Introduction

Severe pediatric asthma is associated with significant morbidity as well as with a high economic burden. It represents a heterogeneous disease with multiple clinical phenotypes. Currently, physicians are facing the challenge to provide a ‘personalized medicine approach’, which is tailored to the diverse pathomechanisms underlying clinical presentations. Three main endotypes of airway inflammation have been described in children with severe asthma. While neutrophilic and paucigranulocytic inflammatory patterns are quite uncommon in childhood, type Th2 inflammation asthma with elevated IgE is the most prevalent in pediatric asthma. Considering the pivotal role of IgE in type Th2 inflammation asthma, the blockade of IgE using anti-IgE therapy represents a potent therapeutic option for severe pediatric asthma in children.

Areas covered

This review aims to focus on the role of omalizumab as a treatment option in pediatric patients (aged six years and above) with severe allergic asthma.

Expert opinion

The clinical efficacy and safety of omalizumab for the treatment of pediatric asthma is well documented in clinical trials and observational studies. Further studies are still required to characterize the potential benefit of anti-IgE therapy in airway remodeling, identify additional biomarkers of clinical response and address current unmet needs, including the limit on omalizumab use in children younger than six years.

中文翻译：

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小儿使用奥马珠单抗治疗过敏性哮喘。

介绍

严重的小儿哮喘与高发病率以及高经济负担有关。它代表具有多种临床表型的异质性疾病。当前，医师们面临着提供“个性化医学方法”的挑战，该方法针对临床表现的多种病理机制而量身定制。在患有严重哮喘的儿童中，已经描述了三种主要的气道炎症内型。尽管在儿童时期中性粒细胞和多核粒细胞炎性炎症非常少见，但IgE升高的Th2型炎症性哮喘在小儿哮喘中最普遍。考虑到IgE在Th2型炎症性哮喘中的关键作用，使用抗IgE疗法阻断IgE代表了儿童严重小儿哮喘的有效治疗选择。

覆盖区域

这篇综述的重点是在严重过敏性哮喘的小儿患者（6岁及以上）中奥马珠单抗作为治疗选择的作用。

专家意见

奥马珠单抗治疗小儿哮喘的临床疗效和安全性已在临床试验和观察性研究中得到了充分证明。仍需要进一步的研究来表征抗IgE治疗在气道重塑中的潜在益处，确定临床反应的其他生物标志物并解决当前未满足的需求，包括在6岁以下儿童中使用奥马珠单抗的限量。