title: Pediatric asthma and development of atopy.
abstract: OBJECTIVE
  There is ongoing controversy about the relationship between atopy and asthma.
  
  
  RESULTS
  In clinical practice, specific IgE and skin test results should not be reported as 'positive' or 'negative', but as the level of IgE and the size of skin test wheal diameter. In assessment of children with severe asthma, these tests are not mutually exclusive but complementary, and both should be carried out and quantified. In the near future, their diagnostic accuracy in children with wheezing may be improved by the measurement of allergen-specific IgG. It is becoming increasingly clear that asthma is not a single disease, but a collection of several diseases with similar/same symptoms. These distinct disease entities (endotypes) may share similar observable characteristics (phenotypes), but arise via different pathophysiological mechanisms. Observable phenotypic features (e.g. sputum inflammatory phenotypes) are not stable in children with asthma. The discovery of novel, latent endotypes of asthma will require integration of a time component to take into account the phenotype instability and longitudinal changes. Not only asthma, but also 'atopy' encompasses a number of different endotypes which differ in their association with asthma.
  
  
  CONCLUSIONS
  Novel endotypes of atopy and asthma which better reflect the unique pathophysiological processes underlying different diseases in the atopy and asthma syndromes can be defined through the fusion of computational thinking and novel mathematical approaches with biomedical science. These novel endotypes may be more relevant for epidemiological, genetic and therapeutic studies.
authors: University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK. adnan.custovic@manchester.ac.uk
authors: Adnan
authors: A
authors: Custovic
authors: Nevena
authors: N
authors: Lazic
authors: Angela
authors: A
authors: Simpson
mesh_terms: D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D019295:Computational Biology; D003658:Decision Making, Computer-Assisted; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D007073:Immunoglobulin E / Q000097:blood; D012882:Skin Tests
chemical_list: D007073:Immunoglobulin E