Current opinion in pulmonary medicine
-
This review examines the changes in the revised National Asthma Education and Prevention Program (NAEPP) Guidelines for the diagnosis and management of asthma pertaining to children and highlights areas that may benefit from further study. ⋯ The recent NAEPP Asthma Guidelines improve on many areas of the diagnosis and treatment of asthma in children and lead to the identification of areas that would benefit from further research.
-
The purpose of this review is to highlight seminal and current literature that informs our understanding of the clinical and investigative utility of biomarkers in asthma. Biomarkers derive from a variety of sources [bronchiolar lavage (BAL), sputum, exhaled breath, and blood], and have widely variant performance characteristics, and applicability. ⋯ To date, the best validated, and best performing biomarkers for clinical asthma appear to be measures of inflammation in induced sputum, and measures of ENO. Some trials using ENO appear particularly promising for early clinical use. EBC metrics are at present too inchoate for clinical purposes. However, not all important clinical and research questions can be addressed with sputum, EBC, or ENO metrics, leaving an important place for BAL, bronchial biopsy, and perhaps EBC measurements in the research arena.