In real life, we all know that for children, disease is often a serious disease, especially childhood asthma. In recent years, the incidence rate of childhood asthma has increased year by year. Once induced, it will bring serious harm to the health of patients. So, what exactly is childhood asthma? Let's take a look below!
1. What is asthma ‡?
Asthma is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness, with recurrent wheezing, coughing, shortness of breath, and chest tightness as the main clinical manifestations, often occurring or worsening at night and/or in the early morning. The etiology of asthma is complex and varies greatly among individuals. Its symptoms are mainly non-specific, and sometimes only one clinical symptom is prominent, such as chronic cough or only chest tightness without wheezing, which brings certain difficulties to the diagnosis of asthma. When children experience the above respiratory symptoms due to exposure to allergens (also known as allergens), cold air, physical or chemical stimuli, respiratory infections, exercise, and excessive ventilation (such as laughing and crying), as well as when wheezing mainly in the exhalation phase can be heard, asthma should be highly suspected. Typical asthma patients can confirm the presence of reversible extensive airflow limitation in the airway through bronchodilation tests; Atypical asthma patients have airway hyperresponsiveness, manifested as positive bronchial provocation test.
What are the clinical characteristics of childhood asthma?
(1) Often manifested as wheezing, coughing, shortness of breath, and chest tightness. There are various triggers, including upper respiratory tract infections, allergen exposure, vigorous activity, laughter, crying, climate change, etc; Has the characteristics of recurrent, seasonal, and reversible; There is a temporal pattern, often occurring or worsening at night and/or in the early hours of the morning, during autumn and winter seasons, or during seasonal changes; Antiasthmatic drugs can usually alleviate symptoms.
(2) Children often have a history of other allergic diseases such as eczema, allergic rhinitis, or a family history of allergic diseases such as asthma.
(3) Children with chronic duration and clinical remission may have no abnormal signs. The most common signs during an asthma attack are prolonged exhalation and wheezing sounds. But when the acute attack of asthma is particularly severe, due to severe airway obstruction, respiratory sounds can be significantly reduced, wheezing sounds can weaken or disappear, and other signs of respiratory failure usually exist, which can be life-threatening.
(4) The characteristics of lung function in children with asthma are variable expiratory airflow limitation and increased airway responsiveness.
Can asthma be inherited?
Asthma is a heterogeneous disease with genetic predisposition, with a certain tendency towards familial clustering. Family history of asthma has long been recognized as a high-risk factor for the onset of asthma. Children whose parents have asthma have a 20% probability of developing asthma, which is 2-5 times higher than other children; Children whose parents both suffer from asthma have a prevalence rate of about 50% The onset of asthma is the result of a combination of genetic and environmental factors.
4. What are the mechanisms and risk factors of pediatric onset?
At present, it is mainly believed that multiple mechanisms such as immune mechanism, neural regulation mechanism, and genetic mechanism jointly participate in the initiation of airway inflammation, the persistence of chronic inflammation, and airway remodeling. The risk factors that affect the occurrence, development, and severity of childhood asthma attacks are complex. Among the numerous risk factors, further attention should be paid to the multiple negative impacts of environmental pollutants, especially fine particulate matter (PM) 2.5, on children's respiratory health. Environmental pollutants can exacerbate symptoms of asthma in children, increase the risk of acute asthma attacks and hospitalization. A study suggests that 13% of global childhood asthma may be related to traffic related air pollution, and obesity is also an important risk factor for childhood asthma and wheezing.
What are the differences and connections between childhood asthma and adult asthma?
Asthma in young children is mainly induced by respiratory infections, and the incidence of allergen induced asthma increases with age; Exercise induced asthma is more common in children than in adults; The lung function testing methods used to diagnose reversible airflow limitation in asthma should be selected according to different ages; The incidence rate of asthma is higher than that of adults due to the incomplete immune function of children, immature lung, trachea and bronchus. The prognosis of childhood asthma is also different from that of adult asthma. After standardized treatment, with factors such as reduced infection and lung function development, 60% of asthmatic children's symptoms can disappear during puberty, but 12% to 35% of children's symptoms will reappear in adulthood. Therefore, it cannot be wrongly assumed that asthma is a childhood disease, and the disease will self heal with age. On the contrary, if childhood asthma is not diagnosed correctly and treated properly in the early stages, it may affect lung development, especially in severely asthmatic children with multiple allergies. 80% to 90% of them may develop into adult asthma, and the incidence of chronic obstructive pulmonary disease is significantly increased in adulthood.
What are the common tests for childhood asthma?
(1) Pulmonary ventilation function test: Pulmonary function test can understand the degree of airflow limitation and airway hyperresponsiveness, which is an important means of diagnosing asthma and an important basis for evaluating asthma control level and severity. For all eligible children (usually over 5 years old), pulmonary ventilation function testing and regular follow-up should be conducted before asthma diagnosis and control treatment begins.
(2) Allergen testing: Allergen sensitization, especially early sensitization to inhaled allergens (≤ 3 years old), is one of the main high-risk predictors of persistent asthma in children. It is recommended to conduct allergen skin prick tests or serum allergen specific IgE tests as much as possible for all children suspected of asthma.
(3) Airway inflammation index detection: detection of exhaled nitric oxide (FeNO) levels to evaluate the status of eosinophilic airway inflammation.
(4) Chest imaging examination: Routine chest imaging examination is not recommended for children with asthma. For children with recurrent wheezing or coughing, when suspecting other diseases besides asthma, chest X-ray or CT examination can be selected based on clinical clues.
What should I do if I suspect my child has asthma?
If a child has the above symptoms, it is necessary to go to a regular hospital's pediatric asthma specialist clinic for treatment, develop personalized diagnosis and treatment plans, so that children's asthma can be well controlled, and give them a healthy and happy childhood.