Concerns with beta2-agonists in pediatric asthma - a clinical perspective

被引：14

作者：

Kersten, Elin T. G. ^{[1
]}

Koppelman, Gerard H. ^{[1
]}

Thio, Bernard J. ^{[2
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Beatrix Childrens Hosp, Dept Pediat Pulmonol & Pediat Allergol,GRIAC Res, POB 30-001, NL-9700 RB Groningen, Netherlands

[2] Medisch Spectrum Twente, Dept Pediat, NL-7512 KZ Enschede, Netherlands

来源：

PAEDIATRIC RESPIRATORY REVIEWS | 2017年 / 21卷

关键词：

beta; 2-agonists; Tolerance; Asthma; Genetic polymorphisms; LONG-ACTING BETA(2)-AGONISTS; AGE-RELATED-CHANGES; BETA-AGONISTS; UNITED-STATES; SALMETEROL; FORMOTEROL; CHILDREN; MORTALITY; THERAPY; BETA(2)-ADRENOCEPTOR;

D O I：

10.1016/j.prrv.2016.05.006

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Beta2-adrenoreceptor agonists (beta 2-agonists) are extensively used in the treatment of childhood asthma. However, there have been concerns regarding their adverse effects and safety. In 2005, the FDA commissioned a "Black Box Warning" communicating the potential for an increased risk for serious asthma exacerbations or asthma related deaths, with the regular use of LABAs. In a meta-analysis of controlled clinical trials, the incidence of severe adverse events appeared to be highest in the 4-11 year age group. Several mechanisms have been proposed regarding the risk of regular use of beta 2-agonists, such as masking patients' perception of worsening asthma, desensitization and downregulation of the beta 2-adrenoreceptor, pro-inflammatory effects of beta 2-agonists, pharmacogenetic effects of beta 2-adrenoreceptor polymorphisms and age related differences in pathophysiology of asthma. In this paper, we review beta 2-receptor pharmacology, discuss the concerns regarding treatment with beta 2-agonists in childhood asthma, and provide suggestions for clinical pediatric practice in the light of current literature. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：80 / 85

页数：6

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