Structural considerations. Early intervention in childhood asthma.
Any therapeutic treatment applied to a developing and/or growing organism is complicated by the fact that the treatment window may hit a critical stage of a developing organ. This means that unlike administration in adults, dosage and timing of drug applications are important issues because of their possible damaging effects. In view of the timing of lung developmental phases, it appears that perinatal interferences by diseases, environmental influences or drugs will affect specifically alveolar development and microvascular maturation. Numerous publications report, that the developing lung can be disturbed by a variety of factors, such as temperature, oxygen tension, cigarette smoke, malnutrition, drugs and hormones, in particular glucocorticoids. In well-documented animal experiments perinatal glucocorticoid treatment, even in very low doses, inhibited alveolization. This effect has been analysed in more detail and a hypothesis for its mechanism has been presented. The above effects on lung development may be extremely difficult to assess in human infants by noninvasive techniques. The message, however, remains that potent drugs should be used with great reservation.
Institute of Anatomy, University of Berne, Switzerland.
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Burri
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Hislop
D000328:Adult; D017668:Age of Onset; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000187:drug effects / Q000254:growth & development*
D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids