The current issue of the Journal of Allergy and Clinical Immunology In practice is entitled Asthma Across the Ages. A whole issue devoted to ASTHMA! I had a lot of fun coordinating this issue with Paul Greenberger.
The goal of this issue is to provide an across the spectrum of life perspective on asthma in order to hopefully contribute new insights on asthma management to improve care for patients. Our editorial that accompanied the issue, entitled Asthma: Overdiagnosed, Underdiagnosed, and Ineffectively Treated, was motivated by recent data from the Centers for Disease Control (CDC) that showed that minorities, particularly black non-Hispanics and Puerto Ricans still suffer a disproportionate share of the burden of asthma. Black non-Hispanics have a 3-fold higher asthma death rate than white non-Hispanics or Hispanics. And close to 50% of patients with current asthma had experienced at least one an asthma flare in the previous 12 months.
We still have so much work to do.
What complicates asthma treatment is we still do not have a definitive way of diagnosing asthma. So, sometimes we overdiagnose. For example, obese patients who are more likely to report shortness of breath may be overdiagnosed.
Sometimes we underdiagnose. Older adults are more likely to be underdiagnosed because they may be diagnosed with COPD.
And this can lead to undertreatment, which leads to asthma flares.
We invited authors with expertise in asthma across the age spectrum to contribute articles. Here are a few highlights. This issue is packed with articles about asthma. Guess who the titles were inspired by?
In a review entitled, “As You Eat It: Effects of Prenatal Nutrition on Asthma,” Lee-Sarwar and Litonjua et al provided a summary of the literature on the effect of diet during pregnancy on risk of childhood asthma. Vitamin D supplementation may have a protective effect on the development of childhood asthma.
Naja et al reviewed asthma in school-aged children, providing an overview of racial/ethnic and socioeconomic disparities to environmental exposures to novel treatments. Their review is “Taming Asthma in School-Aged Children: A comprehensive Review.”
Being a teen these days is hard enough. Having asthma as a teen is even harder. Burg et al review real-world challenges for tens with persistent asthma in “The Tempest: Difficult to Control Asthma in Adolescence.” How do we teach teens self-efficacy?
Adults over age 65 years:
Older individuals with asthma have unique challenges with co-existing illnesses such as heart conditions, sleep apnea, obesity or COPD. Effectiveness of treatments may be different for older individuals and newer medicines. Baptist and Busse review these issues in Asthma Over the Age of 65: All’s Well That Ends Well.
So, no matter what age group you care about, this is a must not miss issue for asthma!