Preschool wheeze, genes and treatment

Paediatr Respir Rev. 2018 Sep:28:47-54. doi: 10.1016/j.prrv.2017.11.003. Epub 2017 Dec 5.

Abstract

Preschool wheeze is a common but poorly understood cause of respiratory morbidity that is both distinct from and overlaps with infantile bronchiolitis and school age asthma. Attempts at classification by epidemiology, pathophysiology, therapeutic response and clinical phenotype are imperfect and yet fundamental to both treatment choice and research design. The four main therapeutic classes for preschool wheeze, namely beta2 agonists, anticholinergics, corticosteroids and leukotriene modifiers are employed with variable and often scanty evidence base, with evidence for a genetic influence on response variations. The article will discuss the pharmacogenetics of the various options, summarise current treatment recommendations, and explore future research directions.

Keywords: Genetics; Pharmacogenetics; Preschool; Therapy; Wheeze.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adrenergic beta-2 Receptor Agonists / therapeutic use*
  • Asthma
  • Bronchiolitis
  • Child, Preschool
  • Cholinergic Antagonists / therapeutic use*
  • Humans
  • Leukotriene Antagonists / therapeutic use*
  • Lung Diseases / drug therapy*
  • Lung Diseases / genetics
  • Pharmacogenetics
  • Phenotype
  • Respiratory Sounds / genetics*
  • Respiratory Sounds / physiopathology

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-2 Receptor Agonists
  • Cholinergic Antagonists
  • Leukotriene Antagonists