Molecular endotypes of pediatric asthma: a novel language directs asthma treatment!

Introduction Pediatric bronchial asthma has been clinically recognized as a heterogeneous disease for decades, including descriptions of patients with allergyassociated disease, viral induced asthma and exercise-induced asthma. Despite this recognition, treatment approaches were similar, involving the use of nonspecific agents, such as inhaled corticosteroids (CS) and beta 2agonists. These drugs, which were generally effective in the majority of asthmatic children, also failed in many. In each case, the molecular underpinnings of the heterogeneity or the varied responses to treatment were unknown. In the middle of the 20th century, a significant increase in the prevalence of bronchial asthma (BA) was reported worldwide. This rise particularly referred to BA of pediatric onset; therefore asthma became one of the most prevalent chronic inflammatory diseases in pediatrics. BA is described as a chronic inflammatory disorder of the airways with inflammatory symptoms causing a variable degree of airflow limitation and is accompanied by an increased sensitivity to multiple pharmacological and nonpharmacological stimuli. The bronchial obstruction seen is often reversible, either spontaneously or with treatment. BA is considered a complex disorder based on a multifactorial interaction of genetic predisposition and diverse environmental influences.