Sy Duong-Quy, Le Nguyen-Ngoc-Quynh, Hoang Nguyen-Huu
{"title":"'Personalized medicine': phenotyping pediatric obstructive sleep apnea.","authors":"Sy Duong-Quy, Le Nguyen-Ngoc-Quynh, Hoang Nguyen-Huu","doi":"10.1097/MCP.0000000000001119","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Obstructive sleep apnea (OSA) is common in children. Phenotyping pediatric OSA has a crucial role in personalized diagnosis and treatment to improve outcomes for this population. This review sets forth a clinical approach that allows for phenotyping pediatric OSA.</p><p><strong>Recent findings: </strong>The emerging concept of phenotyping pediatric OSA is based on identifying a primary cause, which leads to a more precise understanding of the pathogenesis in any individual patient. Phenotyping enables treatment focusing on the primary cause, but does not exclude the need for supplemental management strategies based on other recognizable traits. The identification of pediatric OSA phenotypes (POP) relies on observable characteristics with significant prevalence. This review will concentrate on the most important phenotypes seen in clinical practice: pediatric OSA with craniofacial abnormalities (POPCA); OSA with upper airway disease (POPUAD); OSA with obesity (POPO), and OSA associated with neuromuscular disease (POPNED).</p><p><strong>Summary: </strong>Phenotyping pediatric OSA is a form of personalized medicine. By identifying clinical subtypes, individualized treatment plans can be devised in order to choose therapies that are associated with predictable responses. Moreover, it is rare that a therapeutic modality is devoid of possible complications; knowledge of the phenotype being treated can enable early intervention should those occur. Finally, all of the aforementioned phenotypes require personalized support incorporating individualized care plans so as to optimize the quality of life and overall sleep health of children with OSA.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Pulmonary Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCP.0000000000001119","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Obstructive sleep apnea (OSA) is common in children. Phenotyping pediatric OSA has a crucial role in personalized diagnosis and treatment to improve outcomes for this population. This review sets forth a clinical approach that allows for phenotyping pediatric OSA.
Recent findings: The emerging concept of phenotyping pediatric OSA is based on identifying a primary cause, which leads to a more precise understanding of the pathogenesis in any individual patient. Phenotyping enables treatment focusing on the primary cause, but does not exclude the need for supplemental management strategies based on other recognizable traits. The identification of pediatric OSA phenotypes (POP) relies on observable characteristics with significant prevalence. This review will concentrate on the most important phenotypes seen in clinical practice: pediatric OSA with craniofacial abnormalities (POPCA); OSA with upper airway disease (POPUAD); OSA with obesity (POPO), and OSA associated with neuromuscular disease (POPNED).
Summary: Phenotyping pediatric OSA is a form of personalized medicine. By identifying clinical subtypes, individualized treatment plans can be devised in order to choose therapies that are associated with predictable responses. Moreover, it is rare that a therapeutic modality is devoid of possible complications; knowledge of the phenotype being treated can enable early intervention should those occur. Finally, all of the aforementioned phenotypes require personalized support incorporating individualized care plans so as to optimize the quality of life and overall sleep health of children with OSA.
审查目的:阻塞性睡眠呼吸暂停(OSA)在儿童中很常见。对小儿 OSA 进行表型分析对于个性化诊断和治疗以改善该人群的治疗效果至关重要。本综述提出了一种可对小儿 OSA 进行表型分析的临床方法:新出现的小儿 OSA 表型概念以确定主要病因为基础,从而更准确地了解每个患者的发病机制。通过表型分析,可以针对主要病因进行治疗,但并不排除根据其他可识别特征采取补充管理策略的必要性。儿科 OSA 表型(POP)的识别依赖于具有显著患病率的可观察特征。本综述将集中讨论临床实践中最重要的表型:伴有颅面异常的小儿 OSA(POPCA)、伴有上气道疾病的 OSA(POPUAD)、伴有肥胖的 OSA(POPO)和伴有神经肌肉疾病的 OSA(POPNED)。通过识别临床亚型,可以制定个体化治疗方案,从而选择与可预测反应相关的疗法。此外,很少有治疗方法不可能出现并发症;了解所治疗的表型可以在出现并发症时及早干预。最后,上述所有表型都需要结合个性化护理计划的个性化支持,以优化 OSA 患儿的生活质量和整体睡眠健康。
期刊介绍:
Current Opinion in Pulmonary Medicine is a highly regarded journal offering insightful editorials and on-the-mark invited reviews, covering key subjects such as asthma; cystic fibrosis; infectious diseases; diseases of the pleura; and sleep and respiratory neurobiology. Published bimonthly, each issue of Current Opinion in Pulmonary Medicine introduces world renowned guest editors and internationally recognized academics within the pulmonary field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.