Impact of Comorbidities, Some Biomarkers, Micro RNA in Childhood Asthma Phenotypes, Severity and Response to Therapy

Asthma is a heterogenous disease usually characterized by chronic air way inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough. Asthma affects approximately 300 million people around the world causing about 1,000 deaths per day.

The overall prevalence of asthma among children and adolscents in Eastern Mediterranean Regional Office (EMRO) countries was 10.61%, Among the countries studied, Qatar exhibited the highest prevalence at 16.69%, Egypt (8.85%), Adolescents showed a slightly higher prevalence of asthma at 10.10% compared to children at 9.70%. Boys exhibited a higher prevalence at 11.48% compared to girls at 9.75%. Urban areas demonstrated a higher prevalence at 11.27% than rural areas at 8.29%.

In recent decades, both asthma prevalence and incidence have been increasing worldwide, not only due to the genetic background, but mainly to the effect of a wide number of environmental risk factors, many of which included under the umbrella of "modern lifestyle". However, the worldwide economic globalization could also have contributed to a significant increase in the asthma burden, even in developing countries that presented a low disease prevalence in the recent past.

Severe asthma is an important health burden as children with severe asthma are prone to medication related side effects, life threatening exacerbations, and impaired quality of life. Progressive air flow limitation is also a feature of severe asthma. Most importantly, poor asthma control leads to poor quality of life in children and caregivers.

Comorbidities such as cardiovascular, metabolic, endocrine, respiratory, and psychiatric diseases are prevalent in asthma, owing to chronic inflammation, systemic corticosteroid use, reduced physical activity, and poor sleep.