HYGIENE  ENDOTOXIN  EARLY INTERVENTION  CHILDHOOD ASTHMA  INNER CITY ASTHMA  RHINOSINUSITIS  NATURAL HISTORY Andrew H. Liu, M.D. Staff Contact in association with:

click to enlarge Fundamental to optimal childhood asthma management is an understanding of its natural patterns of onset, duration, progression and remission. Natural history studies, performed worldwide, have revealed different patterns or types of recurrent wheezing in childhood: Transient wheezers: onset in early childhood, wheezing occurs primarily with common respiratory viral infections, self-remitting in several years Non-atopic wheezers: born with hyperresponsive airways, remit more gradually than transient wheezers, but also likely to remit by the end of the lower school years Atopy-associated asthma: associated with allergies and/or atopic dermatitis. Makes up most asthmatic children identified in the school-age years. Tends to persist or relapse in adulthood. Asthma in females with early-onset puberty and obesity: a small group that emerges during the pubertal years. Occupational-like asthma in childhood: some children raised in locales with high exposures to known airway irritants (e.g. farm children with chronic exposure to high levels of endotoxin) may be hypersensitive to these exposures and can develop chronic, persistent asthma LiuLab publications Review: Liu AH, Martinez FD, Taussig LM. "Natural History of Allergic Diseases and Asthma," in Pediatric Allergy: Principles & Practice, 1st ed. Leung DYM ed. Elsevier (2003), pp. 10-22. Related Hygiene Hypothesis — Nature's Immunotherapy for allergies & asthma? Endotoxin, a prototypical microbial exposure in health and disease Childhood Asthma — optimal management Early Intervention for asthma Inner-city asthma — why is it more severe? Coming Paper on childhood asthma types in inner-city children