Preschool wheezing syndrome: guidelines and beyond
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VALIULIS, Arunas, POLUZIOROVIENE, Edita. Preschool wheezing syndrome: guidelines and beyond. In: Perspectives of the Balkan medicine in the post COVID-19 era: The 37th Balkan Medical Week. The 8th congress on urology, dialysis and kidney transplant from the Republic of Moldova “New Horizons in Urology”, Ed. 37, 7-9 iunie 2023, Chişinău. București: Balkan Medical Union, 2023, Ediția 37, p. 239. ISSN Print: ISSN 1584-9244 ISSN-L 1584-9244 Online: ISSN 2558-815X.
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Perspectives of the Balkan medicine in the post COVID-19 era
Ediția 37, 2023
Congresul "Perspectives of the Balkan medicine in the post COVID-19 era"
37, Chişinău, Moldova, 7-9 iunie 2023

Preschool wheezing syndrome: guidelines and beyond


Pag. 239-239

Valiulis Arunas, Poluzioroviene Edita
 
Vilnius University
 
 
Disponibil în IBN: 4 ianuarie 2024


Rezumat

Background and aims. One in three children has at least one episode of wheezing before their third birthday, and the cumulative prevalence of wheezing is almost 50% at the age of 6 years. 15 years have elapsed from the first publication of the ERS Guidelines on preschool wheezing (Brand P, 2008 & 2014). Methods. Letters with the request to indicate the 3 most important recent publications in the preschool wheeze adding a short comment on the choice were sent to opinion-leading academic pediatric pulmonologists including active coauthors of the ERS Guidelines. Results. Answers from 11 of 30 invited pediatric pulmonologists were received. H of the responded active researchers was between 40 and 115. There was almost no consensus in the selected papers. In contrast, looking at the comments on the choices there were more similarities than differences. The major recent research developments indicated were as follows: no distinctions in lower airway inflammation between different clinical phenotypes, i.e. multiple trigger wheeze and episodic viral wheeze do not differ in lower airway pathology, rhinovirus, but not RSV as a cause of acute bronchiolitis can be a marker for chronic asthma and response to OCS, first successful attempt to personalize wheeze therapy was done with old instruments – skin prick tests and blood eosinophil count, more evidence that some phenotypes of preschool wheeze can be related to the chronic obstructive pulmonary disease, cluster analysis as a new instrument to move from phenotype to endotype based stratification, indicating the necessity to change the taxonomy and to personalize the treatment. Conclusions. 15 years after the publication of the first ERS Guidelines we are still a long way from understanding and management of wheezing syndrome in preschool children.