Editorial [ Hot Topic: State of the Science: Pediatric Asthma (Guest Editors: Barbara Velsor-Friedrich and Arlene Butz)]

Asthma is a chronic respiratory disease that affects 300 million individuals world-wide. Overall, in children and adolescents the prevalence ranges from 1.6 – 36.8%. The highest prevalence of this disease occurs in the U.K., New Zealand, Australia, and Ireland with ranges from 28-36%. An increase in the prevalence of asthma is associated with the westernization of developing countries. Asthma has become a leading public health concern due to the dramatic rise in the incidence of this disease over the past 15 years, particularly in minority populations. This special issue is devoted to the state of the science in pediatric asthma. Experts in the field have authored six articles related to the latest in clinical guidelines and the management of this disease in the pediatric population. The first article focuses on physiology by reviewing the complex airway in children with asthma. This article by Drs. Newcomb & Cauble discusses the inter-related components involved in asthma pathogenesis and its fundamental clinical features. New directions in research for the treatment of pediatric asthma are described. An update on asthma assessment in children is discussed by Dr. Sande Okelo. Referring closely to the Expert Panel 3 Guidelines, the diagnosis, assessment, and responsiveness to treatment are reviewed. Dr. Mona Tsoukleris and colleagues analyze research evidence regarding long-acting beta-agonist safety and specific step up and step down medication recommendations in children that have been published since the release of the Expert Panel 3 report (2007). Management of pediatric asthma includes addressing environmental factors to reduce exposure to allergens. Dr. Arlene Butz and colleagues describe the role of allergens such as dust mites, pets, cockroaches, mold, rodents, and second hand smoke as associated with asthma exacerbations. Best practices for control of these allergens are discussed.