Therapy of asthma in pediatric age

Asthma is a condition characterised by airways inflammation and bronchial hyperresponsiveness to specific and aspecific spasmogens associated with reversible airways obstruction. The bronchomotor tone is the result of an interaction between neurotransmitter release and local mediators. The efferent neurohumoral pathways to the muscular, vascular and glandular element include parasympathetic nerves, sympathetic nerves, and non-adrenergic non-cholinergic (NANC) neurotransmission. It is currently recognised that the alteration of these mechanisms can induce bronchial hyperresponsiveness that represents a characteristic feature of asthma. Asthma is common in children and its prevalence in this age group is increasing. The current therapy of asthma involves the use of anti-inflammatory drugs to control the underlying process (causal therapy) and the use of bronchodilators that provide rapid relief of bronchoconstriction (symptomatic therapy). The bronchodilators are represented by β2 adrenergic agonists, methylxanthines and anticholinergic drugs; the anti-inflammatory drugs are represented by corticosteroids, antileukotrienes and chromones. Other new therapies being studied include anti-immunoglobulin E, anti IL-5 agents, endothelin receptor antagonists, and others.