Asthma Phenotypes

Bronchial asthma has its own characteristics in children of different ages. To help doctors and patients navigate, scientists have identified subtypes of asthma “phenotypes.” They include triggers characteristic of a given subtype – triggering factors.

This classification was invented in order to correctly diagnose and plan treatment tactics in time.

Infants (0-2 years). In young children, the duration of symptoms is the main criterion for the severity of the disease.

• If the child had symptoms of obstruction on most days of the week for the past 3 months and there is no other reason for this (developmental malformation, severe infection), then this confirms the diagnosis of asthma;
• If this is the case, a diagnosis of persistent infantile obstruction is made after careful exclusion of other reasons;
• Children with intermittent symptoms (relapsing episodes) are diagnosed with a severe or mild form of the disease, depending on whether they need to take glucocorticosteroids inside, hospitalizations, etc.;
• An important criterion for asthma at this age is the presence of an allergic background, allergies in the family, allergic diseases associated with it.

Preschoolers (2-5 years). In children of preschool age, the key criterion for asthma is the recurrence of symptoms throughout the last year.

• If there are no symptoms between seizures, and the symptoms in most cases occur after a cold, this is a virus-induced bronchial asthma;
• In this age group, viruses are the most frequent triggers;
• There may be bronchial asthma associated with physical exertion;
• Allergic aggravation is an important criterion of asthma;
• Important: Atopy is a risk factor for bronchial asthma, regardless of whether the role of allergens has been proven as triggers of BOS;
• If it is not possible to identify allergens that play the role of a trigger. With a certain caution this phenotype should be characterized as non-allergic bronchial asthma;
• However, this may mean that a causal allergen has not yet been detected.

Schoolchildren (6-12 years).

• Allergen-induced bronchial asthma is detected more often and becomes more obvious, that is, exacerbations are more often associated with the action of allergens (including seasonality of exacerbations);
• Virus-induced bronchial asthma remains a common form of the disease, but it is necessary to detect allergic complications

Teenagers. Atopic bronchial asthma can first appear in adolescence.

• In adolescents, non-atopic bronchial asthma may also develop for the first time;
• In this age group, there may be additional problems in choosing the tactics of reference;
• Many adolescents resist regular medication and any lifestyle restrictions; often teenagers smoke.