Current concepts on the use of glucocorticosteroids and beta-2-adrenoreceptor agonists to treat childhood asthma.
OBJECTIVE
This article reviews current concepts regarding the clinical and scientific rationale for the combined use of glucocorticosteroids and beta-2-adrenoreceptor (beta2AR) agonists in the treatment of childhood asthma.


RESULTS
Several studies have demonstrated that inhaled corticosteroids (ICS) and beta2AR agonists are the most effective medications for the management of asthma in children. Given substantial evidence of an increased clinical benefit when these agents are used together, new studies are being pursued to establish the efficacy and safety of this combinational therapy in infants and children. Ongoing research is also investigating the mechanisms of beta2AR and glucocorticosteroids signaling and their molecular interactions. This new knowledge will likely lead to novel therapeutic approaches to asthma control.


CONCLUSIONS
There is increasing evidence demonstrating that the combination of long-acting beta2AR agonists and ICS may be more effective than high-dose ICS therapy alone in the management of children with uncontrolled asthma. In addition, the use of a single inhaler containing ICS and a quick-acting beta2AR agonist might be a convenient alternative to prevent and treat asthma exacerbations. Future investigations should be designed to more specifically evaluate the efficacy and safety of these therapies in the different asthmatic phenotypes of infants and children.
Nino
Gustavo
G
Division of Pediatric Pulmonology, Penn State Milton S. Hershey Children's Hospital, Penn State College of Medicine, Hershey, Pennsylvania 17033-0850, USA. gninobarrera@hmc.psu.edu
Grunstein
Michael M
MM
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D009330:Nebulizers and Vaporizers; D010641:Phenotype
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents