title: New perspectives in the treatment of allergic rhinitis and asthma in children.
abstract: OBJECTIVE
  Allergic rhinitis and asthma are some of the most prevalent chronic diseases in children. Meticulous evaluations of the therapeutic options and interventions are needed to control this burden. The central pathogenic mechanism is an immediate hypersensitivity reaction, followed by interventions in the allergic cascade. Once inflammation is established, potent anti-inflammatory agents or mediator antagonists could help control the phenomenon and reduce the characteristic symptoms related to severity.
  
  
  RESULTS
  Monoclonal antibody against IgE has demonstrated its efficacy in reducing the symptoms of asthma and rhinitis. In difficult-to-treat asthma patients it allows a reduction in the dose of inhaled steroids, the number of exacerbations, emergency visits and hospitalizations. Its broad implementation is limited by its high cost because adverse events are not a concern. Specific sublingual immunotherapy gave promising results in clinical trials, while modifying immunoglobulins and cytokine profiles, also inducing T-cell tolerance. Safety issues of subcutaneous immunotherapy have been surpassed by the sublingual route, with equivalent efficacy. The new inhaled steroid ciclesonide is effective in established inflammation, is activated only in the respiratory system, and has negligible systemic effects.
  
  
  CONCLUSIONS
  Robust evidence on the efficacy and safety of several novel therapies in rhinitis and asthma is available.
authors.affiliation: Faculty of Medicine, Catholic University of Córdoba, Córdoba, Argentina. cebanac@arnet.com.ar
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Baena-Cagnani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Gómez
authors.forename: Mario E
authors.initials: ME
authors.lastname: Zernotti
authors.forename: G Walter
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007167:Immunotherapy; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000628:therapy*
chemical_list: D000911:Antibodies, Monoclonal