Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities. Also reviewed are links of asthma with mental health disorders, sleep disturbances and other comorbidities. A stepwise approach to asthma management is discussed that includes pharmacologic and non-pharmacologic strategies in the pediatric population. The role of immunotherapy and use of various immunomodulators are considered as well.
Keywords: Asthma; Endotypes; Environmental triggers; Exercise-induced asthma; Immunotherapy; Inhaled corticosteroids; Leukotriene modulators/montelukast; Mepolizumab; Obesity; Omalizumab; Poverty; Short-acting beta-2 agonists (SABA); Sleep disturbances; Socioeconomic status.
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