Published Online: October 2016
Asthma among inner city youth is common and many children have a severe form of the disorder requiring frequent urgent medical evaluations, repeated need for systemic corticosteroid medications and a substantial number of hospitalizations. Recent medical research has confirmed that there are multiple types of asthma that vary not only in severity, but also other underlying characteristics of the disease.
In a study recently published in The Journal of Allergy & Clinical Immunology (JACI), Zoratti and colleagues describe an investigation of over seven hundred children ages 6–17 years living in 9 U.S. inner city communities as part of the Inner City Asthma Consortium’s Asthma Phenotypes in the Inner City study. Detailed information for each child, their family, their environment and their asthma and allergy characteristics was collected at the beginning of the study and during multiple study visits over a one-year period where asthma and nasal medications were adjusted according to existing treatment guidelines. Using a computer “clustering” program, children were categorized into different asthma groups based on whether they had similar or different characteristics.
Five separate groups of children were identified by the clustering program and the characteristics that most distinguished the groups included the severity of asthma, the presence and degree of allergy, nasal symptoms and lung function tests. Groups with higher asthma severity also tended to have a larger number of allergies, high levels of nasal symptoms and abnormal lung function tests. However, one of the five groups (representing 15% of the study population), had few allergies, but was highly symptomatic for asthma despite relatively high doses of medications to prevent symptoms.
The authors concluded that allergy and the associated inflammation triggered by allergies are important features of severe childhood asthma that provide a basis for many asthma management strategies. However, some children have a type of asthma where allergy is less important and alternative management strategies may be necessary.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.