Phenotype and endotype in pediatric asthma

Hyeon-Jong Yang; Bong-Seong Kim; Woo Kyung Kim; Jakyoung Kim; Jin Tack Kim; Dong In Suh; Young Yull Koh; Youn Ho Shin; So-Yeon Lee; Dae Hyun Lim; Ji Tae Choung; Hyo-Bin Kim

doi:10.4168/aard.2014.2.2.85

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Yang, Kim, Kim, Kim, Kim, Suh, Koh, Shin, Lee, Lim, Choung, Kim, and Asthma Study Group in Preschool Children: Phenotype and endotype in pediatric asthma

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Allergy, Asthma & Respiratory Disease 2014; 2(2): 85-90.

Published online: 31 May 2014

DOI: https://doi.org/10.4168/aard.2014.2.2.85

Phenotype and endotype in pediatric asthma

Hyeon-Jong Yang¹, Bong-Seong Kim², Woo Kyung Kim³, Jakyoung Kim⁴, Jin Tack Kim⁵, Dong In Suh⁶, Young Yull Koh⁶, Youn Ho Shin⁷, So-Yeon Lee⁸, Dae Hyun Lim^9,¹⁰, Ji Tae Choung^11,¹², Hyo-Bin Kim¹³; Asthma Study Group in Preschool Children

¹Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

²Department of Pediatrics, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

³Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

⁴Department of Pediatrics, Kangwon National University School of Medicine, Chunchon, Korea.

⁵Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea.

⁶Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

⁷Department of Pediatrics, CHA University College of Medicine, Pocheon, Korea.

⁸Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

⁹Department of Pediatrics, Inha University School of Medicine, Incheon, Korea.

¹⁰Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon, Korea.

¹¹Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

¹²Environmental Health Center for Asthma, Korea University Anam Hospital, Ministry of Environment, Seoul, Korea.

¹³Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Correspondence to: Dae Hyun Lim. Department of Pediatrics, Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: +82-32-890-2843, Fax: +82-32-890-2844, dhyunlim@inha.ac.kr

Received 14 November 2013 Revised 3 December 2013 Accepted 24 January 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

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.

Keywords: Phenotype, Endotype, Asthma, Child

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