title: Inner-city asthma: special considerations for management.
abstract: OBJECTIVE
  Asthma is prevalent in inner-city populations, exhibiting significant morbidity and mortality. This review focuses on the consequential findings of recent literature, providing insight into onset of asthma, complicating factors, prediction of exacerbations, and novel treatment strategies.
  
  
  RESULTS
  Analyses of environmental influence on inner-city children demonstrated novel interactions, implicating potentially protective benefits from early life exposures to pests and pets and isolating detrimental effects of air pollution on asthma morbidity. Through detailed characterization of inner-city asthmatics, predictors of seasonal exacerbations surfaced. Focused, season-specific treatment of inner-city asthmatics with omalizumab identified those most likely to benefit from season-tailored therapy. Comparative studies of urban and rural populations revealed that race and household income, rather than location of residence, impose the greatest risk for increased asthma prevalence and morbidity.
  
  
  CONCLUSIONS
  Challenging previously conceived exposure-disease relationships, recent literature has elucidated new avenues in the complex interplay between immunologically active exposures and their effects on inner-city asthma. These findings, and improved understanding of other relevant exposures, could steer the direction of primary (and secondary) disease prevention research. Moreover, careful identification of asthma characteristics has effectively established predictors of exacerbations, highlighting individuals for which additional therapies are warranted and for whom such treatments are most likely to be effective.
authors: aAllergy and Immunology bPulmonary Medicine Sections, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors: Cullen M
authors: CM
authors: Dutmer
authors: Matthew D
authors: MD
authors: McGraw
authors: Andrew H
authors: AH
authors: Liu
mesh_terms: D000818:Animals; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D019468:Disease Management; D006801:Humans; D000069444:Omalizumab / Q000627:therapeutic use; D011203:Poverty; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D014505:Urban Population
chemical_list: D000069444:Omalizumab