacologically active chemicals, various drugs, and hyperventilation. The fundamental abnormality underlying the hyperresponsiveness appears to be genetically determined; two theories explaining the abnormality have received the most attention. One theory suggests that asthma is due to abnormal beta-adrenergic receptor-adenylate cyclase function with decreased adrenergic responsiveness. An alternate theory proposes that increased cholinergic activity in the airway is the fundamental defect in the disease. The true prevalence of asthma has been difficult to determine owing to uncertainties regarding the definition of the disease. Prevalence in various populations of children ranged from 1.37% to 11.4% or higher. Most studies report a preponderance of asthma in boys over girls, with ratios varying from 1.3:1 to 3.3:1. Risk factors for the disease include a history of atopy, acute lower respiratory tract disease, parental cigarette smoking, and bronchiolitis or croup. The spectrum of asthma is that of an illness beginning early in life and persisting, in some cases, through adulthood. Signs of the disease may be apparent in the first 2 yr of life and are often associated with viral respiratory infections. Disproportionate narrowing of peripheral airways and decreased static elastic recoil properties of the lung predispose infants and young children to asthma. During midchildhood there is a tendency toward improvement, with continued improvement during adolescence. The goal of management of the child with asthma is to reduce symptoms sufficiently so that the child can regularly attend school, engage in play activities, and sleep through the night uninterrupted, while avoiding unacceptable levels of adverse drug effects. Nonpharmacologic management includes both avoidance of environmental irritants and behavioral approaches to overcome emotional precipitants that lead to attacks. Pharmacologic treatment includes the use of four classes of drugs: (1) adrenergics, (2) theophylline, (3) cromolyn, and (4) corticosteroids. The prognosis of asthma in childhood is good. Although airway activity may remain abnormal for indefinite periods of time, most children reach a state where they are virtually free of symptoms.

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Asthma is an allergic inflammatory disease of the airways. The interaction between bronchial epithelial cells and eosinophils is an important feature of an asthma attack. Eotaxin, an eosinophil-specific C-C chemokine, is a potent chemoattractant involved in the mobilization of eosinophils into the airway after allergic stimulation. Cnidii monnieri fructus, the dried fruit of Cnidium monnieri Cusson, has been used as an antipruritogenic agent in ancient China. Osthol is the major component of Cnidii monnieri fructus extract. We investigated the ability of osthol to regulate cytokine-induced eotaxin expression in the human bronchial epithelial cell line BEAS-2B.
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Asthma in childhood

Abstract

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy

Lancet

Arch Dis Child

N Engl J Med

JAMA

J Allergy Clin Immunol

Arch Dis Child

Pediatrics

Pediatrics

J Pediatr

Br Med J

Am Rev Respir Dis

Am Rev Respir Dis

J Allergy Clin Immunol

N Engl J Med

Pediatr Clin North Am

Pediatr Clin North Am

Definition and categories of asthma

Editorial: What is this thing called love?—Or, defining asthma

Am Rev Respir Dis

Immunology and pathophysiology of asthma

The influence of clinical factors on site of airway obstruction in asthma

Am Rev Respir Dis

State of the art: bronchial hyperreactivity

Am Rev Respir Dis

Airway responsiveness to cold air and hyperpnea in normal subjects and in those with hay fever and asthma

Am Rev Respir Dis

Location and mechanism of airway constriction during inhalation of sulphur dioxide

J Appi Physiol

Bronchial reactivity to inhaled histamine: a method and clinical survey

Clin Allergy

Effect of prostaglandins F2α and E2 on airway conductance in healthy subjects and asthmatic patients

Am Rev Respir Dis

Comparative airway and vascular activities of leukotuenes C-l and D in vivo and in vitro

Editorial: Leukotrienes and lung disease

Thorax

Alpha-adrenergic hyperresponsiveness in asthma

N Engl J Med

Effects of adrenergic receptor blockade on airway conductance and lung volume in normal and asthmatic subjects

Br Med J

Exercise-induced asthma

Effect of maximal respiratory manoevuers on bronchial sensitivity of asthmatic patients as compared to normal people

Br Med J

Editorial: Airways reactivity and the need for a simple test

Am Rev Respir Dis

Asthma: classification and pathogenesis

Genetic factors in childhood asthma

Thorax

Mechanisms of bronchial hyperreactivity in normal subjects after upper respiratory tract infection

Am Rev Respir Dis

Bronchial hyperreactivity in healthy subjects after exposure to ozone

Am Rev Respir Dis

Decreased beta-adrenergic receptors on polymorphonuclear leukocytes after adrenergic therapy

N Engl J Med

Neurophysiologic aspects of asthma

Prevalence, natural history and relationship of wheezy bronchitis and asthma in children: an epidemiologic study

Br Med J

A family study of the genetic basis of asthma and wheezy bronchitis

Arch Dis Child

Frequency of bronchial asthma in Swedish school children

Acta Paediatr Scand 43(suppl.)

Allergic diseases in adolescents. I. Description of survey; prevalence of allergy

Am J Dis Child

Prevalence and natural history of asthma in school children

Br Med J

The changing prevalence of asthma in school children

Clin Allergy

Effect of prostaglandins F_2α and E₂ on airway conductance in healthy subjects and asthmatic patients