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Biomarkers and childhood asthma: Improving control today and tomorrow

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Although we aim to normalize the lives of children with asthma by controlling their day and night symptoms and preventing exacerbations and morbidity, optimal childhood asthma management may result when the assessment and monitoring of asthma includes measured biomarkers—meaning objective, biological measures of lung dysfunction and inflammation. Precedence for such an approach to optimizing disease control and outcomes can be appreciated in comparing asthma with insulin-dependent diabetes mellitus (IDDM) management in children. Optimal management of these chronic conditions shares the fundamental goals to eliminate day and night symptoms and prevent exacerbations and morbidity. However, IDDM management focuses primarily on peripheral blood biomarkers of tight control (i.e., daily serum glucose levels) and predictors of long-term morbidity (i.e., hemoglobin A1C, or hemoglobin "remodeling" due to chronically poor control of glucose) for optimal assessment and monitoring and to best achieve these clinical objectives (Alemzadeh R, et al. Diabetes mellitus in children. In Nelson Textbook of Pediatrics, 17th ed. Behrman RE, Kliegman RM, and Jenson HB (Eds). Philadelphia: W.B. Saunders Co., 1947–1972, 2004). The improved outcomes in IDDM have resulted primarily from the progress to a biomarker-based assessment to achieve tight, optimal control and not, presently, as a dramatic change in therapy. The progress in IDDM management provides a compelling paradigm to consider for improving childhood asthma management. Indeed, the time is good to not only consider some newly available biomarkers, but also to reconsider some biomarkers of lung dysfunction, inflammation, and atopy that could be broadly used today. This article reconsiders the use of current and emerging measures of lung dysfunction, inflammation, and atopy in assessing tight control and long-term risk. Concluding emphasis will be placed on what can be implemented today.
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Document Type: Review Article

Publication date: July 1, 2005

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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