Evaluate the Therapeutic Effect of Inhaled Corticosteroid in Asthmatic Children
Evaluate the Therapeutic Effect of Inhaled Corticosteroid in Asthmatic Children
Inhaled corticosteroid (ICS) is considered the first line medication for asthma, however, the
 therapeutic effect is markedly different even in patients with almost similar clinical
 manifestations. Our study was designed to explore the clinical and genetic factors that may
 influence the effectiveness of ICS in asthmatic children.
The three major common classes of asthma controller medications include inhaled
 corticosteroids (ICS), beta-2-agonists and leukotriene antagonists. Among them, ICS was now
 suggested as the first-line therapy demonstrated in Global Initiative for Asthma guideline
 updated in 2017.

 The response to asthma medication is markedly different even in patients with almost similar
 clinical manifestations. Despite the wide availability of therapeutic asthma medications and
 large studies supporting their efficacy, there is significant inter-personal variability in
 the response to each of the three major classes of asthma medications with a subgroup of
 patients that have limited disease control, persistent symptoms and exacerbations even under
 controller medications use. For example, inter-individual variability in therapeutic
 effectiveness to ICS in both asthma children and adults is significant, with 22 to 60% of
 patients being classified as non-responders.

 Although many factors can contribute to variation in response to therapy effectiveness, such
 as higher exhaled nitric oxide, higher total eosinophil counts, higher immunoglobulin E,
 lower forced expiratory volume at one second (FEV1) predicted. and lower concentration of
 methacholine needed to produce a 20% fall in FEV1 from baseline (PC20), it is still believed
 that genetic variability can also play an important role. Hence asthma represents a major
 burden with respect to mortality, morbidity and National Health Insurance costs, searching
 for appropriate mediations for asthma control is imperative and investigating the effect of
 genetic variability on therapy response is an important step to develop personalized
 prescription.
Inclusion Criteria:

 -  Diagnosed by asthma specialists, the age of onset was under 10 years old

 Exclusion Criteria:

 -  Children with cancer, major immunological diseases, such as systemic lupus
 erythematosus (SLE) or Henoch-Schonlein purpura (HSP), rare hereditary diseases, or
 under severe infection.

 -  Children who received ICS or oral steroid in recent 4 weeks