Childhood Asthma: Diagnosis and Innovative Treatment

Dear Colleagues,

The prevalence of persistent obstructive airway disorders (mostly bronchial asthma) has increased progressively in children and adolescents over the last decades, particularly in urban areas and developed countries.  Despite the growing scientific knowledge, widespread diffusion of specific guidelines and appropriate diagnostic tools presently available, the quality of life of these young patients is frequently severely affected, and the morbidity of these disorders, together with the familial and societal burden, are dramatically increasing.

Our interventions aim to optimize the clinical control of their respiratory conditions (namely, symptoms and daily activities) to improve their quality of life and contain the related socio-economic impact.

Unfortunately, the awareness of asthma and adherence to treatment are still dramatically low in children and adolescents.  They generally tend to minimize their health status and refuse regular therapeutic treatments (especially when long-lasting), thus favoring the persistency of uncontrolled asthma and the occurrence of frequent critical relapses. On the other hand, it has been established long ago that clinical outcomes, asthma control and the quality of life are very poor when patients comply ≤ 70% to their prescribed therapy.

Inhaled medications are crucial in the management of asthma (and similar disorders) because inhalation represents the most convenient route for delivering respiratory drugs. Despite the significant technological progress of delivery systems in the last decades, the effectiveness of drug inhalation through inhaler devices still represents a major challenge in respiratory medicine, particularly in children and adolescents.

Moreover, adherence to inhalation treatments is largely sub-optimal in adolescents. Though several subjective factors (such as cultural, educational and psychological) can contribute, the different technologies that characterize the devices presently available on the market can also represent a further barrier for the acceptance and the proper use of inhalers. As patients (particularly young patients) are not capable of inhaling throughout all devices equally well and may incur in different types of critical errors in their use, they should be supported with dedicated effective knowledge and a more specific educational approach.

Though the choice of the best inhaler to prescribe is challenging in daily practice, it is frequently empirically guided, and the determinant of choice is usually completely independent of the knowledge of the technological characteristics of the device itself, its potential performance and the patient’s age.

A higher appropriateness of respiratory treatments via inhalation could be achieved only when the major factors affecting the proper use of different inhaler devices are analytically illustrated and explained and once patients and prescribers are more educated and aware on the potentialities of each inhaler device, as per the principle of “personalized and precision medicine”.

In our opinion, a step forward is needed from this point of view, particularly in favor of young asthma patients that are known to be much less adherent to inhalation strategies than adults.

The underlying philosophy of the upcoming Special Issue it to collect contributions from several experts in this particular field, involved in both basic or clinical research. The aim is to increase the objective knowledge on the potentialities and usability of inhalation devices, and to facilitate awareness of prescriptions in the choice of the most proper inhaler for young asthma patients, thus optimizing the therapeutic outcomes due to a more personalized approach.

Dr. Roberto W. Dal Negro
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• bronchial asthma
• asthma impact
• adolescents
• inhaled medications
• inhaler devices