2012 Volume 26 Issue 1 Pages 168-175
In infants and young children, early intervention for asthma, including both environment improvement and medication, is important for preventing disease onset and progress of airway remodeling. Environment improvements include reducing allergen exposure, avoiding tobacco smoke and preventing virus infections. Early intervention with medication has three different stages. Primary prevention is defined as prevention of asthma onset before allergic sensitization. Palivizumab, a humanized monoclonal antibody against respiratory syncytial virus (RSV), reduces hospitalization for RSV infection and possibly reduces asthma development. Secondary prevention is defined as interventions after allergic sensitization. Suplatast tosilate, a Th2 cytokine inhibitor, decreased the incidence of asthma and prolonged the time to onset of wheezing when used for infants and young children with food allergy. Ternary prevention is a treatment to prevent disease progression after asthma onset. In preschool children, both inhaled corticosteroids and cysteinyl-leukotriene receptor antagonists are recommended for use as first-line treatments for asthma and recurrent wheezing.
